Massachusetts Estate Planning & Asset Protection Blog

Things You Need To Know About Hospital Admissions and Long term care

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Jul 29, 2014

 

Medicade Estate Planning Asset Protection

 

The Bad News: The Three Midnight “admission” Stay Requirement Can Destroy Medicare Coverage for Rehab (the cost could be from $8,000 to 10,000 a month)

 

Alas, notwithstanding all the controversy about the Three Midnight Stay Rule (That you must be on “Admitted” status not on “Observational” status) to qualify for the subsequent Medicare coverage, we still do not see any relief.

 

There is legislation pending to change this so that people are very clear as to when they are on admission status versus observation status, the latter of which does not qualify towards the Three Midnight Stay required by Medicare for coverage in a subsequent rehabilitation center. This has surprised, shocked and disappointed a large number of seniors. Don’t let it happen to you!

 

The Good News: The Old “Improved Standard” for Medicare Coverage is out and the new “Maintain Standard” is in!

 

As a result of the recent court decision in Jimmo v. Sibelius that was decided in 2013, Medicare clarified that maintenance coverage under the skilled nursing. Home health, skilled therapy and outpatient therapy benefit does not depend on whether the patient can improve. Eligibility for Medicare depends solely on whether skilled care is required and whether the actual services are reasonable and necessary.

 

This means that you no longer need to demonstrate that you will be improving every day during treatment. With chronic diseases such as MS, Parkinson’s and other health matters, improvement may not actually be possible. However, healthcare providers humanely try to help patients maintain and sometimes this maintenance is dependent on their skilled care. Now, as decided in the class action lawsuit mentioned above, you will qualify for Medicare.

 

Clients and patients should be made aware that they may request a review for all Medicare claims for skilled care or therapy denied before January 13, 2011.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach 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: Estate Planning, Estate Planning, Elder Law, MassHealth, Estate Planning Tip, elder care, elder care journey, Massachusetts, Elder Law, Estate Planning Recommendations, Massachusettes, 2014

What Is Hospice|Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Mar 18, 2014

Hospice, Estate Planning, Elder Care

 

Certain topics such as death and hospice can be uncomfortable to talk about.  The fact is that death is a natural part of life and hospice is a service that can provide support and comfort to people who have been given time to prepare for death and their families.  Unfortunately, there are a lot of myths circulating about hospice that cause some people to be hesitant to even ask questions about it.  A better understanding of what hospice is, and what it is not, can help alleviate the sense of dread that often is felt when this word is mentioned.

What is hospice?

Many people think that hospice is a place, and though there are facilities that you can go that provide hospice services, that is not what hospice is.  Hospice means a philosophy of care.  Hospice will provide care to a client at their home, whether that is a private home, personal care home, nursing home, etc. 

Workers include nurses, nurses’ assistants, social workers, and chaplains.  They provide care depending on the individual’s needs; visits can be daily to once or twice a week and usually last no more than a couple hours.  They work to find the correct combination of medications in the lowest possible doses.  The goal is to control an individual’s symptoms without undesirable side effects.  While hospice tries to care for the patient in their home, if a short hospitalization is needed to keep them comfortable that is possible, as the treatments will be to provide comfort as well.

Hospice does not mean that a person is “giving up” or that death is imminent.  Hospice is designed to maximize the quality of life.  It is designed for someone who has six months or less to live and the care goals are changed from trying to find a cure to trying to find comfort and acceptance.  Hospice is not only for cancer patients, in fact; more than 60 percent of hospice clients have a diagnosis other than cancer.

How expensive is hospice?  That depends on the insurance plan.  Medicare and Medicaid plans cover the full benefits of hospice 100 percent.  For an individual with private insurance a hospice staff member will help you review your plan and determine how much your out-of-pocket costs will be. 

The more you know about hospice the easier the process can be.  A physician’s order is required for hospice, but that doesn’t mean you can’t start asking the questions.  The hospice staff is also available to speak with you about the process and provide as much information as possible. 

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach 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: massachusetts estate planning strategies, hospice, caregiver, caretakeer, care, Massachusettes

Increase Your Brain Power!|Massachusetts Alzheimer's Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Feb 07, 2014

Estate, Asset, Brain Power, Alzheimer's

 

We've all been through those scary moments.

