Medicaid Planning

Eroding Gains from Part D Medicare

Published on: August 27, 2014 | by Ettinger Law Firm

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.

Resources for Adult Children Caring for Aging Parents

Published on: May 21, 2014 | by Ettinger Law Firm

Being a caregiver to an older adult can be very rewarding for both the caregiver and the person receiving the care. However, being a caregiver also is hard work. It’s hard mentally, emotionally, physically and sometimes financially, as well. However, certain programs and actions can sometimes make caring for an aging parent less difficult.

Assistance Programs

There are a variety of benefit program and support services are available to older adults who need care. Tapping into these sources can help free up financial resources that are otherwise being provided by an adult child caregiver. Programs vary by state, but here are a few places to start–

New 2014 Cost of Long-Term Care Study Released

Published on: April 28, 2014 | by Ettinger Law Firm

Residents throughout New York continue to experience “sticker shock” when exploring their long-term care options. Whether you are planning for possible needs in the future or working quickly to secure support for an ailing loved one, there is a good chance you may be surprised by the overall costs of this care. Naturally, there is a spectrum of care–from occasional, at-home aides to a move into a skilled nursing home. And there are wide variances in quality among specific caregivers. In most cases, however, the overall cost is quite significant, particularly in a relatively expensive state like New York.

The Cost Data – 2014

A helpful starting point to understand the financial toll of long-term care is to examine the newly released 2014 Cost of Care Survey from Genworth. This particular survey has been conducted for over a decade, allowing an understanding of year over year trends on top of providing information on current costs.

Good News for NY Medicaid System – Agreement Reached with Federal Government

Published on: April 18, 2014 | by Ettinger Law Firm

Uncertainty reigned over the last few months regarding the budget situation for the New York Medicaid system. Fortunately, an agreement has been reached which should provide more long-term stability and the ease the minds of both policymakers and NY residents alike.

The underlying problem was claims by the federal government that over a period of years New York engaged in improper billing practices. The mistakes led to billions of dollars being paid to the state that should not have been paid. After discovering the problem, federal officials initially claimed that the money needed to be re-paid. All told, this would amount to nearly $15 billion being drained from state coffers that otherwise would provide support to local residents. No matter which way you slice it, losing those funds would hurt New York Medicaid participants, including seniors.

Settlement Agreement

New Report Explores State of Medicaid Following Affordable Care Act

Published on: April 10, 2014 | by Ettinger Law Firm

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.

Back to the Basics: NY Medicaid Eligibility & Protecting Assets

Published on: March 24, 2014 | by Ettinger Law Firm

The New York Medicaid program is a critical lifeline for millions of residents. Unfortunately, many remain confused by some of the complex details. It is common to have only a fragmented understanding of how Medicaid works from random discussions with friends and neighbors or by hearing snippets of news clips discussing the program.

One of the most misunderstood aspects of the system is the “spend down” requirement. Medicaid is a need-based program, and so qualification requires one to have assets below a very low threshold. But that does not mean that everything you own will be lost before qualifying for Medicaid.

Medicaid Misunderstandings.

Good News Following Ulster County Nursing Home Sale?

Published on: March 21, 2014 | by Ettinger Law Firm

The face of New York nursing home care has been changing in recent years. The traditional model of individual counties throughout the state owning and operating facilities to provide care to ailing seniors is being phased out in may places. Instead, the counties are selling the homes to private companies to operate. The moves are spurred in almost all cases by financial realities–the facilities are too expensive for the county to operate.

Understandably, elder advocates worry about the effect of the change on senior care. In the past, some analyses have suggested that privately-run nursing homes, on average, show more “deficiencies” than their public counterparts. The assumption is that private homes are motivated by profit and more willing to cut resources to residents and refuse to pay wages for the best caregivers in order to boost their bottom line.

But is is important to remember that no two homes are identical, and “averages” do not mean that all privately run homes are rampant with neglect and need to be avoided. Early reports out of Ulster County, for example, offer a hopeful reminder that quality decreases may not automatically follow private nursing homes sales.

Do Even “High Ranking” New York Nursing Home Neglect Residents?

Published on: March 11, 2014 | by Ettinger Law Firm

Nursing home horror stories abound, and everyone has likely heard some tale of seniors suffering neglect at a New York long-term care facility. It is for that reason that elder care advocates always suggest doing your homework before making a final decision about where to receive skilled nursing care.

One of the most well-regarding nursing home ranking system is the federal “Nursing Home Compare” website. The site lists most nursing homes and gives them a star rating, from one to five. The rating is based on health inspections, staffing levels, and various quality measures. As a general guide, browsing the rankings of all local New York homes is a very helpful way to get an idea of home performance.

However, can the star system be relied upon exclusively? Is admission to a home with four or five stars a guarantee that the care provided will be proper?

Billions on the Line with New York Medicaid “Adjustments” from Federal Government

Published on: February 27, 2014 | by Ettinger Law Firm

New York State has the largest Medicaid system in the country. As most know, Medicaid is a joint state-federal program that provides healthcare to low-income residents. Unlike Medicare (which is a program exclusively for seniors based on their age), Medicaid is for all those who do not have enough assets to pay for the insurance they need out-of-pocket.

Medicaid provides general health care to residents of all ages. In addition it acts as the primary public provider of support for seniors in need of a nursing home stays or other elder care. Considering that each kind of support comes from the same pool of Medicaid money, it is useful for those reliant on the Medicaid system to keep up with all matters that affect the overall budget. In other words, any NY Medicaid budget issues may eventually affect elder care and support options.

Federal Government Adjustment

New York Nursing Home Costs & Medicaid “Lookback” Period

Published on: February 24, 2014 | by Ettinger Law Firm

Any family who has gone through the process of helping a loved one into a New York nursing home understands the initial “sticker shock.” New York remains one of the most expensive states in the country for long-term care.

As outlined in the latest Genworth Cost of Care study (from 2013), the median cost of a private room in a long-term care facility in the state is $125,732 per year. Not only that, but the rate is expected to jump by five percent over the next few years. Notably, the average cost nationwide is only $83,950. This means that our state is near the very top of the list when it comes to caregiving costs for seniors.

Do not forget, however, that these studies only report on averages or the median rate. In certain locations, the costs can even run higher. For example, last week Newsday published a story which found that within New York, Nassau and Suffolk counties average the highest in the state. In those counties, the average stay costs over $145,000 per year.