Medicare

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.

Home Health Care Consideration: The Quality of Care in Houston

Published on: April 9, 2014 | By McCulloch & Miller, PLLC

Much is undoubtedly delivered with great love and compassion. But, sadly, it is also provided by family members who have no caregiving skills.

Deciding on medical care later in life or setting it up for a loved one is a difficult process that should be thoroughly evaluated. While there are many options available, essentially the decision comes down to care at home or in a facility. Is the quality of care comparable, especially when it comes to in-home care?

The answer seems to range from “we don’t know” to an unhelpful “it depends.” With so many people receiving care at home, either by default or by design, it is an important option to understand. A recent article in Forbes, titled “We All Want To Live At Home In Old Age, But Know Nothing About the Quality of Care We'll Get There,” to a look under the hood on this subject.

Assisting Loved Ones With Assisted Living in Houston

Published on: April 3, 2014 | By McCulloch & Miller, PLLC

Choosing whether assisted living would be the right option can be a complex decision requiring a dispassionate evaluation of the situation and careful consideration.

The challenges of helping an aging parent plan for their late-in-life care can be strenuous. There are financial, medical and even emotional aspects of this type of planning.

By way of a primer, consider reading (and sharing) a recent Forbes article titled “The Basics: Assisted Living For Your Parent.”

Medicare Rehab Requirements Relaxed?

Published on: February 27, 2014 | By McCulloch & Miller, PLLC

What does this mean? Imagine you have a severe stroke. Before Jimmo, most people thought Medicare would pay for physical therapy only as long as that PT was helping you get better. For instance, Medicare would pay if therapy helped increase the number of steps you could walk without assistance. Now, Medicare will pay for PT even if it only helps you maintain your current ability to walk.

Whenever the rules for receiving Medicare benefits change it has a real impact on real beneficiaries and patients. Sometimes legal changes occur literally overnight, while at other times the changes are more subtle. After a landmark lawsuit a year ago, there may be some tangible effects to the system – for the better. This is especially the case when an elderly loved one requires skilled nursing or physical therapy.

The landmark case was Jimmo v. Sebelius. Recently, Forbes explored the legal evolution Jimmo sparked in an article titled “When Medicare Will Pay for Skilled Nursing or Physical Therapy.”

Medicare Denied? Appeal Your Houston Application.

Published on: January 28, 2014 | By McCulloch & Miller, PLLC

If a beneficiary disagrees with a decision, there are reconsideration and appeals procedures within the Medicare program.

Medicare approvals can be tough at times, and some may find their claims come up with the big "D" – denial. So what happens when Medicare denies a beneficiary’s claim for care?

While it is not always smooth sailing, it is important to know that you are not without recourse. You can appeal Medicare decisions to refuse coverage for needed care, and sometimes you simply must.

More Medicare Coverage For Mental Health Costs May Aid Houston Residents

Published on: January 21, 2014 | By McCulloch & Miller, PLLC

“Hopefully, older adults who previously were unable to afford to see a therapist will now be more likely to do so,” said Andrea Callow, a policy lawyer with the Center for Medicare Advocacy.

Now that 2014 is officially here, it's time to start reviewing the Obamacare provisions that went into effect January 1. One change for elderly and Medicare beneficiaries that went into effect has been on the books since 2008 through the Medicare Improvements for Patients and Providers Act. Medicare will now cover costs for psychological care to the same degree as physical medical costs at the 80/20 Medicare/Beneficiary split.

The New York Times – The New Old Age Blog took note of this change in a recent article aptly titled “Medicare to Cover More Mental Health Costs.” It seems psychological issues are often the most directly felt difficulties in the life and wellbeing of elderly Medicare beneficiaries. With the new change, the long-held gap in coverage between the costs for physical medicine and psychological care has now been closed. Consequently, more elderly beneficiaries will be able to afford the care that is uniquely suited to their own needs and happiness.

Enjoy Some Diet COLA With Your Social Security

Published on: November 23, 2013 | By McCulloch & Miller, PLLC

The nation's elderly and disabled Social Security recipients will receive a 1.5 percent increase in payments in 2014. The same COLA will apply to pensions for federal government retirees and most veterans.

According to recent news from the Social Security Administration, the Cost Of Living Adjustment (COLA) made to Social Security payments will increase 1.5% in 2014. Although it is a small increase, you will be able to enjoy some "diet COLA" with your Social Security next year.

ElderLawAnswers weighed in on the news in an article titled “Social Security Benefits to Rise Only 1.5 Percent in 2014,” while the SSA has issued its own COLA Fact Sheet.