DPW
Implements Changes to Hurly and Home Waiver Rules
Written
By: Attorney
Jeffrey A. Marshall
, CELA*
DPW
has issued an Operations Memorandum containing implementation procedures
for Sections 441.7 and 441.8 of Act 42.
Section
441.7 modifies the resource-first (Hurly) rules to limit the resources
that can be retained by a low-income community spouse.
Section
441.8 requires that the assets of the community spouse be counted in
determining qualification for the PDA 60+ Waiver and other home and
community care waiver programs.
The
new rules became effective
October 1, 2005
.
As
a result of these changes, it has now become more difficult to qualify
financially for Medicaid home care than for nursing facility care.
(Income limitations which apply to Waiver funded home care do not apply
to nursing facility care).
The
change in the law is not limited to new applicants for Waiver. Act 42
affects married seniors who are currently receiving benefits
under the Waiver program. All married Waiver recipients will have to
file a financial “Resource Assessment” form by
Marc
h 31, 2006
.
Many
current Waiver recipients could lose their Waiver funded home care
benefits.
Married
seniors who are currently receiving Waiver services should discuss their
status with their Area Agency on Aging care manager.
Those who could lose benefits should discuss their planning
options with an elder law attorney as soon as possible.
The
DPW Operations Memo is posted on the Elder
Law Firm of Marshall & Associates website.
Also
available on the www.paelderlaw.com
website are an illustration of the effects of these Act 42 changes on a
current Waiver recipient, DPW’s Operations Memorandum on Partial Month
Penalties, and selected provisions of Act 42.
Click
on the following link then scroll down for access to these materials.
http://www.paelderlaw.com/newsandevents.html.
Attorney Marshall can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
Understanding
the Medicaid Changes to Long Term Care – Sessions for Care Managers
and Caseworkers set
Written
By: Melissa Bottorf, Director of Public
Ed
ucation & Marketing
In
an effort to help the community understand how Act 42 will affect
seniors, The Elder Law Firm of Marshall & Associates is presenting
educational sessions to discuss the new Medicaid changes and answer
questions.
A
special session for Area Agency care managers and County Assistance
Office caseworkers will be held on October 26th in
Williamsport
.
Two
sessions for seniors and their family members will be held at the
Lycoming Mall on October 26th and October 28th.
Please
call 1-800-401-4552 or e-mail Melissa at mbottorf@paelderlaw.com
to make you reservation.
Professional
Session:
Wednesday, October 26th from
9:30 AM
until
12:00 PM
Community Theatre League,
100 West Third Street
(
Trade & Transit
Center
)
Williamsport
Consumer Sessions:
Wednesday, October 26th from
6:30 PM
until
8:00 PM
Lycoming Mall Community Room
Or
Friday, October 28th from 10:00 AM until
11:30 AM
Lycoming Mall Community Room
Medicare Approves Prescription Drug Plan Organizations
for
Pennsylvania
Written
By: Attorney
Jeffrey A. Marshall
, CELA*
The
Centers for Medicare & Medicaid Services (CMS) has granted approval
to 19 organizations to offer prescription drug plans in
Pennsylvania
beginning
January 1, 2006
. Many of the organizations
will offer more than one plan option.
In
addition, 16 Medicare Advantage organizations have been approved to
offer prescription drug coverage in at least some geographic areas of
the state.
This
means that Medicare beneficiaries will have a wide (and confusing) array
of plans from which to choose from when enrollment begins in November.
A
list of organizations offering Medicare prescription drug plans in
Pennsylvania
is available online at the following link.
http://www.cms.hhs.gov/map/map.asp.
A
list of specific stand alone plans approved by CMS as of September 25th
with information as to premiums, deductibles, and number of top 100
drugs on the formulary is available at http://www.cms.hhs.gov/map/charts/chart4PA.pdf.
Attorney
Marshall can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
2006
Medicare Figures Announced: Part B Premiums to Increase 13%
Written By:
Attorney
Jeffrey A. Marshall
, CELA*
Federal
officials have announced the Medicare premium, deductible, and
co-insurance amounts that beneficiaries will have to pay in 2006.
The Part B premium paid by most Medicare recipients will increase
by $10.30 (13%) to $88.50 per month.
This is on top of a 17% increase last year. The basic Medicare
premium has increased by nearly $30 a month, or 51 percent, from 2003 to
2006.
The Centers for Medicare and Medicaid Services
(CMS) estimates that about one-fourth of Medicare beneficiaries can
receive assistance that pays for their entire Part B premium.
