Massachusetts Estate Planning & Asset Protection Blog

Is your Planning Stuck in Limbo? (part 2)

Posted by Dennis Sullivan & Associates on Tue, Aug 01, 2017

How does the debate over health care reform affect you and your estate plan?

35274856603_c2af85ca10_b.jpg In our last post we discussed the importance of keeping up with the constant changes happening in health care reform. We will continue to examine how the on-going deliberations in Washington may affect you, your future health care and your estate.  We at Dennis Sullivan & Associates are keeping up to date on all the changes, and making sure you stay informed on all the important details.  For more information on the current law of the land, you can download our Report: Senior & Boomers Guide to Health Care Reform.   

The Senate has dealt a devastating setback to Republican efforts to repeal and replace Obamacare, defeating a GOP "skinny repeal" bill early Friday morning. With the "skinny repeal" bill off the table, lawmakers are unsure of where the health care debate is headed. 

Senate Majority Leader McConnell and his staff are trying to find a balance between conservative Republicans, who want a full repeal of ObamaCare and a replacement that has lower health care costs, and more moderate Republicans who want to preserve its more popular benefits.

The deal-making process is in full swing, with the additions of opioid funding and allowing health savings accounts to be used to pay for insurance premiums. Some Senators are for potentially leaving in some taxes to pay for more generous benefits, after weeks of being criticized by Democrats for offering “tax cuts for the rich and Medicaid cuts for the poor.” Conservatives want to cut more from the regulations and many from Medicaid expansion states are uneasy about future cuts to Medicaid.

Senator Ted Cruz of Texas has offered an amendment called the “Consumer Freedom Option” that would allow insurance companies to sell any health coverage plan they wish as long as they provide one plan that satisfies the “essential benefits” mandates of Obamacare. While the Cruz amendment appeals to conservatives who want to provide consumers with lower cost options, moderates are concerned it could negatively impact those with pre-existing conditions. Supporters have suggested that federal subsidies could help ensure that premiums don’t increase for those who are seriously ill. The CBO is currently scoring this amendment.  

President Trump, along with Senator Rand Paul of Kentucky and Senator Ben Sasse of Nebraska, has even offered to repeal ObamaCare for now and replace it later.

Of course, no one is going to get everything they want so there must be compromises. Majority Leader McConnell has said that if the Senate is not able to pass a bill soon, Congress will have to pass a bipartisan measure to shore up the imploding health insurance markets.

And so, the Civics lesson continues. The process is at work.  As we see here the process can be long, unstable and worrisome.  Luckily for you your estate planning doesn’t have be. We at Dennis Sullivan and Associates make your estate planning and asset protection worry and stress free.  Once you have a plan in place you will feel confident knowing it will protect you, your family and your life savings.  You can enjoy life to the fullest knowing you and your family are protected no matter what unknowns lay ahead. 

 

At the Estate Planning & Asset Protection Law Center, we help people and their families protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: Affordable Health Care, Affordable Health Care Act, Announcements, Elder Law, Estate Planning, Financial Planning, Health Care, Health Care Ruling, Medicaid, Medicare, Obamacare, Retirement, applying for medicare, Medicaid penalties, care costs, care, coverage, coverages, disenrollment, elder care, enrollment, elder care journey, federal, health, health Care act, life-care plan, long term care, medicaid qualification, medical expenses, proposed changes, senior, unreimbured medical expenses, seniors

Massachusetts Elder Law Attorney | Medicare Disenrollment

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Oct 31, 2012

Earlier in the week we covered the timelines and procedures for Medicare Enrollment.  Today we will focus our blog on the timelines and procedures for disenrolling from Medicare Advantage Plans.

Voluntary Disenrollment

A person may choose to end his or her membership in a Medicare Advantage plan for any reason, but only during one of the election periods- annual, MADP, or special. Beginning in 2012, a person may disenroll from an MA plan to enroll in one of the Medicare-rated "five-star" plans at any time of the year. An individual who wishes to voluntarily disenroll should write a letter or complete a disenrollment form and send it to 'his or her plan's customer service department. The date of one's disenrollment depends on when the plan receives the written request to disenroll. In general, written requests to disenroll must be received by the Medicare Advantage pl an no later than the tenth of the month to be effective the first of the following month. Written requests to disenroll that are received after the tenth of the month will be effective the second month after the request is received.

An exception to this general rule is that disenrollment requests received between November 1 and November 10 are usually effective ·December I. However, because the month of November is also the annual election period, one can ask for a January I effective date.

