Did you know that Medicare pays for many preventive medical services? An important preventive service provided by Medicare includes the following:
Abdominal aortic aneurysm screening is available for persons at the highest risk for aortic aneurysms.
WHO: People at risk for abdominal aortic aneurysm, which typically includes men 65-75 who have ever smoked
HOW OFTEN: One time and must have received a referral for screening during your Welcome to Medicare exam
YOUR COST: Free
Medicare provides many disease prevention and early detection services to help Medicare beneficiaries stay healthy and detect health problem early when treatment works best.
With Original Medicare a yearly Wellness Visit is available at no cost.
With Medicare Advantage Plans, the subscriber should check with the plan.
From time to time we will be highlighting here preventive services Medicare beneficiaries can get at no cost.
Some people are very proficient with online activity, and, for those who are, it is a good idea to establish online accounts for Medicare and Social Security. Not only can Medicare beneficiaries obtain a great deal of information without sitting on the telephone waiting at the 1-800 number, online accounts provide easy access to caregivers short and long-distance.
To create an account at Medicare go to myMedicare.gov and for Social Security go to www.ssa.gov/myaccount.
Some of the useful things a person can do with an online account include the following:
• Personalized Medicare benefits and services
• View Claims Information (access and print Medicare Summary Notices)
• Keep up with deductibles
• Learn about your providers
• Keep up with drug lists
• Download personal information with Blue Button
• Replace a Medicare card
• Change Direct Deposit
• Find out if you qualify for benefits
• Obtain verification of benefits
• Apply for benefits
• Appeal a decision
Jan is teaching a two part course on Elder Law at Osher Lifelong Learning Institute at Auburn University (OLLI at Auburn). See page 11 of the OLLI Spring 2016 catalog for the course description. The first session is Wednesday, March 30, 2016, from 10:15 a.m. – 11:45 a.m., and the second will be on Wednesday, April 6, 2016, from 10:15 a.m. – 11:45 a.m. Topics to be covered include Older Americans Act Legal Assistance, Authority Issues and Advance Directive Options, Long-Term Care Planning, Long-Term Care Payment Options Including Medicaid, Special Needs Planning, Probate, Administration of Estates and Funeral Planning. If you aren’t a member of OLLI, check out all the benefits and learning opportunities here.
Materials for the training can be downloaded at elder-law-training-for-olli-at-auburn-033016-60244085 and will be posted at this site soon.
The Alabama Benefit Checklists have been updated for 2016. They are archived in Resources at this site.
Long-term care insurance was originally designed to protect purchasers from the catastrophic expense associated with long-term care in a nursing home. However, over time the public has clearly voiced a preference for home care over care in an institution. In response to that preference, long-term care insurance companies now offer a variety of in-home services to help individuals pay for services to assist a person with activities of daily living. In fact most policies sold today are comprehensive policies which cover services in different long-term care settings including at home.
The majority of policies sold today are comprehensive policies. They typically cover care and services in a variety of long-term care settings to include at home skilled nursing care, occupational, speech, physical and rehabilitation therapy, and personal care. Some policies also cover homemaker services, such as meal preparation or housekeeping as well; adult day health care centers; hospice and respite; assisted living; and other residential care facilities and nursing homes.
Consumers should be aware of limitations on coverage, such as prior hospitalization requirements, and pre-existing condition exclusions. It is important to thoroughly understand what is being purchased, so a good deal of homework is involved in examining long-term care policies. Be sure that the services purchases are not services that are already covered by Medicare.
There are incentives in the form of resource protection offered by Medicaid for a person to purchase long-term care insurance.
For policies issued prior to March 1, 2009, Medicaid will not consider resources of a person equal to the amount of long-term care insurance benefit payments in determining Medicaid eligibility when the long-term care insurance policy has paid at least the first three years of nursing home care and/or home health care services.