 We see a familiar face in an old movie on TV, and we frantically try to remember the name. Or we start walking to another room...and we suddenly forget why we're walking there.

 Well...relax. Incidents like these are quite normal. But, in addition, there are steps we can take to slow down cognitive decline. The brain is like the rest of the body - it responds to exercise!

 Here are a few things you can do...

  •  NEVER STOP LEARNING! - Stimulating our brains is the best protection against dementia and Alzheimer's. 
  •  GET ENOUGH SHUT-EYE - If you get less than six hours of sleep a night, your risk of stroke is greatly increased. 
  •   EAT LIKE YOUR LIFE DEPENDS ON IT! - Most of your plate should be filled with green, leafy vegetables. Eat plenty of fish, nuts and olive oil. And avoid refined carbs. Studies show the "Mediterranean Diet" helps people live longer, healthier lives.
  •  WELCOME NEW CHALLENGES - The biggest memory complaint of Boomers and Seniors is difficulty in remembering names. So try memorizing three names a day - of celebrities, someone you met at the pool, TV personalities, athletes, etc.
  •   MOVE YOUR BUTT! - It's a great cardiovascular workout. And if you do it with a friend, it enhances stress-relieving social interaction, and brain-stimulating conversation.
  •   TRY MEDITATION - Reducing stress and anxiety generates improved blood flow to the brain. Try something simple. Inhale for a count of seven, hold for a count of seven, exhale for a count of seven. And repeat seven times.

If you've got questions about Alzheimer's or dementia, we've got answers.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach 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: Alzheimer's Disease, alzheimer's activities, Alzheimer's, Massachusettes, 2014, Brain Power

Confused About the Affordable Health Care Act (Obamacare)? | Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Thu, Nov 14, 2013

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We are here to help!

The Affordable Care Act (Obamacare) provides insurance for those who are uninsured, many of whom have, unfortunately, become overcome with confusion, fear, and misunderstanding, that they are avoiding to process all together. We understand that! We are navigating the options for the people we help, but even we are little unsure of the best options for them.

But there is one thing we are sure of, its the new benefits added to Medicare recipients! These added benefits include yearly Wellness visits (an opportunity to talk about your future), and coverage for numerous procedures that were not covered before.

For more information about this confusing topic, visit our website to receive your free copy of our report, "The Senior's & Boomer's Guide to Health Care Reform and Avoiding Nursing Home Poverty."

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

Make sure you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about Obamacare, Medicare cuts, taxes, & how to avoid nursing home poverty!

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

Click the picture below for some more information on the 
"Senior & Boomers' Guide to Health Care Reform & Avoiding Nursing Home Poverty." 

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Tags: Medicare, Medicaid, MassHealth, Wellesley, medical expenses, medicaid qualification, Medicare, Obama, 2013, Massachusettes, Affordable Health Care, Obamacare

Massachusetts Elder Law Attorney | The Fiscal Cliff & Its Impact on Medicare

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Sun, Feb 17, 2013

As you have likely hear by now, the fiscal cliff deal passed by Congress on January 1, 2013 (the American Tax Payer Relief Act) has made a number of changes to a number of important laws and programs in this country

While the deal itself does not contain significant changes or cuts to traditional Medicare, serious and fundamental threats to the Medicare program are expected to arise in the coming months as Congress grapples with broad budgetary issues. As a result, programs like Medicare, Medicaid, and Social Security are poised to take center stage in discussions about Sequestration, the debt ceiling, and decreasing the national debt.

Important Medicare-Related Provisions of the Deal

  • Sustainable Growth Rate (SGR) – Physician Payment

The Sustainable Growth Rate, also known as the "doc fix", is a formula created in 1997 to control the rate of Medicare cost growth by setting targets for expenditures on physician services. Despite being law, Congress has not followed the SGR formula and has voted each year to override the SGR formula in order to avoid steep cuts in provider reimbursements. The Relief Act once again pushes back the application of SGR for another year. Another round of discussions over SGR is expected as part of efforts to replace the formula.

  • Outpatient Therapy Caps

Current Medicare law places a yearly dollar amount cap on all outpatient physical and speech therapy services ($1,900 in 2013).  Beneficiaries and their providers, however, have been able to file for an exception when the provision of additional therapy services is determined to be medically necessary. This exceptions process was set to expire on December 31, 2012, but the fiscal cliff deal extended the exceptions process to December 31, 2013.

