If you hired a home care worker directly and the worker does not live with you, federal regulations require that you:
It is important for everyone, young and old, to plan for both end-of-life care and unforeseen medical problems. There are certain documents you can prepare to appoint a trusted person to assist you with health care decisions if you are incapacitated.
Health Care Surrogate
A great first step in preparation for this is to designate a health care surrogate. A health care surrogate is an appointed individual who makes health care decisions for you when you become unable to make them yourself. This individual advises doctors and makes important medical decisions for you. Your living will and appointment of a health care surrogate are two documents that can guide your health care decision-making. A health care surrogate does not have any control of your finances unless indicated. Typically, you would designate a durable power of attorney to have access to your finances.
If you have further questions about this topic or setting up your estate and end-of-life documents, contact one of our experienced estate planning attorneys at (941) 906-1231.
Medicare has changed their coverage of Speech Generating Devices which affects many people’s access to devices they rely on to communicate. In April of 2014, Medicare changed their categorization of Speech Generating Devices (SGDs) which electronically generate voices for patients who are unable to speak due to ALS or spinal cord injuries. The policy change by Medicare had three major results:
Many patients also need eye-gaze technology to use SGDs and, although Medicare had covered these costs to allow patients the ability to communicate in the past, after these rule changes they began routinely denying coverage of eye-gaze devices.
Advocates for patients in need of SGDs have been trying to enact change and in late April, 2015, succeeded in getting the Steve Gleason Act passed through the Senate. This act would return the ability to upgrade devices to be able to use the internet and long-distance communications on SGDs to patients. It would also allow patients to retain their devices and coverage when entering hospitals or care programs. This legislation is awaiting approval in the House. Also in late April, Medicare changed their definition of what technologies SGDs could access to allow again for patients to access the internet and other services through their SGDs. Although this policy has not yet gone into effect and SGDs are still being rented by Medicare instead of purchased, advocates are hopeful that changes will take place soon to ensure patients are given the technologies they need to communicate.
When an individual goes to the hospital, they may not be admitted right away. If one is not “admitted” to the hospital, Medicare will not pay for hospitalization and a patient may have a large medical bill as a result. There may be a period in which an individual is being “assessed”. This is called “Observation Status”. Observation status ends once a patient is admitted or discharged.
After a three (3) night hospital stay, Medicare will cover rehabilitation. Previously, patients are not aware of the difference between observation status and being admitted. The new law known as Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act signed by President Obama will take effect one year from August 6, 2015, the date it was signed. Hospitals have to develop a notification system within this year.
The new law will require the hospitals to give notice to the patients who have been under observation status for more than 24 hours of their outpatient status within 36 hours or upon discharge, whichever happens sooner. The notice must advise the patient of their outpatient status and advise that their stay does not qualify for rehabilitation services covered by Medicare because they did not meet the three (3) night requirement.
This is one step closer to ensuring hospital patients are properly being informed.
Q: Do I automatically receive Medicare Part D if I am approved for Medicaid in Florida?
A: Medicare Part D now pays for prescription drug coverage for all Medicaid recipients. However, it is not immediate or automatic even if you are notified of Medicaid approval. Upon approval of Medicaid, you must apply for a Medicare D plan, which will be paid for by Medicaid. If you are moving into a facility, such as assisted living or nursing home, you should contact the facility to find out which Medicare D prescription drug plan they recommend. For additional information and assistance, you can contact the Department of Elder Affairs SHINE program, which provides free unbiased insurance counseling to Florida seniors, caregivers, and family members regarding Medicare, Medicaid, and other health care issues. The Elder Helpline is 1-800-96-ELDER (1-800-963-5337).
Coverage through the federal Pre-Existing Condition Insurance Plan (PCIP) ends December 31, 2013. PCIP will not pay for any medical services after December 31, 2013. You must enroll for new coverage between October 1at and December 15, 2013. If you enroll after December 15, your coverage can start no earlier than February 1, 2014.
When the health care law was signed in 2010, it created PCIP as a temporary program. PCIP made health coverage available to uninsured people with pre-existing conditions until key parts of the law took effect.
Starting in 2014, health insurance companies can no longer deny you coverage or charge you more because of your health condition. On October 1st the new choices for health coverage will be available. You can get coverage in the individual market, through your employer, or from public programs like Medicaid and the Children’s Health Insurance Program (CHIP).
PCIP enrollees have new options.
Every state has a Health Insurance Marketplace, where you can learn whether you qualify for lower costs based on your household size and income. All Marketplace insurance plans offer the same essential health benefits and cover treatment for pre-existing health conditions. For Florida you can enroll by going to www.healthcare.gov.
You have other options for buying new health coverage. You can buy a plan on your own from a licensed health insurance company, or enroll in a job-based plan. But in order to get lower costs based on your income, you must buy your plan through the Marketplace.
You must take action to get new coverage. PCIP coverage does not automatically convert to a Marketplace plan.
If you need legal advice for estate planning, probate and trust administration, Medicaid planning, or VA benefits, please contact our office at (941) 906-1231 for an initial consultation.
The Tampa Bay Times has published an article on September 25, 2013 providing a preview to the rates expected to be published on October 1, 2013 for health insurance under the affordable care act.
A single 27 year old earning $25,000.00 per year can buy a bronze poilicy (the least expensive) for $167.00 per month. He/she will receive a tax credit due to their low income of $54.00 per month reducing their premium to $113.00 per month. This tax credit will be paid directly to the insurance provider.
A family of 4 living in Tampa Bay earning $50,000.00 per year can get a silver policy (the second lowest cost plan) for $282.00 per month, after receiving the tax credit.
Coverage offered by these plans are expected to include preventative care and maternity care.
Everyone will be able to research plans in their communities beginning October 1, 2013 at www.healthcare.gov.
For more information on estate planning, Medicaid planning or tax planning, please contact our office at (941) 906-1231 for an initial consultation.
Babette Bach will be the keynote speaker for a seminar March 20, 2013 at the Jewish Foundation in Sarasota. Topics will include estate planning and the basic recommended documents to have in place, Medicare and Medicaid Planning.
Ms. Bach is looking forward to speaking to the members of the community on such an important topic. She appreciates the invite to lecture.
If you need legal advice for estate planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.
Babette Bach will be the keynote speaker for a seminar March 15, 2013 at the Palm Aire Country Club in Sarasota. Topics will include estate planning and the basic recommended documents to have in place, Medicare and Medicaid Planning.
Ms. Bach is looking forward to speaking to the members of the woman’s club on such an important topic. She appreciates the invite to lecture.
If you need legal advice for Estate Planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.
The end of the year approaches and uncertainty grows. Policy leaders in the U.S. have yet to reach an agreement on a policy package which will help the U.S. economy avert the pitfalls associated with the scheduled spending cuts and tax increases.
One side calls for increased tax, another for reduced government spending. The budget remains deadlocked. Many Americans want to know how political policy revisions will affect the deficit and supplemental programs.
State and federally funding programs, such as Medicaid and Medicare, remain on the table for revisions and recipients are concerned.
Medicare spending totaled $492 billion in 2012 and that total is expected to rise over the next 10 years. Health care costs continue to skyrocket. This rise plus incline in lifespan is playing havoc on the deficit. Both Republicans and Democrats believe that reform is needed. Measures must be taken to improve Medicaid and Medicare. Experts believe there is not enough time in 2012 to work out a long tem solution. Short term deals will be made regarding the end of the year budget with long term plans being reviewed after the New Year.
If you need advice for Medicare or Medicaid planning, estate planning, probate and trust administration or VA benefits, please contact our office at (941) 906-1231 for an initial consultation.
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