For policies issued on or after March 1, 2009, Medicaid will not consider resources equal to the amount of benefits paid (dollar-for-dollar) by an Alabama Long-Term Care Insurance Partnership Policy (Partnership Policy) for long-term care services received in determining Medicaid eligibility and in estate recovery. The amount to be excluded will be above and beyond the standard resource exclusion provided under the Medicaid State Plan. To qualify for this exclusion, the individual must be covered by a Partnership Policy that has been certified by the Alabama Department of Insurance as a policy that covers a person who was a resident of Alabama when coverage first became effective under the policy. Medicaid will provide reciprocity with respect to long-term care insurance policies covered under other states.
Once upon a time a married worker could file for Social Security benefits at full retirement age and then suspend the benefits, allowing the worker’s spouse to begin drawing spousal benefits while the worker postponed receiving benefits until a later date resulting in higher benefits due to the delay in drawing. The strategy was known as “File and Suspend,” and it resulted a substantial monetary gain for couples who used it.
But “File and Suspend” is a thing of the past as a result of the budget signed into law November 2, 2015. Under the new rules, effective April 30, 2016, a spouse cannot begin receiving benefits until the worker is actually receiving benefits, too. Workers can still file and suspend, but the spousal benefit suspends along with worker’s benefit.
The law does not affect those already electing “File and Suspend” or those who turn 66 prior to the effective date who elect to “File and Suspend” before April 30, 2016.
Another strategy known as “Claim Now, Claim More Later” has been eliminated. That strategy allowed a spouse who takes benefits at full retirement age to choose whether to take spousal benefits or benefits on his or her own record. This allowed a higher-earning spouse to claim a spousal benefit at full retirement age and then switch to draw his or her own retirement benefit instead at age 70. Under the new law the worker cannot take spousal benefits and let his or her benefits continue to increase. An exception to this is the election allowed by a surviving spouse who will still be able to choose to draw on the deceased spouse’s account first and later switch to a larger retirement benefit.
For years I have been arguing with folks who say that older people don’t use the internet and can’t engage through that medium. That didn’t make sense to me. For instance, people who are 70 today were 50 when personal computers began to emerge as a household staple, and they were often more likely to have the resources to explore new technologies coming into the consumer marketplace. People who are 60 today were 40 then and at the height of their careers where the gradual integration of technology was a job requirement. Retirees today connect with old and new friends on Facebook, tweet about their favorite subjects, pin their favorites, check email and text to communicate with family, friends and groups. In fact entire industries of online caregiving have developed. Sadly entire online industries of fraud have also developed requiring a great deal of poise for anyone online to stay safe. With that said, there are people who never went online, but I’m pretty sure that their caregivers, both personal and professional, did. But the question remains, who is not online these days?
I am not the only person wondering about that. A Pew Research Center Study shows that 15 percent of the American population is not online, but the number is shrinking quickly. From that study:
“For example, 86% of adults 65 and older did not go online in 2000; today that figure has been cut in half. And among those without a high school diploma, the share not using the internet dropped from 81% to 33% in the same time period.”
With that said, some people will never go online. Some people never drove a car, but someone gave them a lift. Today we recognize that by 2030 25 percent of the population will be 60+, and almost all of them will be online. Recognizing this trend, The 2015 White House Conference on Aging produced some interesting tech related announcements worth exploring. Among the 2015 WHCoA ideas, is development of a web site named aging.gov:
“to provide older Americans, their families, friends, and other caregivers, a one-stop resource for government-wide information on helping older adults live independent and fulfilling lives. The Web site links to a broad spectrum of Federal information, including how to find local services and resources in your community for everything from healthy aging to elder justice to long-term care, as well as how to find key information on vital programs such as Social Security and Medicare.”
An innovative perspective is provided by The Center for Technology and Aging’s 2014 report (updated) titled The New Era of Connected Aging: A Framework for Understanding Technologies that Support Older Adults Aging in Place. The report provides an overview of how technology can improve the lives of seniors and help them remain in independent living arrangements. The report examines some of the products emerging to support monitoring and management of physiological status and mental health, chronic condition management, technologies to support safe functional status at home, technologies to promote connectedness and products to support caregivers.
