Wednesday, June 27, 2012

Medicare Savings on Prescription Drugs for Seniors as a Result of the Affordable Care Act




According to the Centers for Medicare and Medicaid Services More than 5.2 million Medicare beneficiaries have saved a total of $3.7 billion on their prescription drugs since the health care reform law (a.k.a. Affordable Care Act a.k.a. "Obama Care") went into effect.   The Affordable Care Act—also known as health care reform—which passed in 2010, required financial assistance for seniors who fall into Medicare's so-called "donut hole." As a result of health care reform, Medicare beneficiaries who fell into the donut hole in 2010 received $250 as a one-time, tax-free rebate to help pay for their prescription drugs. Even more relief came into effect in 2011 as the law also required that those Medicare beneficiaries who fell into the donut hole because of high prescription drug costs should receive a 50 percent discount on covered brand-name drugs, and 7 percent coverage of generics.

See CNN Article: http://money.cnn.com/2012/06/25/pf/health-reform-medicare/

Polls show that more Americans are opposed to the Affordable Care Act than those that approve it.  Some commentators claim this is because opponents have spent 235 Million dollars in ads criticizing the law where only 69 Million has been spent in ads supporting the law. 

See New York Times Report: http://www.nytimes.com/2012/06/21/health/policy/health-care-law-loses-ad-war.html?_r=1&em

On the other hand see the benefits of the law: http://www.whitehouse.gov/the-press-office/2012/03/23/new-report-affordable-care-act-gives-americans-more-security-better-bene
The nation eagerly await the Supreme Court's decision regarding the constitutional challenges initiatedby Republicans and conservatives alike. The Affordable Care Act has an "Individual Mandate" that requires everyone to have insurance coverage or they will be fined. Provisions are included in the Act to subsidize insurance coverage for those who can afford it. The rationale behind this is that everyone has a basic right to healthcareand that it will be less costly if everyone is covered. Opponents claim that the requirement force people to buy an insurance policy is unconstitutional and that the federal government does not have the right to force people to do this. However, the commerce clause, has been used in scores of cases as a constitutional basis for the federal government to enact laws where the economic affect of the law crosses state lines.


Attorney Casiano founded the Casiano law firm in San Diego Elder Law and Estate Planning Firm to serve the needs of seniors and their families with the complex legal issues that arise as one grows older.  If you have any questions regarding your Medicare, Medicaid, or Medi-Cal coverage, feel free to give "Vinny" a call at 619-800-6820 and he will speak to you at no charge to see if he can assist you.


Tuesday, June 26, 2012

The Truth About Medicaid and Medi-Cal Paying for a Nursing Home



Are you a Senior Who is Afraid of Running Out of Money?

Do you worry about the cost of long term care if you or your spouse can not live at home any longer?

Nobody ever wants to be put in nursing home?  The reality is that many seniors end up having to go to a nursing home (sometimes called a skilled nursing facility, SNF or convalescent home).  Families are shocked when they find out that the cost of staying in a nursing home is $225-$300/day!

  • Are there any government programs to help defray this cost?
  • Does a family have to spend all of their money before they can become eligible for a program?
  • Is there a way to preserve any of a seniors' money and still get government assistance? 
  • Are adult children responsible to pay back the government from the inheritance if their parent receives Medicaid or Medi-Cal?

Sometimes a senior needs to be admitted into a nursing home for rehabilitation services, mom falls and breaks her hip or dad has a stroke.  Sometimes it is because a senior simply can no longer live at home alone safely due to their inability to take care of themselves.  As we age most of us will need assistance with what is called our daily living activities.  

With costs of staying in a San Diego California nursing home for only a few months costing tens of thousands of dollars, most families want to know if there is any help to pay for this.

There is help - but you do need to plan for it!

The good news is that Medicaid or what California calls Medi-Cal will help pay for care received in a nursing home if the person who goes into the nursing home meets strict income and asset limits.  Basically the government will look at how much money you bring into your family from ALL sources as well as how much money (property and savings) a family has.  If you fall below a certain amount then the government will help pay.  If you are over their set limits,  then you are on your own and have to pay on your own! 


Please note that a person can be charged with Elder Abuse if they transfer money from a senior - even their parents - unless they have the property authority to do so! 

There are things you can do even if you have too much money to qualify for Medicaid and Medi-Cal!


There are quite a few strategies that one can use to preserve their hard earned money and property.  The only kicker is that this needs to be done while you still are competent and know what you are doing.  In other words, your kids can not decide after you are unable to make you own decisions to take steps to save your money unless you have already given very specific instructions and the OK to do so in your estate planning documents.  

Most people I speak with want to save their money and property including their home for their husband or wife and then for their children rather than spend it all on a nursing home in the last few years of their life.

Each family is different and what works for one may not work for another

Since each family is different, a plan that works for one family may not be right for another family.  The only way to know what is right for your family is to meet with an experienced Elder Law Attorney who knows the rules and how to legally get you qualified for Medicaid - Medi-Cal and how to avoid having to pay the government back for the services received once you pass away!

Free Phone Consult with Elder Law Attorney Vincent M. Casiano, Esq.

I know how confusing this can be, so I do offer to speak with potential clients at no charge to talk to them about their family's situation to see if I am able to help.  I welcome calls from wives, husbands, and adult children that are concerned about their parents' health and safety.  Call me so we talk and we can decide if you want me to help your family - 619-800-6820.