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

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, Elder Law, Attorney, advantage plan, enrollment, Massachusetts, disenrollment

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