For better and for worse, Medicaid is the primary method of paying for nursing home care in the United States. But navigating the Medicaid system is complicated and confusing. Here are the basics. Medicaid (Medical Assistance in Maryland) is a joint federal-state program that provides health insurance coverage to low-income children, seniors, and people with disabilities. In addition, it covers long-term care for those who qualify. The coverage is in a nursing home, in Maryland there is coverage of care in an assisted living facility or at home (except for a limited amount of waivers). In the absence of any…
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Federal law requires each state to attempt to recover long-term care benefits from Medicaid recipient’s estates after their death. This is known as Medicaid estate recovery. If a Medicaid recipient had failed to protect their house, it may need to be sold to settle the claim. Who Does the Medicaid Estate Recovery Program (MERP) Affect? For Medicaid recipients ages 55 or older, states must seek recovery of payments from their estate for the following: nursing facility services; home and community-based services; and related hospital and prescription drug services. States may also recover costs for any medical care…
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A power of attorney is a very important estate planning tool, but in fact there are several different kinds of powers of attorney that can be used for different purposes. Before executing this crucial document, it is important to understand what your options are. A power of attorney allows a person you appoint — your “attorney-in-fact” or agent — to act in your place for financial or other purposes when and if you ever become incapacitated or if you can’t act on your own behalf. There are four main types of powers of attorney: A limited power of attorney…
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A nursing home contract needs to have the following: Services and charges. A nursing home contract must describe what services the home will provide for the basic rate. The basic rate is usually a daily fee. The basic rate must include at least: room and board social services nursing care skin care, cleaning, and grooming protection from accidents and infections social and rehabilitative activities Extra fees may be charged for services not included in the basic rate. Rates and fees may not be increased without at least 45 days written notice. The contract must state the reasons why rates…
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Any complete estate plan should include a medical directive. This term may encompass a number of different documents, including a health care proxy, a durable power of attorney for health care, a living will, and medical instructions. The exact document or documents will depend on your state’s laws and the choices you make. Both a health care proxy and a durable power of attorney for health care designate someone you choose to make health care decisions for you if you are unable to do so yourself. A living will instructs your health care provider to withdraw life support if…
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Although people are willing to volunteer to care for a parent or loved one without any promise of compensation, entering into a caregiver contract (also called personal service or personal care agreement) with a family member can have many benefits. The Benefits of Becoming a Family Caregiver Caring for a relative rewards the family member doing the work. It can help alleviate tension between family members by making sure the work is fairly compensated. In addition, it can be a be a key part of Medicaid planning, helping to spend down savings so that the elder might more easily be…
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There are some serious drawbacks to many options for giving gifts to grandchildren. For instance, there might be no tax or estate planning advantages. Or, you may have no control of the funds (or lose control after a certain point). The money could also affect a grandchild’s eligibility for financial aid. An option that overcomes many of these problems involves transferring money into a trust established to benefit a grandchild. With the help of an attorney, you can draft a trust that reflects your express wishes about when the income and principal will be available to the grandchild, and…
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Medicare offers a federally subsidized drug program for seniors, in which private health insurers offer limited insurance coverage of prescription drugs to elderly and disabled Medicare recipients. The drug benefit is available only through insurers that contract with Medicare to market drug plans. What does the drug benefit cost and what do you get? Medicare recipients who elect to be covered by the drug benefit will pay premiums averaging around $33 a month in 2022. This is an average; some plans will charge more, some less. After meeting a deductible, which can’t be more than $480 (in 2022), you need to pay…
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As Medicare premiums rise, a Medicare Advantage plan can seem like an attractive option. But if you are considering switching from traditional Medicare to a Medicare Advantage plan, you need to know what to look for. Medicare Advantage plans are run by private insurers, unlike traditional Medicare, which the federal government operates, although the medical providers are private. The government pays Medicare Advantage plans a fixed monthly fee to provide services to each Medicare beneficiary under their care. The less money they spend on patient care, the more money they and their investors make. The plans often look attractive because…
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If you have Medicare Parts A and B, you can join a Medicare Advantage plan. Under Medicare Advantage beneficiaries may choose from a number of private health plans, which include the following: Health maintenance organization (HMO) plans that require you to go to doctors, other health care providers, or hospitals on the plan’s list, except in an emergency. You may also need to get a referral from your primary care doctor to see a specialist. Preferred provider organizations (PPOs) that allow the use of doctors and hospitals outside the plan network for an extra out-of-pocket cost. Private fee-for-service plans (PFFSs),…
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