(For more information on premium assistance see our article “An
Alphabet Soup for Saving on Medicare Costs: QMB, SLMB and QI” at http://www.paelderlaw.com/capchanges.html.)
Unfortunately, many seniors who are eligible for this help with Part B
premiums do not receive it either because they are unaware of its
existence or find it too difficult or confusing to apply.
According to CMS “continued rapid growth in the
intensity and utilization of Part B services is the primary reason for
the premium increase. This growth is seen in physician office visits,
lab tests, minor procedures, and physician-administered drugs.
It also includes rapid growth in hospital outpatient services.
Additionally, increased fee-for-service expenditures contribute
to higher payment rates to Medicare Advantage health plans. Also,
enrollment in Medicare Advantage plans is increasing as those plans have
become much more widely available. These factors are leading to higher
Medicare costs related to the Medicare Advantage program.”
By law, Medicare beneficiaries pay 25% of the cost
of Part B benefits with the Federal Government picking up the remainder.
However, as a result of the new Medicare law, higher income
individuals and couples will see their premiums double or triple
beginning in 2007 since they will be required to pay a larger percentage
(up to 80%) of the costs of their Part B benefits.
Seniors need to brace themselves. In 2006 many
seniors will be hit with additional monthly premiums as a result of the
prescription drug coverage (Part D) provisions of the Medicare
prescription drug law. Average monthly premiums for the drug coverage
should average approximately $32 per month (although individual premiums
will vary widely depending on the plan chosen). This means that next
year, the average Medicare beneficiary will be paying approximately $120
a month in combined Medicare Part B and D premiums.
Medicare is a federal health insurance program for
people 65 years of age and older, some disabled people under 65 years of
age, and people with end-stage renal disease.
Medicare plays a significant role in providing health care in the
United States
. Nationally, it covers
approximately 35 million seniors and 6 million younger people with
disabilities. In
Pennsylvania
, over 2 million people (17% of the population) are Medicare
beneficiaries.
The
announced Medicare deductibles, premiums, and co-pay amounts for 2006
are as follows:
Medicare
Hospital
Insurance (Part A)
- Deductible - $952 per Benefit Period ($912 in
2005)
- Coinsurance - $238 a day for the 61st through the
90th day (was $228 in 2005), per Benefit Period; $476 a day for each
"nonrenewable, lifetime reserve day" ($456 in 2005)
- Skilled Nursing Facility Coinsurance - $119 a day
for the 21st through the 100th day per Benefit Period ($114.00 in 2005)
- Hospital Insurance Premium - $393 ($375 in 2005)
- Reduced Hospital Insurance Premium - $216 ($206
in 2005)
Medicare
Medical Insurance (Part B)
- Deductible - $124 per year ($110 in 2005)
- Monthly Premium - $88.50 ($78.20 in 2005)
The CMS News Release is available online at http://www.cms.hhs.gov/media/press/release.asp?Counter=1557.
Attorney
Marshall can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
Marshall & Associates
Unveils New Website
Written
By: Melissa Bottorf, Director of Public
Ed
ucation & Marketing
Finding accurate & easy to understand
information about issues affecting
Pennsylvania
’s seniors can be a daunting task for families and professionals
alike. That’s why Marshall
& Associates is pleased to announce the launch of a completely
redesigned website that is intended to be a comprehensive resource for
anyone looking for information about elder law, estate planning and a
variety of other senior-related topics.
There is a constant evolution in the laws,
regulations, and programs that are so critical to the health and well
being of older Americans. Our
website now features a News & Events
link that will keep you posted on the recent changes in legislation
& regulation. If you are looking for articles on a particular subject, our
search box at the top of every page will allow you to quickly search the
entire site by keywords. We
also made the site easy to navigate by creating special sections with
information that’s most important for legal
& financial professionals, social
workers, and caregivers.
Now, you can easily e-mail Marshall & Associates’ staff,
schedule appointments for yourself or your clients, and even read past
editions of the Elder Care Law Alert.
To check out all of our changes, please visit our
website at www.paelderlaw.com.
Alzheimer’s
Association Memory Walks Slated for October
Written
By: Melissa Bottorf, Director of Public
Ed
ucation & Marketing
Alzheimer’s Disease
affects more than 4.5 million Americans of every race, gender and
culture and costs our nation at least $100 billion a year.
Unless we find a way to stop it, up to 16 million Americans will
have the disease by 2050. Every step brings new hope for better
treatments & a cure.
