Articles Posted in Medicaid Planning

The first part of this article explained that there are many programs and benefits available to seniors that live in New York. The second part of the article continues to explain various services that are available to the state’s elderly population.

Temporary Assistance

This program provides cash benefits for senior citizens with limited income for essential food, clothing, and shelter items. You can be any age to apply, but people over the age of sixty do not have to meet the program’s work requirements. The resource limit for an individual is $2,000 and $3,000 if any household member is ages sixty or older. Employed applicants may be able to disregard some of their earnings and still qualify for the program. There is a sixty month limit on this program, and it applies for the lifetime of the applicant.

As an elderly resident of New York state, age sixty years or older, you have access to many programs, benefits, and community services that you might not be aware of. Different benefits throughout the state have varying requirements regarding age, finances, and other rules regarding eligibility. This article, and the local chapter of the state’s Office for Aging, is here to provide you with the information that you need to take advantage of the services that are available in the state for you.

It is important to remember that when discussing these programs, the term “resources” refers to the assets or property that you own. This includes cash, bank accounts, investments, and valuables but not a home, car, income-producing property, or personal property. In addition, “income” refers to earned and unearned income for work performed, social security benefits, pensions, retirement account withdrawals, and valuable gifts.

Social Security

There are over fifteen million people caring for loved ones that suffer from Alzheimer’s disease, and while most are acutely aware of the emotional toll that care can take many do not realize the financial strife that it can cause, as well. According to a new survey released by, over one quarter of Alzheimer’s caregivers spend over $4,000 each month, around $50,000 each year, on their loved one’s needs.

Breakdown of Costs

According to the same survey, these costs include a variety of goods and services. They include costs for home care, assisted living, or nursing home care. The Genworth Cost of Care Survey found that each of those services cost around $45,000, $42,000, and $87,600 (for a private room), respectively. On average, a person suffering from Alzheimer’s disease lives for another eight to twelve years and at $4,000 per month the costs accumulate quickly.

Elderly couples are divorcing at a higher rate than ever before for a surprising reason: soaring medical and long-term care costs. These expenses are being aggravated by longevity and uninsured risk from a lack of long-term care insurance. Although these senior couples still care for each other very much, the cost savings from divorce are inflicting the least amount of damage when compared to other financial options.

Medicare and Medicaid

Seniors are now turning to divorce to stave off financial ruin trying to qualify for Medicare and Medicaid coverage. In terms of Medicare coverage, the program only covers 100 days of nursing care. If you or your spouse needs long-term nursing care you must either pay out of pocket until your assets fall beneath a certain threshold or tap into your long-term care insurance if you have it.

The Centers for Medicare and Medicaid Services says that it reviews more than 100,000 complaints and appeals every year. Beneficiaries of the programs file around 16,000 complaints relating to hospital care and discharge orders as well as 18,000 complaints against nursing homes, home health services, and hospice programs. Another 30,000 complaints and appeals are specifically geared towards the Medicare Advantage programs. How Medicare handles its complaint and appeals process is no trivial matter, and the program has recently revised its complaint process.

Updated Medicare Complaint Process

On August 1, Medicare made a change to its complaint filing system: it added new, toll-free numbers to call to lodge a complaint. The new phone numbers represent a larger change in the Medicare complaint system. Each state used to have a quality improvement organization, or Q.I.O. Up until August 1, these organizations worked with providers on issues like hospital readmissions or preventing infections, reviewed beneficiary complaints, and expedited appeals.

When Medicare was expanded in 2003, the expansion that established prescription drug coverage was called a “promise, a solemn promise, to America’s seniors.” Part D Medicare officially took effect in 2006, but still some seniors were afraid of falling into the infamous “doughnut-hole” coverage gap.

Initial Benefits of Part D

In Part D’s first few years, national data has shown that the program had helped seniors make progress with their prescription drugs. Overall, out of pocket costs decreased for medication, seniors took their medication more regularly, and were less likely to forego basics like food or heat in order to afford for their prescriptions.

Being a caregiver to an older adult can be very rewarding for both the caregiver and the person receiving the care. However, being a caregiver also is hard work. It’s hard mentally, emotionally, physically and sometimes financially, as well. However, certain programs and actions can sometimes make caring for an aging parent less difficult.

Assistance Programs

There are a variety of benefit program and support services are available to older adults who need care. Tapping into these sources can help free up financial resources that are otherwise being provided by an adult child caregiver. Programs vary by state, but here are a few places to start–

The New York Medicaid system is the primary means of providing long-term care to many seniors in the state. However, the system’s popularity led to financial strains, and public officials have worked for years to address rising costs and budget challenges. The most popular large-scale change to the program pushed by reform advocates is referred to as “managed care.”

The idea of managed care is to move away from paying service providers per specific task provided and instead compensate them a flat fee for each resident–regardless of what care the resident needs. The idea is to eliminate the company’s incentive to provide care that is not needed simply to increase their reimbursement. By providing a flat fee per resident, caregivers are incentivized to provide efficient, quality care.

Purging “Unprofitable” Clients?

It is a common problem for New York residents: how to protect your ailing parents’ assets. For many families, the largest asset is the family home. Many seniors spent their entire lives pouring money into their home, with property rates increasing over the years, the home is a significant asset to be passed on to heirs. At the same time, if the senior does not have long-term care insurance, there is always the risk of the home being lost to pay for a nursing home or other support services.

The Life Estate

After first considering the risk, many adult children who are unfamiliar various elder law and estate planning tools attempt rudimentary protection efforts. For example, the adult son or daughter may convince their parent to sign a new deed, giving ownership of the home to the child. This seemingly avoids having the transfer go through probate and may protect the home from some long-term care costs (though this is not always the case).

Residents throughout New York continue to experience “sticker shock” when exploring their long-term care options. Whether you are planning for possible needs in the future or working quickly to secure support for an ailing loved one, there is a good chance you may be surprised by the overall costs of this care. Naturally, there is a spectrum of care–from occasional, at-home aides to a move into a skilled nursing home. And there are wide variances in quality among specific caregivers. In most cases, however, the overall cost is quite significant, particularly in a relatively expensive state like New York.

The Cost Data – 2014

A helpful starting point to understand the financial toll of long-term care is to examine the newly released 2014 Cost of Care Survey from Genworth. This particular survey has been conducted for over a decade, allowing an understanding of year over year trends on top of providing information on current costs.

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