Medicaid Planning

Home Care with Community Medicaid

Published on: June 8, 2023 | by Ettinger Law Firm

Home care paid for by New York State is known as “Community Medicaid”. Paying your own living expenses, plus the cost of caregiving services, is beyond the means of many.

Since 2020, there have been numerous attempts to create a new thirty month look-back period for Community Medicaid eligibility. So far, none of these attempts have been successful and now 2024 is the earliest expected date for implementation. There is no current look-back period for Community Medicaid in New York. This means that you may move assets out of your name this month and obtain Medicaid home care benefits next month, provided you need the care.

Currently, an individual may keep about $1,700 per month plus the amount of any health care insurance premiums. Any excess income must be used towards their care. What if your living expenses exceed $1,700 per month? Enter the “pooled income trust”.

2023 Elder Law Estate Planning Changes

Published on: January 6, 2023 | by Ettinger Law Firm

Happy New Year to all!

There have been significant changes in the law in a number of areas as of January 1, 2023.

The gift tax exclusion, which many people still think is $15,000, is now $17,000, up from $16,000 in 2022. Each person may give up to $17,000 to as many people as they want to without incurring any Federal gift tax liability and without using any of their Federal estate tax exemption at death.

Audits Could Leave Many People Without Health Insurance

Published on: June 22, 2022 | by Ettinger Law Firm

State audits have the potential to impact 15 million individuals including 6 million children losing their health insurance. Some state workers are concerned that they might lack the resources to aid people in finding new insurance coverage.

The existing federal public health emergency will expire this year, which will subsequently trigger a requirement that state workers must examine Medicaid to determine who qualifies as eligible. Over the last two years, these audits have been suspended. With the resumption of these adults, up to 15 million individuals are losing their medical insurance.

The Role of the Biden Administration

Postal Service Switches Retirement Benefits to Medicare

Published on: June 22, 2022 | by Ettinger Law Firm

Congressional efforts to revise the country’s mail service might come at the cost of an even more nuanced issue involving Medicare.

The Postal Service Reform Act of 2022 would help to free post office costs by resolving the unusual and challenging legal requirement to fund 75 years of retirement health benefits in advance. In return, this Act would require future Postal Service retirees to participate in Medicare.

The Congressional Budget Office reports that the movie would save postal retirement as well as healthcare programs more than $5 billion and add more than $5 billion in costs to Medicare from now until 2031.

The Impact Covid Has on Long-Term Care Insurance

Published on: June 16, 2022 | by Ettinger Law Firm

Over the last few years, Covid-19 has caused many people to think deeply about health issues. Now that the height of the pandemic has passed, many people are left wondering how this has impacted long-term care insurance.

A noticeable increase in long-term care insurance has occurred following the summer of 2020 as reported by many medical experts. Many people who previously rejected long-term care coverage have since changed their opinions.

What Is Long-Term Care Insurance?

The Role of the Stop Unfair Medicaid Recoveries Act

Published on: April 18, 2022 | by Ettinger Law Firm

Current federal regulations require Medicaid programs run by states to try to recoup the cost from estates of recipients who have since passed away even if the state would rather not pursue such recovery.

Medicaid programs must pursue compensation for the cost of nursing home services as well as home and community-situated services in addition to other associated services if a person who receives Medicaid was at least 55 at the time the services were provided. States have the choice to pursue recovery for other services due. The recovery is restricted by the size of the deceased individual’s estate. No other public benefit program requires that correctly paid benefits be received from a deceased Medicaid recipient’s family members. The minimum revenue created by estate recovery is surpassed by the burden it places on low-income individuals. The burden unfairly falls on families whose loved one’s experience

The Stop Unfair Medicaid Recoveries Act was introduced by an Illinois representative and if passed into law would revise the Social Security Act’s Title XIX to repeal requirements that states create a Medicaid Estate Recovery Program and restrict the circumstances when a state can institute a lien on property owned by a Medicaid beneficiary.

7 Limitations to Medicare

Published on: April 7, 2022 | by Ettinger Law Firm

With more people approaching the age of 65, a growing number of people are considering the potential benefits available from Medicare as well as other insurance options. Medicare A plays the critical role of paying for hospital stays as well as other services like skilled nursing facilities and hospice care. Meanwhile, Part B assists with physician visits and outpatient care.

If you’re close to enrolling in Medicare, you should consider what Medicare covers. By learning what Medicare covers now as well as what it doesn’t, you can begin thinking of alternate strategies to make sure that you receive all of the appropriate care that you need.

Prescriptions

Dobson Highlights Challenges with Medicare Part D Medication Coverage

Published on: March 24, 2022 | by Ettinger Law Firm

On February 11, 2022, the appellate court for the 11th circuit reversed a decision by a lower court. The appellate court in Dobson v. Secretary of Health and Human Services held that Medicare must provide coverage for a beneficiary’s off-label use of a medication.

How the Case Arose

The case concerns a Florida man who communicated with the Center for Medicare Advocacy because the man’s Part D Medicare coverage declined dronabinol coverage. Dronabinol is a man-made type of cannabis that is known under the trade names of Marinol, Reduvo, and Syndros. The medication is used to stimulate appetite as well as to treat nausea and sleep apnea. The medication is approved by the FDA for the treatment of HIV/AIDS-related anorexia and nausea and vomiting caused by chemotherapy.

Commonly Asked Questions about Over-the-Counter Tests and Medicare

Published on: March 10, 2022 | by Ettinger Law Firm

It’s almost an understatement to say that the Covid-19 pandemic has changed our lives and how we live in a range of ways. While Medicare did not pay for Covid-19 tests that were available over the counter, the Center for Medicaid Services is in the process of executing an effort in the spring of 2022 that will offer payment directly to qualifying pharmacies as well as other business entities that participate in this program to help Medicare recipients receive up to eight Covid-19 tests free each month.

Currently, Medicare Advantage Plans sometimes cover and pay for over-the-counter (OTC) Covid-19 tests as a supplement in combination with providing Medicare Part A and Part B coverage. If you’re enrolled in a Medicare Advantage Plan, you should review the terms of the plan to check whether the plan will cover and pay for Covid-19 tests.

All Medicare beneficiaries with Part B qualify to receive eight free OTC Covid-19 tests, despite whether a person is enrolled in a Medicare advantage plan.

How Medicare and Medicaid Are Addressing Long-Term Care Issues

Published on: March 10, 2022 | by Ettinger Law Firm

Deciding how to receive the medical care that a person needs is a critical part of the elder law process. Unfortunately, the unpredictable nature of aging and medical issues can make it challenging to determine what lies ahead. Various states have also begun to attempt to resolve financing challenges associated with elder care that a growing number of Americans will face in the next couple of decades as a growing portion of the baby boomer generation requires medical care.

The Growing Need for Assistance

Any person can end up needing assistance as they age. This is true regardless of whether a person ends up facing dementia, a significant drop in eyesight, or mobility issues. The degree of assistance and how long a person faces these issues can vary substantially. A person might end up needing assistance with meals, other daily living activities, or total care for the months or years before they pass away. Other times, people end up needing total care for years. The unpredictable nature of a person’s future makes it challenging to plan ahead.