Medicaid Planning

Federal Court Confirms Use of Annuities in Medicaid Planning

Published on: October 6, 2015 | by Ettinger Law Firm

Medicaid is a joint federal and state program that provides needed health care coverage for many americans, including those requiring long term care. Since Medicaid is a means-based program, individuals often need to spend down their assets in order to qualify for Medicaid. One way to accomplish this is through the purchase of short term annuities to reduce available assets for purposes of Medicaid. In Zahner v. Secretary, Pennsylvania Department of Human Services, the United States Court of Appeals (3rd Circuit) heard appeals from two individuals that applied for Medicaid, but were denied the advantage of using annuities to reduce their countable assets for purposes of eligibility. While the case arises out of Pennsylvania, it is instructive for those seeking Medicaid coverage in the State of New York, as well as other states.

Facts of the Case

In Zahner, two Medicaid applicants each made substantial gifts to family members leading up to their application and need for Medicaid institutional care, which lead to a period of ineligibility. To help cover the cost of their nursing facilities during the period of ineligibility the appellants purchased a short-term annuity. One applicant paid approximately $84,000 to receive approximately $6,000 over a 14 month period, and the other paid approximately $53,000 to receive approximately $4,500 over a 12 month period. Each annuitant paid $1,000 to set up the annuity. When including fees, the cost of the annuity exceed the return on both annuities. The state’s department of human services determined that the transactions were not annuities and counted the transaction as a resource for purposes of their application, thereby re-calculating the period of ineligibility for Medicaid institutional care.The Medicaid applicants sued, and the district court found that the annuities were sham transactions set up to shield assets for purposes of Medicaid eligibility. On appeal the 3rd Circuit considered whether the purchase of the annuities qualified for the safe harbor by which certain annuities are excluded as an available resource for purposes of Medicaid eligibility.

The Happiest and Healthiest Careers to Retire From – Part 1

Published on: August 20, 2015 | by Ettinger Law Firm

Forbes loves to tell us who the happiest workers are, or what the healthiest careers are. But no one seems to talk about post-job satisfaction. While these types of articles are generally highly subjective, we can certainly look at professions that tend to produce happier retirees. Whether these can actually be ranked is another thing altogether.

The following list focuses on just 3 areas of health and satisfaction: smoking rates, self-reported job satisfaction, and obesity rates. Obviously, there are plenty of other areas that play a role in health and happiness, but these are generally good indicators as well.

Nurses

Red Tape in Medicaid Applications

Published on: June 30, 2015 | by Ettinger Law Firm

Medicaid is one of the most utilized government programs for elderly American citizens that are in need of medical assistance that they cannot afford. In order to qualify for the Medicaid program, an applicant must meet a number of criteria and an application can either be filled out online or in paper form. However, many applicants to the Medicaid program have run into issues of red tape and other problems when attempting to apply for benefits.

Online Medicaid Application

The online application for Medicaid can be found on the federal Medicaid program website. For seniors that are tech savvy, the online application can be filled out in about 45 minutes. The website contains all kinds of information like eligibility, benefits, and required documentation needed to be considered for the program. After an online application is submitted, there may be follow-up phone calls by the program to make sure that everything regarding their application is in order, but usually an accepted applicant can receive their benefits card within 45 days of submitting the online application.

Florida Rejects Medicaid Expansion

Published on: June 26, 2015 | by Ettinger Law Firm

The Florida House of Representatives rejected an expansion of the state’s current Medicaid system that leaves hundreds of thousands of people caught in the state’s coverage gap. This gap applies to people living in the state who make too much money to apply for coverage but too little to cover the costs of their medical care. It has the possibility of having a serious effect on elderly people who live down in Florida full-time or have made it their primary residence for Medicaid eligibility purposes.

Florida Medicaid Program

Florida currently has 1.3 million people enrolled in the federal exchange for healthcare insurance, more than any other state in the country. Most of these people qualify for subsidies, but if these subsidies were invalidated then they would lose their access to coverage. This is of particular concern now as the U.S. Supreme Court is currently ruling on the case of King v. Burwell, which will determine whether federal tax subsidies that allow for low and middle income people to purchase insurance through the marketplace will be unconstitutional.

New Rules Bring More Oversight to Insurers’ Medicaid Plans

Published on: June 15, 2015 | by Ettinger Law Firm

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.

Benefits and Programs for Elderly New Yorkers, Pt. 2

Published on: February 3, 2015 | by Ettinger Law Firm

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.

Benefits and Programs for Elderly New Yorkers, Pt. 1

Published on: January 30, 2015 | by Ettinger Law Firm

As an elderly resident of New York state, age sixty years or older, you have access to many programs, benefits, and community services that you might not be aware of. Different benefits throughout the state have varying requirements regarding age, finances, and other rules regarding eligibility. This article, and the local chapter of the state’s Office for Aging, is here to provide you with the information that you need to take advantage of the services that are available in the state for you.

It is important to remember that when discussing these programs, the term “resources” refers to the assets or property that you own. This includes cash, bank accounts, investments, and valuables but not a home, car, income-producing property, or personal property. In addition, “income” refers to earned and unearned income for work performed, social security benefits, pensions, retirement account withdrawals, and valuable gifts.

Social Security

The Cost of Alzheimer’s: $4,000 per Month?

Published on: November 20, 2014 | by Ettinger Law Firm

There are over fifteen million people caring for loved ones that suffer from Alzheimer’s disease, and while most are acutely aware of the emotional toll that care can take many do not realize the financial strife that it can cause, as well. According to a new survey released by AgingCare.com, over one quarter of Alzheimer’s caregivers spend over $4,000 each month, around $50,000 each year, on their loved one’s needs.

Breakdown of Costs

According to the same survey, these costs include a variety of goods and services. They include costs for home care, assisted living, or nursing home care. The Genworth Cost of Care Survey found that each of those services cost around $45,000, $42,000, and $87,600 (for a private room), respectively. On average, a person suffering from Alzheimer’s disease lives for another eight to twelve years and at $4,000 per month the costs accumulate quickly.

Couples Divorcing to Save on Long-Term Health Costs

Published on: September 5, 2014 | by Ettinger Law Firm

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.

How to Complain to Medicare

Published on: September 3, 2014 | by Ettinger Law Firm

The Centers for Medicare and Medicaid Services says that it reviews more than 100,000 complaints and appeals every year. Beneficiaries of the programs file around 16,000 complaints relating to hospital care and discharge orders as well as 18,000 complaints against nursing homes, home health services, and hospice programs. Another 30,000 complaints and appeals are specifically geared towards the Medicare Advantage programs. How Medicare handles its complaint and appeals process is no trivial matter, and the program has recently revised its complaint process.

Updated Medicare Complaint Process

On August 1, Medicare made a change to its complaint filing system: it added new, toll-free numbers to call to lodge a complaint. The new phone numbers represent a larger change in the Medicare complaint system. Each state used to have a quality improvement organization, or Q.I.O. Up until August 1, these organizations worked with providers on issues like hospital readmissions or preventing infections, reviewed beneficiary complaints, and expedited appeals.