Will Mom Get a COVID-19 Stimulus Check in the Nursing Home ?

The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act (passed on March 27, 2020) is a $2 trillion economic relief package designed to help offset the huge financial crisis caused by the Coronavirus (COVID-19) pandemic.

A new article on MedicaidPlanningAssistance.org entitled “Do COVID-19 Stimulus Checks Impact Eligibility for Persons on Medicaid? In Nursing Homes? Or Spouses?” says that many Medicaid beneficiaries who live at home, assisted living, adult foster care, or nursing homes and their families are worried the money will push them over the Medicaid income or asset limit, disqualifying them from Medicaid benefits.

Likewise, Medicaid applicants have the same concern that the additional cash will make them go over Medicaid’s limits, and prevent them from becoming eligible for Medicaid.

Stimulus checks won’t be counted as income and thus won’t affect Medicaid beneficiaries or applicants. However, if the stimulus money isn’t spent within 12 months, it may be counted as an asset.  This could impact eligibility in 2021.

Nursing Home Residents. The stimulus check to Medicaid beneficiaries who live in nursing homes won’t affect their Medicaid benefits. The check doesn’t disqualify anyone from Medicaid nursing home care. Medicaid won’t count the money as income, which means it can’t push one over Medicaid’s income limit and mean the loss of Medicaid benefits. Although Medicaid-funded nursing home residents must surrender all of their income, except for a personal needs allowance and a monthly maintenance needs allowance for a non-applicant spouse (if applicable) to Medicaid, the money from the stimulus check won’t have to be surrendered to Medicaid. The stimulus check won’t count as assets, if it’s spent within 12-months of receiving it.

Spouses of Nursing Home Residents. Spouses of nursing home residents—known as “Community Spouses”—who aren’t on Medicaid themselves will receive a stimulus check. This won’t affect their spouses’ Medicaid eligibility in any way. The money from the stimulus check isn’t considered income by Medicaid, and even if it were, the income of a non-applicant spouse isn’t considered in the continuing Medicaid eligibility of his / her nursing home spouse.

There’s no time limit in which a spouse of a nursing resident must spend his / her stimulus check.  Non-applicant spouses can spend the stimulus check any way they want.

Reference: MedicaidPlanningAssistance.org (April 16, 2020) “Do COVID-19 Stimulus Checks Impact Eligibility for Persons on Medicaid? In Nursing Homes? Or Spouses?”

 

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Medicare and Coronavirus – Will Medicare Cover Coronavirus Tests?

Medicare and Coronavirus – A test for the new coronavirus will be covered under Medicare Part B, and some large Advantage Plan providers are waiving copays or preauthorization requirements that would be applicable for diagnostic testing.

CNBC’s recent article entitled “Medicare will cover coronavirus tests. Here’s how to get one if you think you have symptoms” says that your physician would need to order a test, if they are concerned that you have the virus.

Lab services are covered by Medicare. However, if you want a random test out of the blue, it wouldn’t be covered if there’s no medically necessary reason for it. However, given the current environment, if a doctor is concerned, they’re going to say the test is medically necessary.

The number of COVID-19 cases is being tracked and is currently climbing. The fast spread of the virus has created issues with the stock market, as concerns of a global economic slowdown increase.

While the U.S. case count is low compared to some other countries, state and local governments are getting ready for community outbreaks as the virus continues to spread.

Many people experience mild symptoms from COVID-19. However, the virus appears to take a greater toll on individuals with underlying health conditions and seniors. It is similar to the influenza virus, better known as the seasonal flu. A vaccine for COVID-19 is probably a year away, if not longer. If the flu is caught early, it can be treated with antiviral medication that may lessen the symptoms and duration of the illness. However, there isn’t that option for this coronavirus.

The Centers for Disease Control and Prevention recommended that high-risk individuals stock up on supplies (such as extra medications and groceries), maintain some space between others and yourself, wash your hands frequently and avoid crowds. If there’s an outbreak in your area, stay at home as much as you can.

If you develop any symptoms that are concerning, contact your doctor by phone for guidance. The CDC has encouraged providers to use their best judgment for who should be tested, which may depend on your symptoms or other factors, such as known exposure to an infected person.

If your doctor or other provider thinks you need testing, they’ll contact their local health department or the CDC for instructions on where you can get the test, says the National Institutes of Health. The coronavirus test may involve a swab, blood draw, or other method, based on where the test is administered. The CDC said that coronavirus testing is now available across all 50 states, and Quest Diagnostics and LabCorp — two of the country’s largest private labs — are making test kits available.

Medicare Part B covers diagnostic tests. However, some of Medicare’s 62 million beneficiaries — the majority of whom are over 65 — may have a copay, if they have an Advantage Plan. Those plans may differ from original Medicare as to the amount patients must pay for any particular service. However, the good news is that many providers are waiving any cost-sharing associated with getting a COVID-19 test, as well as any prior authorizations that normally would be required, if a test is deemed warranted.

If there is a doctor’s appointment involved, you could have a copay or coinsurance, depending on your specific Medicare coverage. Costs beyond that would depend on whether you have the virus, whether you need additional medical treatment, or should self-quarantine.

Reference:  CNBC (March 10, 2020) “Medicare will cover coronavirus tests. Here’s how to get one if you think you have symptoms”

 

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Can an Elder Law Attorney Help My Family?

The right elder law attorney can counsel a family through the difficult details and requirements of the situations such as Paying for a Nursing Home that may come up to protect the rights and welfare of seniors and their families. An elder law attorney may help with issues, such as guardianship, conservatorship, power of attorney, estate planning, Medicaid planning, probate and estate administration and advanced directives.