Even though a person has requested disenrollment, he or she must continue to receive all covered services from the plan's contracting medical providers until the date the disenrollment is effective. The individual will be covered by Original Medicare after this, unless he or she has joined another Medicare Advantage plan.

Note that other factors are also involved in voluntary disenrollment. For instance, consider a Medicare beneficiary whose first Medicare enrollment was in a Medicare Advantage program, and within the first 12 months of coverage, decides to disenroll from the program and enro ll in Original Medicare. In this situation, he or she has 63 days to purchase any Medicare supplement plan (within the scope of the plans that the carrier offers) on a guaranteed basis.

Also, a person may have originally enrolled in Original Medicare and a Medicare supplement program, then decided to switch to Medicare Advantage- and then decided to switch back to Original Medicare. In this case, the individual may, within 12 months after that decision, go back to Original Medicare and the same Medicare supplement offered by the same MS carrier as before, if he or she has been in the Medicare Advantage plan for less than a year. A problem that may arise involves Part D coverage. If an enrollee decides to use the one-year guarantee to switch out of Medicare Advantage, CMS rules require the enrollee to complete a standalone Part D application and mark the "Special Election Period" box that appears in the "Office Use Only" portion of the application to disenroll from the prescription drug program. CMS will then use the SEP on the Part D application to begin the process for the MA disenrollment and return the applicant to Original Medicare. (This SEP procedure is also available when enrolling into an MA plan when receiving Medicaid assistance or when applying for Medicare disability at any time during the year.)

An individual may voluntarily disenroll during the MADP period (January I through February 14) by writing or calling his or her plan (or calling 1-800-Medicare), but a written request for disenrollment may be required. The MA company must provide a disenrollment notice within seven days of receiving the request. If the (dis)enrollee wants to return to Original Medicare and obtain a Medicare supplement policy, the Medicare supplement company will require that the new applicant complete the MA questions on the Medicare supplement application and that he or she send a copy of his or her MA plan disenrollment notice, a copy of the letter that he or she sent to his or her MA plan requesting disenrollment, or a signed statement verifying that he or she has requested to be disenrolled from his or her MA plan. If an individual is disenrolling after the February 14 date, a copy of the applicant's MA plan disenrollment notice will be necessary.

Involuntary Disenrollment

A Medicare Advantage plan cannot disenroll a member for any health-related reasons. However: a member in a Medicare Advantage plan may be, or must be, disenrolled from the plan for any of the following reasons:

  • permanently moving out of the service area;

  • temporarily moving out of the service area for an uninterrupted absence of more than six months;

  • losing entitlement or discontinuing enrollment in either Part A or Part B Medicare benefits or failing to pay Part B premiums as required;

  • filing false or deliberately misleading information during enrollment;

  • exhibiting disruptive behavior (the plan must first receive permission from CMS to disenroll for this reason);

  • allowing someone other than the enrollee to use the plan membership card;

  • failing to pay plan premiums after the plan has notified the enrollee that he or she has a 90-day grace period during which the enrollee can pay the premiums; or

  • dying.

To learn more about protecting your home, spouse, and life savings from increasing medical and nursing home costs register to attend one of our free, educational workshops by clicking the image below or by calling (800) 964-4295.  Seating is limited and workshops do fill, registration is required.

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You can also learn more by reading our new Seniors Guide to Health Care Reform & Avoiding Nursing Home Poverty.  This guide reveals crucial information smart Americans must know regarding health care reform and how to protect what matters most, your spouse, home, and life savings.  The guide also includes secret steps being taken by families all over the country to avoid nursing home poverty.  Request your copy while supplies last by click the image below!

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Tags: asset protection, Health Care, elder care, assisted living, health Care act, dementia, care, Attorney, Alzheimer's, disenrollment

Massachusetts Elder Law Attorney | Medicare Enrollment Timelines and Procedures

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Oct 30, 2012

Medicare Enrollment Timelines and Procedures

An eligible individual may enroll in a Medicare Advantage plan a number of times. Each of these periods has been given an identifying name (and associated acronym). Though other periods are available, the following are most commonly used:

Initial Election Period (IEP)-Also known as initial coverage enrollment period, the keyword is "initial" This period is when an individual initially becomes eligible for Medicare. Accordingly, an individual may elect to enroll in a Medicare Advantage plan when he or she first becomes entitled to both Part A and Part B of Medicare. The initial election period begins three months before, includes the month of, and ends three months after a person's birthday. This creates a seven-month in initial election period.medicare, massachusetts, elder law, attorney

