Medicare

The Big Mistake People Make About Medicare and Assisted Living

Published on: October 16, 2017 | By McCulloch & Miller, PLLC

A large percentage of Americans require assisted living care at some point during their senior years. Their understanding of how that gets paid for is way off base. It’s a hard lesson to learn.

Approximately one-third of Americans (34%) thought that Medicare would cover their nursing home costs, as reported in a survey from the Associated Press-NORC Center for Public Affairs Research. Another third, 27%, may have been a little smarter to say that they weren’t sure.

That’s not true, says WRAL’s recent post, “Expect Medicare to cover assisted living? Think again.” These results may correlate with the fact that only 37% of Americans think they’ll need any care in their later years, but in reality, about 70% will require this care.

More Changes Coming to Medicare in 2018

Published on: August 10, 2017 | By McCulloch & Miller, PLLC

Higher fees are coming to high earners, when income thresholds for the highest surcharge tiers drop even further next year.

If you were hit with premium surcharges for Medicare Part B and Part D already, these costs will increase again in 2018, according to a recent article in Kiplinger, “Medicare Surcharge Thresholds to Drop.”

This recalibration of the trigger points was a part of the Medicare Access and CHIP Reauthorization Act of 2015, also called the "Doc Fix" law, which ended the annual battles over fee schedules for doctors' Medicare payments. To help pay for the permanent fix, lawmakers have asked high-income beneficiaries to foot the bill.

Avoid Penalties by Signing Up for Medicare Part B at the Right Time

Published on: July 21, 2017 | By McCulloch & Miller, PLLC

You must sign up for Medicare Part B no later than eight months after retirement, or the penalties could be serious.

These are the details that really matter when it comes to retirement and Medicare. If you signed up for Medicare Part A on your 65^th birthday but were still working, you probably didn’t enroll in Part B. Now you’ve just turned 68 and plan on retiring this year. When do you need to enroll in Medicare Part B, and what do you need to know to ensure that you’re covered?

Kiplinger’s recent article, “What to Know About Enrolling in Medicare Part B,” says that many people who are still working do this. They sign up for Medicare Part A at 65 (because it’s free) and wait to sign up for Part B, while they’re covered by their employer’s insurance. However, you are required to sign up for Medicare Part B no later than eight months after you leave your employment and lose that coverage. Failure to do so, can result in a lifetime penalty and a gap in coverage.

Understanding the Basics about Medicare

Published on: April 25, 2017 | By McCulloch & Miller, PLLC

Even if you are still working, once you turn 65, you have to navigate your way through an entirely new and complex health care system. While there’s no HR department, there are resources.

It starts the day you turn 65, and it’s a bit of a challenge. Seniors need to get up to speed fast on the many requirements of Medicare. A recent post of Kiplinger’s, “FAQs About Medicare,” warns that mistakes can be extremely costly and difficult to fix. You’ll want to study up on this in advance.

For starters, if you signed up for Social Security before age 65, you’ll automatically be enrolled in Medicare parts A and B and receive your card three months before your 65th birthday. Part A covers hospitalization and is generally premium-free. Part B covers outpatient care, such as doctors’ visits, x-rays and tests, and costs $134 a month for people who enroll in 2017 (or more for high earners).

Alzheimer’s or Dementia Screening Now Covered by Medicare

Published on: February 8, 2017 | By McCulloch & Miller, PLLC

You might think that any doctor seeing patients over a certain age would automatically screen for Alzheimer’s or other dementia-related diseases, but until now that has not been the case.

Starting in January, Medicare will now begin reimbursing doctors for screening and providing information about care planning for patients with Alzheimer’s and other cognitive impairment diseases. What seems like common sense public health policy, took many years of advocacy from patient groups.

Santa Cruz Sentinel’s recent article, “Diagnosing Alzheimer’s: Medicare now pays doctors to stop and assess memory loss,” reports that more than 5 million Americans are living with Alzheimer’s, and as many as 16 million will have the disease in 2050. The cost of caring for those with the disease and other types of dementia is also skyrocketing. In the U.S., it’s estimated to total $236 billion in 2016 and is anticipated to increase to $1.1 trillion by 2050.

