Reuters reported that Walgreens has agreed to settle two civil fraud lawsuits and pay out $269.2 million over allegations that the Deerfield, Illinois-based pharmacy chain overbilled federal health care programs. Both settlements were filed under seal in U.S. District Court in Manhattan. Continue reading “Pharmacy Chain Agrees to $269.2 Million Settlement”
Tag: Medicaid
Navigating the Uncertainties for Long-Term Care Needs
Medicare is a Federal program enacted in 1965. It is an earned-benefit program for those that are aged 65 or older or disabled. It consists of parts A, B, C and D. Part A is for hospital insurance coverage, as well as limited stays in nursing homes and some rehabilitative services such as physical, vocational, and speech therapy. Usually, there is no co-pay for Part A coverage. However, it is $167.50 per day for skilled nursing facility visits in excess of twenty-one days. Continue reading “Navigating the Uncertainties for Long-Term Care Needs”
Start Planning Today: Healthcare Coverage Can be Complex
Medicare
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.
Continue reading “Start Planning Today: Healthcare Coverage Can be Complex”
Don’t Forget to Sign a Spousal Refusal
To be eligible for Medicaid, which is a need-based program, certain income and asset requirements must be met. Oftentimes, one spouse will require care in a skilled nursing facility, while the other spouse continues to reside in the community home. More often than not, the spouse residing in the community home depends largely on joint income and assets in order to continue to pay necessary expenses. For this reason, Medicaid provides certain spousal allowances, which allow the community spouse to retain his or her income plus the institutionalized spouse’s income up to a total of $3,022.50. Continue reading “Don’t Forget to Sign a Spousal Refusal”
Spousal Refusal
A common misconception is that a community spouse must spend down all of his or her assets due to an institutionalized spouse requiring nursing home care before Medicaid benefits will be available. Medicaid is a means-test program that entitles individuals to benefits including Chronic Care Medicaid. Chronic Care Medicaid covers care that is provided in a skilled nursing facility. Because Medicaid is a need-based program, certain income and asset requirements must be met in order to be eligible for the benefits. Continue reading “Spousal Refusal”
Plan Now For Your Supplemental Security Income
If you are concerned about a disabled child’s income, there are government benefits that he or she may be able to receive with proper planning. Supplemental Security Income (SSI) provides income for food and shelter to aged, blind and disabled persons with little or no income. In New York State, a person is automatically eligible for SSI if he or she is eligible for Medicaid. Continue reading “Plan Now For Your Supplemental Security Income”
Estate Planning to Protect Your Loved One’s Assets
If a family member or loved one is currently receiving Community Medicaid and has a home in his or her name, Medicaid is entitled to issue a claim against the property upon his or her death. In accordance with federal law, a person receiving benefits from the New York State Medicaid program is subject to estate recovery for assets passed through probate. This means that once a probate proceeding occurs, the Department of Social Services is entitled to recover for the services provided to the deceased through the Medicaid program because the assets were in their name alone. Continue reading “Estate Planning to Protect Your Loved One’s Assets”
2017 Medicaid Program Recap
Medicaid is a means-test program that may provide benefits for Chronic Care Medicaid or Community Medicaid, among other things. Chronic Care Medicaid is care that is provided in a skilled nursing facility and Community Medicaid is care that is provided in an individual’s home by a home health aide.
Qualifying For Chronic Care Medicaid In 2017
An applicant may have up to $14,850.00 in resources. A person may have retirement accounts, such as IRAs, so long as he or she is taking the minimum monthly distributions. A pre-paid burial account is considered an exempt asset. A person may have a maximum of $14,850 in assets and an income of no more than $50.00 per month. Any additional income must be used towards his or her cost of care.
Continue reading “2017 Medicaid Program Recap”
Selecting A Trustee For A Special Needs Trust
A Special Needs Trust (SNT) preserves the assets of a person with special needs to support his or her lifestyle. An SNT allows the person to receive supplemental resources without jeopardizing his or her public benefits. Public benefits include Supplemental Security Income (SSI) and Medicaid benefits. An SNT is usually created by a parent or loved one for a child with special needs. Oftentimes, parents may find it difficult to select a trustee for the SNT that he or she is funding. A trustee is responsible for overseeing administrative decisions, including any distributions. Continue reading “Selecting A Trustee For A Special Needs Trust”