  • Medicare Private Health Plans

The authority of Medicare Advantage Special Needs Plans (SNPs) to restrict enrollment to specified groups of beneficiaries (for example, dual eligible individuals) was extended until January 1, 2015.

The authority for Medicare Cost Plans, a type of Health Maintenance Organization (HMO) through which Medicare beneficiaries may choose to receive their benefits, was extended until January 1, 2014. These plans are only authorized to operate in certain regions of the country.

  • Outreach to Enroll Medicare Beneficiaries in Low-Income Programs

Funding to improve enrollment in programs for low-income Medicare beneficiaries was reauthorized for another year. This funding is allocated to State Health Insurance Programs (SHIPs), Area Agencies on Aging (AAA), Aging and Disability Resource Center (ARDCs), and the National Center for Benefits Outreach and Enrollment. The money is intended to help eligible individuals enroll in Medicare Savings Programs, the Part D Low Income Subsidy, and other programs.

  • Commission on Long Term Care

The Relief Act established a fifteen member commission to develop a plan for implementing and financing a comprehensive, coordinated and high quality system that ensures the availability of long term services and supports (LTSS). Efforts in the Affordable Care Act to enact such a system, known as the CLASS Act, were repealed in the Relief Act.

Commission members will be appointed this month by House and Senate leaders as well as the White House. The Commission will be tasked with producing a comprehensive and detailed report with recommendations for legislative or administrative action within 6 months. If approved by a majority of the Commission members, this report will be introduced as a Senate bill.

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Elder Law Lawyer, Massachusetts, Estate Planning

The Relief Act also included a number of provisions adjusting how Medicare providers are paid. Many affect how certain Medicare hospitals are paid. There are also provisions affecting Medicare payment of radiology services, ESRD treatment, diabetic supplies and ambulance transportation, among others.

The Medicare provisions in the Relief Act are not as harmful to the program as many of the dangerous proposals offered to Congress over the past few months.  There have been proposals made to double look back periods and decrease Medicare and Medicaid benefits.  Drastic cuts are still on the table as policy-makers seek to address the looming sequestration and debt ceiling with savings from health care programs. For real health savings that address the underlying problem of health care costs system wide, policy-makers and advocates should begin with solutions that improve the health and well-being of Medicare beneficiaries while preserving the Medicare program for those who depend on it now and in the future.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones. We provide clients with a unique education and counseling approach 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 to learn more about what you can do to enhance the security of your family and legacy.

Tags: Elder Law, asset protection, Baby Boomers, senior, Attorney, Fiscal Cliff, Massachusettes

Massachusetts Elder Law Attorney | Want to Save Money on Long-Term Care? Get It Now!

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Feb 06, 2013

Whenever a client tells us they'll look into long-term care insurance "some day," ask yourself these questions: Am I a betting man (or woman)? And, if so...do I always bet against the odds?"describe the image

What we mean, is that by putting off long term care insurance, you are betting that medical costs won't go up and that long-term care insurance will be easier to get as you get older?  You are also betting that "some day" will arrive before you get sick.

A recent report revealed that the closer people get to retirement, the more frightened they become about meeting long-term care costs.  These fears impact women even more than men. And there's good reason for that. Women generally have greater long-term care needs, as they live longer, and are less likely to have a partner to care for them.  In fact, Genworth Financial, the largest long-term insurer in America, is talking about raising rates for women.

There are a few possibilities to address some long-term care costs, among them Medicare and hybrid plans, which might have riders with life insurance or annuities.

But there's only one way to get the best price: GET IT NOW!  Can you name even one item for which you pay less now than you did a few years ago?  As a general insurance principal, the older you get, the higher the premium. So, if you can pull it off now, you'll thank yourself later.

If you're betting that "someday" will come before you get sick...are you willing to bet every cent you've ever earned on it, because no insurance company will accept you after you're sick!  

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique education and counseling approach 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 to learn more about what you can do to enhance the security of your family and legacy.

workshop, estate planning, Massachusetts, attorney

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

Tags: long term care, Retirement, Elder Law, Attorney, insurance, Massachusettes, medical

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