Start Planning Today: Healthcare Coverage Can be Complex

Garden City elder law and estate planningMedicare

Medicare is a federal program enacted in 1965 that was established to provide health coverage to those 65 and older and those with a qualifying disability. Medicare consists of four sections:

  • Part A – hospital insurance, inpatient care, rehabilitation care in a skilled nursing facility, as well as physical, vocational, and speech therapy, hospice, lab tests, surgery, and home health care. Medicare Part A does not have a premium, so long as an individual or their spouse worked forty quarters or more. Part A provides twenty days of full coverage for those in a skilled nursing facility. After the first 20 days, however, there is a $167.50 per-day-co-pay.
  • Part B – covers 80% of outpatient insurance for physician office visits, medical devices, and some rehabilitative services. Medicare Part B has a $134.00 premium but varies with income.
  • Part C or Medicare Advantage – is an optional plan that replaces Medicare Part A and B for a private insurance company.
  • Part D – covers prescription drugs.


Medicaid is a state program that may provide coverage for through either Community Medicaid or Chronic Care Medicaid based on an individual’s means. Community Medicaid is at home care, whereas Chronic Care Medicaid is care provided in a skilled nursing facility. For Community Medicaid, an individual may not have assets in excess of $15,150.00 and no more than $857.00 per month in income. There is no look back period for Community Medicaid. In addition, an irrevocable pre-paid burial and qualifying retirement assets are considered exempt assets.


For Chronic Care Medicaid, there is a five-year look-back period of all financial transactions. Here, an applicant will be penalized for any transfers made out of his or her name during the five years from the date of application. It is worth noting that some transfers may be considered exempt.


For those looking to preserve assets and resources, it is important to contact an experienced New York elder law and estate planning lawyer that may assist you with the process. While Medicare and Medicaid are tools that may assist in covering certain medical expenses, proper planning is key to utilizing these tools to the greatest extent that the law provides. From the simple to complex, the attorneys at Blodnick, Fazio & Associates are skilled in all aspects of elder law and estate planning and are dedicated to representing their clients with diligence and compassion. For more information or to schedule a consultation, contact our Garden City estate planning lawyers at (516) 280-7105.

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