Build Back Better Act Items of Interest to Seniors

The details of the Biden administration’s scaled-back budget bill titled the “Build Back Better Act” are out after several months of negotiations among Democratic lawmakers. Although there is a great deal out of the bill, such as Medicare coverage for dental and vision, the good news for elder care advocates is the $150 billion dedicated to Medicaid home and community services, along with regulations leading to a federally required nursing home staffing standard. Also, the bill does not include any estate tax changes. There is much more in the bill (or out of the bill, depending on your perspective). You [...]

2021-11-15T17:38:26+00:00November 4, 2021|

Advocacy is Essential When Applying for Medicaid

As an attorney for Rothkoff Law Group, I help support our Public Benefits staff with complicated Medicaid issues and unexpected application outcomes when applying for Medicaid. As a result, I have found the internal processes of state Medicaid agencies processing Medicaid applications do not always comply with state and federal Medicaid laws, often to the detriment of our clients. For this reason, it is essential to have an advocate when applying for Medicaid for long-term care in both New Jersey and Pennsylvania. It is worth noting I do not believe the Medicaid agency’s occasional failure to comply with Medicaid rules [...]

2021-10-21T14:18:25+00:00October 21, 2021|

Planning Ahead for the Medicaid Look-Back Period

What is a Medicaid Look-Back Period, and why should you be concerned about planning ahead for Medicaid benefits? We encounter the following factual scenario on a regular basis, which will shed some light on why you may want to start planning now. Mom can no longer live independently. Mom sells her house and moves in with her son and his family. Son uses mom’s money to remodel or add an addition to his home and to help pay household expenses, such as utilities, food, maintenance. Mom never puts anything in writing indicating son can use her money for such expenses. [...]

2021-11-09T16:20:43+00:00September 16, 2021|

Self-Directed Medicaid Home Care Options

For a multitude of reasons, even once approved for Medicaid, many families have been hesitant to move their loved ones to an Assisted Living or Nursing Home environment, opting instead for home care. However, home care through an agency comes with issues of its own, primarily rooted in staffing shortages. It is no secret that the United States’ aging population is growing, an impending crisis exacerbated and exposed by the COVID-19 pandemic. The Philadelphia Inquirer recently called out Pennsylvania’s lack of comprehensive eldercare solutions, rating their “level of preparedness at a ‘C’ or ‘D,’” not nearly good enough to match [...]

2021-11-09T16:22:42+00:00September 10, 2021|

Qualified Income Trust for Medicaid

Applying for Medicaid for yourself or a loved one can be a difficult process. Many people believe they have successfully navigated all clinical and financial criteria, only to discover that the applicant requires a Qualified Income Trust, or QIT. Prior to December 1, 2014, all Medicaid applicants in the State of New Jersey with a monthly income in excess of the annual income limit, $2,382.00/month in 2021, were ineligible for the benefit. The creation of QITs has allowed for a wider range of applicants but has further complicated the Medicaid application process. Improper use of a QIT can result in [...]

2021-11-09T16:29:07+00:00July 22, 2021|

Medicaid and Veterans’ Benefits: Important Documents to Save

Throughout my years of document gathering for Medicaid and Veterans' benefits applications, most of my clients exclaim at some point, “why didn’t anyone ever tell me I needed to keep this stuff?” With the never-ending pile of junk mail gathering, it can be tough to separate the “keep” and “trash” piles when considering what you may someday need down the road for Medicaid and Veterans' benefits. Below, I have listed the most common items that people wish they had held onto: Social Security card Medicare card Passport (current or expired) Photo ID (current or expired)  Birth certificate Marriage certificate Spouse’s [...]

2021-11-09T16:34:28+00:00June 9, 2021|

Medicaid Crisis Planning: Paying for Long-Term Care

Medicaid crisis planning is a crucial step in preparing for the future and taming the unexpected. And as with the case of Marie, a client I was happy to assist, Medicaid crisis planning helped turn an unexpected situation into the best possible outcome for her and her husband. $300,500.00 was most of Marie’s life savings. When she remarried while in her late 60s, it did not matter that her new husband had scant funds. Marie was happily working, and her new husband, Charlie, could help with the bills using his significant pension. No more than 10 years after their marriage, [...]

2021-11-09T16:35:00+00:00June 3, 2021|

How the $1.9 Trillion COVID-19 Relief Bill Impacts Seniors, Health Care

The American Rescue Plan Act of 2021, commonly known as the COVID Relief Bill, became law on March 11, 2021.  The law includes the widely publicized $1,400.00 stimulus checks and expanding vaccine distribution, in addition to increasing access to health insurance, funding for the long-term care community, and continued support for the Elder Justice and Older Americans Acts. For those on Medicaid, the the COVID Relief Bill stimulus check is not income or a resource for Medicaid purposes.  The funds may be gifted penalty-free for the first 12 months.  After 12 months, it is considered a resource impacting Medicaid eligibility.  [...]

2021-11-09T16:52:20+00:00March 25, 2021|

Expanded Skilled Nursing Facility Medicare Coverage During the Pandemic

The COVID-19 pandemic has been particularly devastating for nursing homes and their residents. Aside from the tragically disproportionate loss of life, care for surviving residents has been delayed or interrupted due to infection, facility lockdowns, or other health system disruptions. As a result, the Centers for Medicare & Medicaid Services (CMS) has waived two limitations on Medicare Part A skilled nursing facility (SNF) coverage during the coronavirus pandemic: The 3-day qualifying hospital stay requirement; and The 100-day benefit period.  However, CMS treats the two SNF coverage expansions differently from each other with regard to its connection to COVID-19. Three Day [...]

2021-11-09T16:59:20+00:00March 4, 2021|

Elder Law Planning: More Than Just Medicaid

When it comes to elder law planning, and when I meet with clients, the focus tends to be heavily centered on finances. When retirement accounts are dwindling due to a spouse’s high nursing home bill or a parent’s complex financial management style has left an adult child overwhelmed and confused, it is easy to become focused on Medicaid as the magic solution. However, Medicaid is just one piece of a much larger puzzle. A few years ago, I worked with the sister caregiver of a client who required long-term care. Due to the brother’s medical diagnoses and young age, his [...]

2021-11-09T18:50:09+00:00February 15, 2021|
Go to Top