How to Prepare for Long-Term Care Costs in Houston

Published on: August 15, 2016 | By McCulloch & Miller, PLLC

The cost of long-term care can take a huge bite out of retirement savings, exhaust family resources and create strain on relationships. Don’t count on Medicare, but do plan in advance.

At least seven out of ten Americans age 65 and over will need long-term care at some point. Most people simply underestimate the cost of long-term care, or they think that Medicaid will cover the costs. Your best defense against long-term care costs: advance planning with professional help.

The Memphis Daily News article, “Long-Term Care – Not for Everyone,” says that Medicare does little for these costs and only for a short time period. Medicaid doesn’t apply until the assets of an estate are spent down, so many people must pay for these costs out-of-pocket. The article says that there are only two ways to address these expenses: with your investment/retirement portfolio and with long-term care insurance. Most people review the cost of long-term care insurance and elect to roll the dice, but when that first round of expenses hits, they probably will wish they’d bought it long ago. Now it’s usually too late to buy it. If you can afford to self-insure, you can save your estate and yourself some serious money.

U.S. Department of Justice Creates Several New Elder Justice Task Forces

Published on: May 27, 2016 | By McCulloch & Miller, PLLC

Nursing homes that give substandard care to residents are the target of new Elder Justice Task Forces intended to move faster in targeting and penalizing certain facilities.

The National Review reports in "DOJ Task Forces Target Elder Fraud in Health Care" that teams from several Elder Justice Task Forces deployed by the U.S. Department of Justice will go after heath care providers who commit crimes against residents and patients, most of whom are elderly and vulnerable.

The Elder Justice Task Forces have a goal of coordinated, joint investigations to allow for quicker enforcement actions and prosecutions. These Task Forces combine federal, state, and local resources from law enforcement, the U.S. Department of Health and Human Services, state adult protective services agencies, long-term care ombudsman programs, U.S. attorneys' offices, state Medicaid fraud control units, and state and local prosecutors' offices.

Medicare 2016 Premium Concerns Loom

Published on: October 23, 2015 | By McCulloch & Miller, PLLC

As a direct result of complex relationships between Social Security and Medicare and a number of other unforeseen issues, 2016 will be an expensive year for some seniors, according to Forbes' recent article, "Untangling the Medicare Premium Mess — And What It Means For You." Medicare laws require it to increase premiums annually to cover increases in per capita costs. This would typically be about $16, which most seniors can manage.

Except that 2016 will not be a normal year. Most retirees have their Medicare premiums deducted from their Social Security benefits, but because inflation was so low this year, there won't be a cost-of-living increase in 2016 for Social Security. And the law says that if Social Security benefits don't rise—you guessed it—neither can the Medicare premiums.

That means about 70% of Medicare beneficiaries won't see the premium hike. However, that leaves the entire burden of this year's Medicare cost increases on the remaining 30%. Those guys are going to be hit with 50% premium hikes.

Can You Navigate the Medicare Maze?

Published on: June 24, 2015 | By McCulloch & Miller, PLLC

"If you get a claim denial, always contact your doctor or hospital to see if they can help you through the appeal," said Shirley Whitenack, president of the National Academy of Elder Law Attorneys and a partner with law firm Schenck, Price, Smith & King.

Larry Tocco retired last year from a job in the collections department of a credit union. After some medical treatment, he started receiving past-due notices from health care providers after his claims on a Medicare plan weren't paid. After several frustrating phone calls, Larry learned he was still on the active employee roll of the health insurance plan covering his former employer. As a result, his Medicare plan was considered secondary coverage.

A benefits manager from the credit union told him they sent the retirement paperwork, but the representatives with the Medicare provider said they didn't get it.

Medicare Knowledge: Keeping Up With The Changes

Published on: May 19, 2014 | By McCulloch & Miller, PLLC

Medicare has published new rules spelling out the changes, and an education campaign aimed at healthcare providers began in January. But many healthcare providers haven't grasped it, either.

As you may know, Medicare has recently undergone a big change affecting long-term care and the availability of skilled nursing or therapy. Namely, thousands are now eligible for Medicare benefits, but you might just have to point that out to care providers.

The slow transition to full adoption of the rules and new standards of care, as well as the continuing plight of those left in a lurch, is discussed in a recent Reuters article titled “New Medicare coverage of long-term care off to a rocky start.” As pointed out there, you or a loved one may be eligible for benefits, but may need to fight to receive the benefits.