Tag: assisted living

When Can a Resident of a Rehab Facility, Assisted Living or Nursing Home be Denied Medicare Coverage?

Medicare covers the cost of skilled nursing for twenty days and then eighty additional days on a co-payment basis for a total of one hundred days of coverage. However, sometimes a patient will be told by a facility that they do not qualify for skilled nursing under Medicare and that their benefits are being terminated early.

What is the appropriate standard for terminating coverage?

An important court decision was made in January 2013 in the Vermont case of Jimmo v. Sebelius. In that case, a lawsuit was settled between the Center for Medicare Advocacy (CMA) and Medicare contractors which dealt… Read the rest

4 Medicaid Traps- Mistakes to Avoid

Medicaid covers the cost of long-term care, be it in a nursing home, assisted living community or care at home, if certain eligibility requirements are met.  Due to the skyrocketing costs of long-term care, many people who need long-term care will need to consider Medicaid. Medicaid mistakes are common and can be devastating for a family. The following is a summary of the most common Medicaid mistakes to avoid.

  1. Not Considering Early Planning Options

Medicaid has a five year look back period. That means that when a person makes a Medicaid application, the state will look back five years for any… Read the rest

Medicaid Planning with Life Insurance

Long term care Medicaid coverage has rigid income and resource eligibility requirements as I’ve covered in previous posts like How to Qualify for Medicaid Coverage for Long Term Care.

One exempt asset is a life insurance policy with a cash value less than $1,500. However, for many people facing long term care costs and potential Medicaid applications, the question becomes what to do with life insurance policies with cash values above the exempt amount of $1,500. If you simply cash it in and spend the money, you may be losing a great deal of financial benefit for your beneficiaries.  If the cash… Read the rest

What is the Difference Between Medicare and Medicaid

 

Differences between Medicare and Medicaid at a glance:

Medicare: Federal health insurance, administered by SSA.

  • To be eligible,
    • You or your spouse must have paid into the Medicare system for at least ten years.
    • You must be 65 or older unless you have a disability or permanent kidney failure.
    • You must be a citizen or permanent resident of the United States.
  • No income requirements.
  • May have premiums, copays & deductible.
  • To enroll:
    • If already receiving SS or Railroad benefits before age 65, then automatically enrolled in Part A & Part B.
    • If not receiving, should contact SSA three
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Power of Attorney Must Have These 5 Things for Medicaid Planning

Long term care is expensive. A nursing home or assisted living facility can easily cost between $5,000 and $10,000 a month. Medicaid is a government health care program that will cover the cost of long term care when you meet certain income and asset requirements. Under current rules, an individual can have no more than $1,500 in countable assets and a healthy spouse can keep up to half her baseline countable assets up to $119,220.

The goal of Medicaid planning is to preserve assets, either for yourself, your spouse, your children or other loved ones. The law is constantly changing and with it, Medicaid… Read the rest