This is the same election period as the initial enrollment period of Medicare itself. In MA jargon, this period is known as the "aging in" period (when the enrollee turns 65) and allows the MA producer to enroll prospects who qualify under the IEP at anytime during the year. In other words, prospects within this initial period do not need to wait-coverage begins the first day of the birth month. The IEP rules are the same for all MA plans, regardless of whether they include prescription drug coverage. For those who are receiving Medicare disability benefits, the IEP for enrolling in an MA plan is seven months from the time that the individual receives Medicare disability benefits.

Annual Coordinated Election Period (ACEP)- Also known as fall open enrollment, or annual enrollment period, the key word is "annual" This is the period every year during which Medicare beneficiaries can sign up for, drop, or change their enrollment in a Medicare Advantage or Part D plan. In previous years, this period was November 15th through December31; however, due to PPACA, it runs from October 15 through December 7 beginning in 2011.

During this annual enrollment period, beneficiaries can elect to remain in their current Medicare Advantage plan, change to a new MA plan, or drop out of Medicare Advantage and enroll in Original Medicare. Those who are enrolled in Original Medicare can switch to an MA plan during this time. Also during this time, beneficiaries can add, change, or drop prescription drug coverage. The member can make one change per year to any plan. A lock-in period applies whereby if an enrollee to an MA plan chooses to elect a plan during this period, he or she must stay in that plan until the next ACEP period.

Beginning in 2012, plans that obtained a " five-star" designation under Medicare's star rating system will be allowed to be sold at any time during the year.

Medicare Advantage Disenrollment Period (MADP)- This is the period during which individuals can disenroll from a Medicare Advantage plan or an MA Prescription Drug plan and enroll in Original Medicare (either with or without a stand-alone PD plan). This period runs from January I through February 14 of each year. New coverage is effective the first day of the next month following the change. Part D coverage can be added or dropped, and a Medicare supplement policy can be purchased.

Special Election Period (SEP)- SEPS are special periods (anytime) during which an enrollee is permitted entry into or allowed to discontinue enrollment in a Medicare Advantage plan and change his/her enrollment to another Medicare Advantage plan or return to Original Medicare. The person may enroll in an MA plan if he or she is recently disabled or begins receiving assistance from Medicaid and does not have to wait until the October 15 (annual enrollment) period.

In the event of the following circumstances, a SEP is warranted:

  • The MA plan in which the member is enrolled is terminated, which is called involuntary disenrollment- involuntary loss of creditable coverage.

  • The enrollee permanently moves out of the service area or continuation area of the MA plan.

  • The Medicare Advantage company offering the plan violated a material provision of its contract with the enrollee.

  • The enrollee meets such other material conditions as CMS may provide, such as an involuntary loss of creditable group coverage.

  • Enrollment is delayed because an employer's coverage or spouse's employer group health insurance coverage is being tenninated.

  • The individual experienced a recent disability.

The individual is receiving any assistance from Medicaid. This includes:

  • full dual eligibles;

  • partial dual eligib les (Medicare Savings Program enrollces);

  • beneficiaries residing in long-tenn care facilities; and

  • other qualifications relating to long-term care facilities, creditable coverage, US

  • (low-income subsidy) eligibility, Part D coverage, and other circumstances that give

  • CMS discretion to creatc a SEP.

General Enrollment Period (GEP)- This is a little-used Medicare period from April I to June 30, with coverage effective July I for those who did not enroll in Part B at the time they became eligible for Part B.

The Affordable Care Act has brought many changes affecting Medicare and health care.  Seniors are concerned about these changes and what they mean for their health care.  That is why we wrote the Seniors Guide to Health Care Reform & Avoiding NUrsing Home Poverty.  This guide will provide answers to important questions on how the new health care laws will affect health care for Seniors and Boomers as well as steps smart families are taking to avoid nursing home poverty.  Click the picture below for your free copy of this critial information. 

describe the image We also invite you to learn more about how you can protect your home, spouse and life savings from increasing medical and nursing home costs by attending one of our free, education workshops hosted by our team of professionals.  Seating is limited, registration is required.  Click the workshop image below or call us at (800) 964-4295 to register.

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Tags: Medicare, Massachusetts, Elder Law, Attorney, advantage plan, enrollment, disenrollment

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