The debate is no longer whether technology will be used by and for seniors; the question is how. The challenge will be to use technology to enhance the lives of seniors and their caregivers and promote the well-being and independence of seniors as they age. What an exciting era in which to age and work with seniors!
In January the Department of Veterans Affairs (VA) announced changes to agency regulations for calculating eligibility for Special Monthly Pensions (such as New and Improved Pension, Aid and Attendance and Housebound Benefits). When the rule is adopted it will result in sweeping changes in how the VA calculates eligibility for pensions, and it will result in penalties for transferring assets out of the veteran’s name within three years of application. Through this change, the VA will look more like Medicaid.
Special Monthly Pensions are for veterans who served for 90 days or more during active wartime who were honorably discharged. They may qualify for benefits if their health care expenses leave them without adequate resources to live. Surviving spousal benefits are also available when the veteran is deceased.
Income and Asset (Net Worth) tests are performed to determine eligibility, and there is currently no penalty for transferring assets.
Currently to calculate Income, qualifying medical expenses are deducted from the veteran’s (or spouse’s) income to calculate adjusted income. In 2015 a veteran with no dependents applying for A&A who does not have $1789 per month in adjusted income may be eligible for an amount to bring his or her income up to $1789 (referred to as Maximum Annual Pension Rate or MAPR). The monthly MAPR for a veteran applying for A&A with one dependent is $2120. There are different minimum eligibility standards for different categories of benefits (such as New and Improved Pension, A&A, Housebound Benefits and veteran alone or with dependents, widows, surviving children, etc.), but that is the general scheme. Income minus qualifying medical expenses = adjusted income which is subtracted from the MAPR to determine the amount the veteran or spouse is eligible to draw.
Currently to calculate Assets (Net Worth) the VA has allowed the applicant to have $80,000 or less to qualify with the residence and automobile excluded.
So remember, the VA already looks at Income and Assets (Net Worth), and you have to meet both tests to qualify for a Special Monthly Pension.
The Proposed Rule
Under the proposed rule Income and Assets (Net Worth) will still be considered, but there will be more some changes in what counts and how it counts.
Transfer Penalty:
Applicants who give away their property within three years of applying for benefits will be penalized. In other words, there will be a three year look back, and transfers can result in a penalty lasting as long as ten years, meaning that the veteran cannot draw benefits for the length of the penalty. To calculate the penalty the amount transferred within three years of application will be divided by the monthly MAPR in effect at the time of the application to arrive at the number of months of penalty. The penalty begins to run at the time of the transfer.
The New Income Calculation: Gross income will continue to consist of payments from any source except for casualty losses and capital gains from the sale of an asset. Medical expenses will continue to be deducted from gross income to calculate adjusted income. The applicant’s adjusted income must fall below the MAPR to qualify for a pension.
The New Asset (Net Worth) Calculation: Allowable net worth will line up with Medicaid’s community spouse protected amount of $119,220. This amount is calculated by adding all the resources not excluded plus annual adjusted income for the year.
To determine net worth the VA does exclude the principal residence and a “reasonable amount of land” around the house, capped at two acres. As under current rules, the automobile and household items do not count so long as they, too, are “reasonable.” Basic living expenses such as food, clothing and shelter can be deducted from the year’s income that is included in the calculation for Net Worth level.
There is one more possible adjustment required to arrive at the final Net Worth. Remember those proceeds from casualty losses and capital gains from the previous year that did not count as income? In calculating the Assets (Net Worth), those amounts may be added to this year’s assets to arrive at countable Net Worth.
Contact your County VA Office to apply for a Special Monthly Pension or to obtain more information about eligibility.
Veteran Pension Rates (MAPR) are published yearly.
Jan Neal Law Firm, LLC 