Archive for March 2011
Voluntary National Long-Term Care Insurance Program
Is the Community Living Assistance Services and Supports (CLASS) Act a voluntary cash benefit program where people pay into a trust fund and then have that cash available to them for long-term services and supports related to a qualifying severe disability, or is it destined to become a new federal entitlement program that is not sustainable? On March 17, 2011, the House Energy and Commerce Committee Subcommittee on Health held a hearing to debate those points, and discuss changes before implementation. The CLASS Act is part of the federal health care reform law (Affordable Care Act). The big question is, what are the alternatives if, as they indicate, 26 million people will require some form of long-term care by 2060? See advocacy@naswdc.org March 2011
Are you your parents’ caregiver? – Get it in writing!
Many people spent countless hours providing care services to parents or other family members, sometimes moving out of their homes or giving up their jobs to do so. Did you know that you could arrange to have them pay you, and if you do, you could be doing them a favor?
Click on this link for an excellent piece that aired on this topic on NPR’s Marketplace on March 18: http://marketplace.publicradio.org
Although most of us don’t plan to rely on Medicaid to care for our parents if they become ill or incapacitated, for families with modest savings, it may be a necessity. However, as it says in the Marketplace piece, Medicaid will not cover the cost of care until most of the savings are gone. Having your parents give their money to you is not a solution, because Medicaid will impose a penalty. But if you contract with your parents to provide specific services (say, at the same rate that they would pay a non-medical care agency), then the money they pay you for those services is not a gift, so it doesn’t result in a transfer penalty.
If this makes sense for your family, you should consult an Elder Law Attorney to help you navigate the requirements of your state’s Medicaid rules, and draft an appropriate Personal Service contract. You should also consider factors such as whether you should be an employee or an independent contractor, and the tax implications of those choices for both you and your parents.
Think about your Digital Estate
When we prepare our will or trust, or when we are called upon to distribute the assets of a loved one who has passed away, we think about the physical and financial property. Many people prepare an attachment to their wills that describes who they would like to receive their jewelry and special household or personal items such as artwork and family heirlooms. We might also prepare a list of all of our bank accounts, brokerage accounts, stocks and other financial assets. If called upon to settle the estate of a loved one, we know we should look through a wallet or the mail to identify all of their credit cards, and we know how to check with the county recorder to see if there is a mortgage on any property.
Now that we are well into the 21st century, we need to think about our digital estates, as well. Photos, which would have been in albums (or shoeboxes) in years past may now be stored only on our computers, or possibly on websites such as “Shutterfly.” In addition to our Visa card, we may also have a paypal account, and, if we sell items (for example on E-bay) as well as purchase with it, there may be a positive balance. If someone is called upon to run our business, the books may only appear on QuickBooks, or even in a “cloud” accounting program. How will somoeone know whether you have any of these items, and wherer to look for them if you do? Will they know your passwords so they can get into them?
Phoenix, Arizona Attorney Rex Anderson has developed the Digital Asset Questionnaire to help you document your Digital Estate and provide guidance to those who may have to access it, whether an emergency should come up when you are out of town, or after you have died. This inventory of your digital property is just as important to your estate planning as identifying your life insurance beneficiaries or the personal representative of your will.
Medicare Co-Pays and Deductibles Increase in 2011
If you have had to use Medicare for a hospital stay this year, you probably noticed that the co-pays and deductibles have increased. Here is a quck summary:
Medicare Part A Deductible: $1,132 (was $1,110 in 2010)
Co-pay for hospital stay, days 61-90: $283/day (was $275/day in 2010)
Co pay for hospital stay, days 91-150: $566/day (was $550/day in 2010) Remember that the patient pays 100% after day 150)
Skilled nursing facility co-pay, days 21-100: $141.50/day (was $137.50/day in 2010. There is still no co-pay for days 1-20)
The Basic Part B premium is still $96.40/month unless those premiums were not withheld from your social security check in 2010, in which case the premium will be $115.40 in 2011. Also, the Part B deductible has increased to $162 in 2011, from $155 in 2010.
Supplemental insurance policies that cover your co-pays and deductibles should be offsetting these increases, although you may find that premiums have increased, as well.
Medicare’s Annual Wellness Visit
Last month, I posted a brief summary of the 4 parts of Medicare. Today, I want to make sure everyone knows about a new benefit that was added this year, as a result of the Affordable Health Care Law (Health Care Reform).
Up until now, Medicare only covered your care once you were sick, Now, they will cover the cost of an annual “Wellness Visit” or physical by your primary care physician for everyone who has been enrolled in “Part B” for at least a year, and who has not had their “welcome to Medicare” exam within the last 12 months.
The following services are included in the Annual Wellness Exam:
1. A review and update of your medical and family history
2. Measurements of height, weight, body mass, blood pressure, heart rate, lung function and other routine measurements
3. Advice and referrals to help reduce risks to your good health, such as weight loss, stress reduction, fall prevention and smoking cessation
4. Establishing or updating each person’s screening schedule for the next 5-10 years for appropriate routine screenings such as mammograms, PAP tests or tests for prostate cancer, appropriate to the age and risk factors of each patient
The exam will also include tests to check for cognitive impairment. Early detection of cognitive concerns give the best opportunity not only for treatment, but for families to plan for the current and future care of someone whose cognition may be declining.
As long as you participate in Part B, there is no co-pay or other cost for this annual exam.
National Healthcare Decisions Day
National Healthcare Decisions Day is coming up on April 16. You can celebrate by getting your Healthcare Advance Directives in place during the next 6 weeks.
Although at least 70% of all adults say they have thought about end-of-life issues, and have had casual conversations with friends or family members, only 30% of us have any sort of Healthcare Advance Directives in place, and about 1/3 of those are out of date, either because they don’t reflect changes in your state law, because you’ve selected an agent who is now deceased or no longer available, or, sadly, because you have changed your perspective about what you would want done if you were terminally ill and unable to express your views. If advance directives are not in place, your doctor, the hospital, or, in the worst of cases, the courts, are required to determine what you might have wanted or what you would have said in this situation. A current, legally compliant Advance Directive allows you to speak for yourself.
If you would like to learn more, or if you are part of an organization or group that would like to mobilize your neighbors to communicate this important day, visit www.nhdd.org for all kinds of resources, including guides for that important conversation with family members or tools to help you organize events.
