Community Medicaid and Chronic Medicaid

To qualify for Community Medicaid an applicant may have no more than $14,850.00 in assets. Community Medicaid provides coverage for at home care. It does not have a look back period and allows an individual to be eligible for benefits within one month. In addition, the $14,850 does not include qualifying retirement accounts, where the individual is taking monthly required distributions. Continue reading “Community Medicaid and Chronic Medicaid”

What to Consider Before Choosing a Nursing Home

Today, as many as 1.3 million Americans live in nursing homes. Choosing a nursing home for a loved one can be difficult and there are many factors that need to be taken into consideration before making a decision. Although every elder’s needs are unique, there are common criteria that may serve as a guide when choosing the best nursing home for a loved one’s needs. These important factors include method of payment, location, quality, and specialized services. Continue reading “What to Consider Before Choosing a Nursing Home”

Which Trust Helps Me Qualify for Medicaid?

Through conscious Medicaid planning, New York residents may be able to preserve some of their assets for their children or other heirs while still meeting Medicaid’s income requirements. One means of achieving this is through the establishment of a trust. By placing assets into certain types of trusts an individual can eliminate their countable assets for Medicaid eligibility purposes. However, only certain trusts may be useful in qualifying for Medicaid. Continue reading “Which Trust Helps Me Qualify for Medicaid?”

Common Long-Term Care Planning Misconceptions

Many people share common concerns as they reach retirement age: Will they have the ability to remain independent in their homes without intervention from others? Are they going to be able to maintain good health and receive adequate health care? Will they have enough money for everyday needs and not outlive their assets and income? Despite the fact that thousands of Americans are concerned with these aspects of aging, many have failed to develop adequate long-term care plans that specify which services they will need and how they will pay for them. Unfortunately, many Americans also share common misconceptions about long-term care planning that may be factors in why individuals fail to establish a properly executed long-term care plan prior to when they need the services. Continue reading “Common Long-Term Care Planning Misconceptions”

Chronic Medicaid vs. Community Medicaid

In New York, Community Medicaid helps cover the cost of home care and Chronic Medicaid pays for all or part of nursing home care. However, there are certain income and asset requirements that apply to these Medicaid programs because they are need based. Continue reading “Chronic Medicaid vs. Community Medicaid”

How New York Residents Can Choose a Long-Term Care Plan for Loved Ones

In caring for an elderly loved one, it can be challenging to choose whether an outside long-term care option is best, or to offer care from within the home. Often, financial burdens and how much Medicaid will cover becomes a main consideration. Medicaid can cover both nursing homes and home and community-based services. Planning ahead and knowing what factors to weigh when choosing a long-term care plan is vital to reduce the stress on your loved one as they start requiring more assistance.

First, it is important to compare what Medicaid will cover for both home-based care services and institutional services. Medicaid offices, which are state run, set out eligibility for specific benefits. Professional agencies can assist you in understanding your various options.

After narrowing down available options, if it is best for your loved one to enter long-term care at a nursing home facility, there are resources to help you find the best location. To research the quality of life at a nursing home, you can contact the New York State Department of Health. This is the agency which investigates complaints and oversees health and safety standards in nursing homes participating in Medicaid.

Once you have compared the quality of the nursing homes in a given area, it is important to visit them and make sure they meet the care needs you are searching for. Comparing each home’s policy, such as visiting hours, how the staff treats the patients, and types of activities available, are all important in choosing the right facility.

Instead of a nursing home facility, you may choose to care for your loved one at home. This may require modification to the home, such as handicapped bathrooms and ramps. Hiring nurses and therapy aids may also be necessary, unless community adult day care is a better option. Medicare may not cover all of the necessary costs for home health care, so it is important to research all alternatives. Another alternative is to have an assisted living facility care for your loved one. However, Medicaid does cover this type of care.

Understanding the options for long-term care for an elderly loved one can be challenging. Applying for Medicaid and making sure necessary needs are covered can be a complex process. P&P Medicaid provides Medicaid application services. The company also provides a full range of geriatric care management services to help individuals and their families make decisions about and supervise their long-term care needs.  Please contact P&P Medicaid Consulting, Inc. at (516) 541-4770 for more information.