The Senior List’s recent article entitled “What is Elder Law and How Can an Elder Law Attorney Help Me?” explains that because the laws on the care of the elderly differ in each state, and are always subject to change, it is essential to find an elder law attorney who is skilled, knowledgeable and up-to-date on elder law policy and legal issues.

Before meeting with an elder law attorney, create a list of the specific concerns for the present and foreseeable future, so you know what qualifications and capabilities your attorney will need. You want a lawyer who’s experienced and educated, as well as comfortable to speak with and relatable.

You can ask these questions of your elder law attorney to help you make your decision:

  • How long have you been practicing in elder law?
  • Do you stay up to date on this area of law, by ongoing study and attending seminars on this subject matter?
  • Take a look at the required services we think will be needed. Can you fulfill them?
  • Do you have litigation experience?
  • What type of fee schedule do you offer?

If you’d like to try to stay up to date on what’s happening within elder law, go online and search for “aging and disability” or The right elder law attorney can counsel a family through the difficult details and requirements of the situations such as Paying for a Nursing Home as well as the name of the state in which the senior lives. Every state government has a department in charge of these matters (the official names will vary).

While caring for a love done can be stressful, understanding what options are available to them and to you, can make it all much easier.

Reference: The Senior List (Oct. 10, 2019) “What is Elder Law and How Can an Elder Law Attorney Help Me?”

 

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What Is The Latest On The New York Legislation Concerning Medicaid Spousal Refusal?

The last five governors in New York targeted a maneuver called “spousal refusal” for repeal 28 times. Newsday’s recent article entitled “State considers end to ‘spousal refusal’ to pay for nursing home care” says that there are some who think that this practice is a scheme to benefit the wealthy. However, an increasing number of advocates for middle-class elderly New Yorkers strongly support it as an essential way to keep a “well” spouse from poverty, when health care costs are skyrocketing.

Currently, New York and Florida are the only states that permit this practice.

However, now the state Medicaid Redesign Team is looking at if they should stop the decades-old practice. Governor Andrew M. Cuomo appointed the group of health care leaders to cut $2.5 billion from Medicaid, and their recommendations are due by mid-March.

Eligibility for Medicaid is based on family income and wealth, but there can be exemptions and special circumstances. A married couple who are both 65 years old or older can have no more than about $38,000 in annual income, and assets of no more than about $120,000, if one spouse is to be covered by Medicaid for nursing home care or comparable home care. As a result, any income and assets above those thresholds must be used to help pay for this care, which averages more than $10,000 a month in the Empire State.

This spousal refusal option lets the “well” spouse—the one who is not in need of care— to collect more income and retain more of the couple’s assets under his or her name. This process is replete with loopholes and is also complicated by federal law designed to protect more assets to avoid “spousal impoverishment.”

With a mandate to trim $2.5 billion from Medicaid in New York, it’s not clear how much spousal refusal costs the state. In 2016, the price was estimated at $10 million. However, this didn’t consider the continuing annual costs of each refusal, or the increased costs of care as the spouse who entered a nursing home gets older.

Spousal refusal has an increasing number of supporters for maintaining the practice, who say that it helps middle class families deal with soaring health care costs, prevents couples from having to spend their savings and give away assets to qualify for Medicaid and makes it unnecessary to contemplate divorce only to protect assets.

There’s one additional benefit: a spouse could enter a nursing home more quickly because Medicaid payments will kick in immediately and would avoid the lengthy process of determining eligibility.

Reference: Newsday (February 23, 2020) “State considers end to ‘spousal refusal’ to pay for nursing home care”

 

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Medicaid Application – Why an Attorney Should Help You

For Medicaid Applications, Elder law attorneys can be very helpful when planning for Medicaid coverage, and they can save money in the long run, ensuring that you (or a loved one) get the best care. Instead of waiting to see how wrong the process can get, says The Middletown Press, it’s best to “Use a lawyer for Medicaid planning” right from the start. Here’s why.

Conflict of interests. When a nursing home refers a family to people for preparing the Medicaid application, very often the person has dual loyalties: to the nursing home who refers them the work, and to the family who will pay them a fee for help with applying for benefits. Whose interests comes first?

Everyone wants the Medicaid application to be successful, but let’s be realistic. It’s in the nursing home’s best interest that the resident pays privately for as long as possible, before going on Medicaid. It’s in the resident or family member’s best interest to protect the family’s assets for care for the resident’s spouse or family.

An attorney has a duty of loyalty only to her client. She also has an ethical and professional responsibility to put her client’s needs ahead of her own.

Saving money is possible. Nursing homes in some areas cost as much as $15,000 a month. While every market and every law practice is different, it would be unusual for legal fees to cost more than a month in the facility. With an experienced attorney’s help, you might save more than her fee in long-term care and probate cost. Most attorneys will consult with new clients at little or no cost to determine what they need and what they want to achieve before paying a larger fee.

The benefit of experience. It’s all well and good to read through pages of online information, but nothing beats the years of experience that an attorney who practices in this area can bring to the table. Any professional in any field develops knowledge of the ins and outs of an area and applying for Medicaid is no different. Without experience, it’s hard to know how it all works.

Peace of mind from a reliable, reputable source. Today we hear a lot about “FOMO,” or fear of missing out. Consulting with an experienced attorney about a Medicaid application will help you avoid years of wondering, if there was more you could have done to help yourself or your loved one.

There are multiple opportunities for nursing home residents to preserve assets for themselves and spouses, children and grandchildren, particularly when a family member has special needs. However, here’s a key fact: if you wait for the last minute, there will be far less options than if you begin planning long before there’s a need to fill out a Medicaid Application.

Reference: The Middletown Press (July 29, 2019) “Use a lawyer for Medicaid planning”

 

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