Articles Posted in Medicaid Applications

The federal government has proposed new rules for private healthcare insurers that have Medicaid and children’s health plans for the first time in over a decade. The proposed rules would cover healthcare plans for millions of people across the United States and calls for insurers to provide a report of what portion of money they’re paid by the government is actually going towards health benefits and is recommending that states take that into account when setting their rates.

Medicaid Program

Medicaid and CHIP cover more than 70 million people in the United States, and 12.6 million people were added last year alone from the expansion of the Affordable Care Act. The Medicaid program is state-run, but it is overseen in part by the federal government and the Centers for Medicare and Medicaid Services. Private Medicaid plans operate in 39 states across the country and cover more than half of all Medicaid beneficiaries.

The first part of this article explained that there are many programs and benefits available to seniors that live in New York. The second part of the article continues to explain various services that are available to the state’s elderly population.

Temporary Assistance

This program provides cash benefits for senior citizens with limited income for essential food, clothing, and shelter items. You can be any age to apply, but people over the age of sixty do not have to meet the program’s work requirements. The resource limit for an individual is $2,000 and $3,000 if any household member is ages sixty or older. Employed applicants may be able to disregard some of their earnings and still qualify for the program. There is a sixty month limit on this program, and it applies for the lifetime of the applicant.

Elderly couples are divorcing at a higher rate than ever before for a surprising reason: soaring medical and long-term care costs. These expenses are being aggravated by longevity and uninsured risk from a lack of long-term care insurance. Although these senior couples still care for each other very much, the cost savings from divorce are inflicting the least amount of damage when compared to other financial options.

Medicare and Medicaid

Seniors are now turning to divorce to stave off financial ruin trying to qualify for Medicare and Medicaid coverage. In terms of Medicare coverage, the program only covers 100 days of nursing care. If you or your spouse needs long-term nursing care you must either pay out of pocket until your assets fall beneath a certain threshold or tap into your long-term care insurance if you have it.

When Medicare was expanded in 2003, the expansion that established prescription drug coverage was called a “promise, a solemn promise, to America’s seniors.” Part D Medicare officially took effect in 2006, but still some seniors were afraid of falling into the infamous “doughnut-hole” coverage gap.

Initial Benefits of Part D

In Part D’s first few years, national data has shown that the program had helped seniors make progress with their prescription drugs. Overall, out of pocket costs decreased for medication, seniors took their medication more regularly, and were less likely to forego basics like food or heat in order to afford for their prescriptions.

The New York Medicaid system is the primary means of providing long-term care to many seniors in the state. However, the system’s popularity led to financial strains, and public officials have worked for years to address rising costs and budget challenges. The most popular large-scale change to the program pushed by reform advocates is referred to as “managed care.”

The idea of managed care is to move away from paying service providers per specific task provided and instead compensate them a flat fee for each resident–regardless of what care the resident needs. The idea is to eliminate the company’s incentive to provide care that is not needed simply to increase their reimbursement. By providing a flat fee per resident, caregivers are incentivized to provide efficient, quality care.

Purging “Unprofitable” Clients?

As the first wave of healthcare insurance enrollment ends as part of the Affordable Care Act, observers are quick to comment on the changes enacted by the law. In addition to millions who took advantage of insurance sold in private marketplace exchanges, there has also been a significant increase in Medicaid participants–both in New York and nationwide.

According to a New York Times report last week, across the country there are now over 62 million Americans receiving some Medicaid support. The increase is more targeted in states like New York that specifically took advantage of options in the Affordable Care Act that allow for expansion of the program.

Importantly, much of the discussion about healthcare exchanges and Medicaid expansion refer to general health insurance coverage–not necessarily care that includes long-term support for the elderly.

We are in the midst of significant changes to the New York Medicaid system. The critical state-federal program serves as a lifeline for many residents–including those in nursing homes. As part of President Obama’s healthcare overhaul, Medicaid is expanding, opening opportunities to more residents than ever before. New York has been cited as a model for that expansion, as our state has the most robust system in the country.

At the same time, however, with expansion comes increased scrutiny on exactly how each Medicaid dollar is spent. Both state officials and federal regulators are focusing on cutting out fraud and otherwise maximizing the value of funds. While this may seem like only a concern of policymakers, these changes will also trickle down and directly affect New York residents who rely on the system. As oversight changes, there may be alterations to the Medicaid application process and new rules about what benefits a resident can receive as part of the system.

More Overpayments

Late March is best known for many as the time of year that they fervently fill out their “March Madness” college basketball bracket in hopes of winning the office pool or family competition. For others, however, this marks the time when the procrastination ends and you finally get around to filing your taxes. With less than a month left before the classic April 15th deadline, if you have not done so already, it is time to start gathering paperwork and getting the task out of the way.

Elder Care & Taxes

Tax issues are notoriously complex and confusing. And considering the thousands of pages that make up the Tax Code, New York residents can be forgiven for not committing the details to memory or spending their free-time analyzing the issues. Yet, one general tip that most are aware of is the need to claim all possible deductions in order to lower your overall tax burden.In that regard it is important not to forget the way that elder care intersects with your taxes.