The Financial Burden of Elderly Care on Long Island’s Middle Class

As Long Island’s baby boomers reach retirement age, there is an influx of adults who require long-term care and Social Security benefits. As it stands, two-thirds of Americans age 65 and over will soon fall into this category. This trend was not unexpected, but perhaps unprepared for. With limited funds supplied by Social Security and private or Medicaid insurance, the burden falls to younger family members, who, buried by inflation and the slow-moving economy, are often already struggling to make ends meet.

In the last 10 years, the cost of long-term care has risen dramatically.  According to a report by insurer Genworth Financial, the median bill for an assisted living facility is nearly $50,000 a year and for a semi-private room in a nursing home, it’s now over $100,000 a year. To lend perspective to these figures, the median household earns $52,000 in the U.S.

It’s not easy to see a parent or loved one’s health care needs rise, and even more uncomfortable to face the financial realities associated with that care. Many people turn to Medicaid to relieve some of the cost, but it is oftentimes difficult to secure the coverage necessary to support their aging loved ones. This phenomenon is particularly felt among the middle class, who feel they are left without any viable options.

More and more people rely on home healthcare for more extended periods of time. The option to hire in-home aides, although primarily out of pocket, is promising, since the cost is much lower than it is in institutionalized facilities such as nursing homes. Yet at a rate of $20 per hour (a conservative estimate), the cost of just eight hours a day of home health support tallies to $58,240 a year — an unaffordable price tag for 50 percent of American households. Round-the-clock in-home care at the same rate would come in at $174,720 per year, which only wealthier families could even consider.

If you’re unsure about the right kind of care for a loved one, or have questions about how to afford their care, contact elder care professionals at P&P Medicaid. In addition to assisting with Medicaid applications on behalf of clients, our company also provides a full range of geriatric care management services to help individuals and their families make decisions about and supervise their long-term care needs.  Please contact P&P Medicaid Consulting, Inc. at (516) 541-4770 for more information.

Is the Affordable Care Act the New Medicaid/Medicare?

Wilbur J. Cohen, U.S. Secretary of Health, Education and Welfare under President Lyndon B. Johnson, created the United States Medicare and Medicaid programs in the 1960s.  Inspired by the success New Deal at the end of the Great Depression, Cohen aimed to provide “relief, recovery and reform” to older and low-income Americans who could not afford coverage in the competitive commercial market.

It’s hard to believe President Johnson could have imagined such success for the Medicare and Medicaid programs when he signed them into law in July 1965. At that time, his main objective was simply to provide “the miracle of healing to the old and to the poor.”

While Medicaid is a federally funded program, it is controlled by local governments in each state and county. If one is eligible, based on age and disability, several applications and an evaluation of a person’s income and resource restrictions must be coordinated to determine to what degree Medicaid will to help pay for all medical expenses. Medicare offers many similar services as Medicaid, but it is available only to people over age 65, or younger if they are found to be certified disabled, who have worked and paid into the U.S. Social Security system.

Today, at the 50 year anniversary of the two programs, the nation still relies on that legislation. In fact, the Obama administration continues to make improvements to both platforms, in addition to using them as a basis for the Affordable Care Act, referred to by many as “Obamacare.” Like Medicare and Medicaid, the Affordable Care Act offers a combination of federal and private healthcare coverage. Unlike its predecessors, the program is open to all Americans, rather than just the elderly or those with limited incomes.

First enacted in March 2010, Obamacare’s original provisions led many insurers to forecast a decline in enrollment due to an increase in out-of-pocket expenses. Under pressure from the Obama administration’s Affordable Care Act, however, Congress reduced payments to Medicare Advantage. The legislation stated that beginning in 2014, Medicare Advantage plans could not spend more than 15 percent of Medicare payment on administrative or insurance costs. This could result in a reduction of individual member plan cost by up to $1,000 without reduction of benefits. Since this legislation was passed, member enrollment unexpectedly increased from 11 million in 2010 to 16.6 million in 2015.

Today, under Obamacare, more than half of the states’ governments have expanded Medicaid eligibility. Overall health insurance enrollment has soared thanks to government subsidies to private insurers who are now providing and coordinating almost 80 percent of new beneficiaries. Additionally, over 30 percent of the 55 million Medicare beneficiaries and more than half the 66 million Medicaid beneficiaries are now in privatized health care plans. White House officials are hopeful that Obama’s healthcare program will one day garner the standing and popularity of Medicare and Medicaid.