Memory
Walk 2005 is the nation’s number one fund-raiser to help people
battling Alzheimer’s Disease. About
80 cents of every dollar you raise for the Greater Pennsylvania Chapter
goes directly to promote research, find effective treatments and improve
the quality of life of those affected by the disease.
Marshall & Associates is proud to be a corporate sponsor and
to have a team participating in this year’s Memory Walk. For a list
off all walks in
Northeast PA
, or to find out how you can start
a team or donate, please go to www.alzpa.org.
Montoursville Walk at
Indian
Park
Saturday, October 8th,
2005
Registration at 10:00 AM
Walk at
11:00 AM
Contact: Melissa Bottorf,
Walk Chairperson 321-9008 or mbottorf@paelderlaw.com
Wilkes-Barre
Walk at
Kirby
Park
Saturday, October 8th,
2005
Registration at 8:30 AM
Walk at
9:30 AM
Contact: Estella Killian,
Regional Director 822-9915 or estella.killian@alz.org
Bloomsburg Walk at Columbia Mall
Saturday, October 15th,
2005
Registration at 10:00 AM
Walk at
11:00 AM
Contact: Estella Killian,
Regional Director 822-9915 or estella.killian@alz.org
Melissa can be contacted at mbottorf@paelderlaw.com or
at 1-800-401-4552
In
the Community…
The professional staff of
Marshall and Associates will be presenting to the following groups and
organizations over the next couple of weeks.
Many of these events are open to the public.
If you would like more information or would like to schedule
someone to speak at your group, please contact Melissa at 321-9008 or at
mbottorf@paelderlaw.com
-Attorney
Jeff Marshall & Planning Specialist Perry Landon provided an
in-service to the Northumberland
County Area Agency on Aging Caseworkers regarding Act 42 on Tuesday, October
4th at
10:00 AM
.
-Attorney
Jeff Marshall will talk about Legal
& Financial Considerations in Retirement for Muncy Bank and Trust’s Fall Seminar on Wednesday, October 12th
at
2:00 PM
at the Farm Complex in
Montoursville. For more
information, contact Maggie Aderhold at 570-546-2211.
-Attorney
Kevin Grebas and Planning Specialist Josephine Reviello will make a
presentation on Ways to Pay For Long Term Care
for Amerprise Financial on
Wednesday, October 12th at the Comfort Inn in Lehighton.
-Planning
Specialist Lisa Barner will talk about The
New Medicare Part D Changes to the Rose
View Center Family Council Meeting on Wednesday, October 12th
at
7:00 PM
.
-Attorney
Jeff Marshall & Planning Specialist Perry Landon will provide an
in-service to the Lackawanna County Area Agency on Aging Caseworkers about Act
42 on Thursday, October 13th.
-Attorney
Kevin Grebas will talk about Ways
to Pay for Long Term Care at First
Liberty Bank and Trust in
Wilkes-Barre
on Thursday, October 13th
at
12:00 PM
.
-The
United Methodist Church in Pittston has invited Attorney Kevin
Grebas to make a presentation on Identity
Theft on
Thursday, October 13th,
2005
at
7:30 PM
.
-
Planning Specialist Perry Landon will provide a brown bag lunch
n’learn on the Changes
with Act 42 to the Evangelical
Community Hospital Social Services Department on October 18th
at
12:00 PM
.
-Planning
Specialist Lisa Barner will provide two sessions on The New Medicare Part D Changes
to the Muncy Valley Skilled
Nursing Unit on Wednesday, October 19th.
The first session will be at
3:00 PM
and the second will be held at
7:00 PM
.
-Attorney
Matthew Parker will present a break-out session on Elder
Law at the 2005
Central
Atlantic
Trust & Wealth Management Conference on Thursday, October 20th
at
3:00 PM
.
The Conference will be held at the Hershey Hotel & Convention
Center.
Back
issues of The
Elder Care Law Alerts
are available on our website.
You
can even search our site by a keyword
or phrase!
Do you have a friend or
colleague who would enjoy reading the
Elder Care Law Alert? If
so, please feel free to forward it to them. Simply use the “Forward” button on
your e-mail program.
To subscribe or unsubscribe to the Elder Care
Law Alert,
simply send your request to:
webmail@paelderlaw.com
*Attorneys Marshall and Parker are certified as Elder Law Attorneys by the National Elder
Law Foundation under authorization from the Pennsylvania Supreme Court.
