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Florida Elder Law Blog - A blog by Elder Law Associates, South Florida's premier elder law attorneys, who handle elder law, medicaid planning, guardianships and much, much more.

Tuesday, November 29, 2011

 

South Florida Elder Law: Medicare's Open Enrollment Season Already Underway

This year's holiday shopping season has begun early for Medicare beneficiaries: the program's Open Enrollment Period, during which you can enroll in or switch plans, began October 15 and ends on December 7.

During this period, you may enroll in a Medicare Part D (prescription drug) plan or, if you currently have a plan, you may change plans. In addition, during the seven-week period you can return to traditional Medicare (Parts A and B) from a Medicare Advantage (Part C, managed care) plan, enroll in a Medicare Advantage plan, or change Advantage plans. Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.

Even beneficiaries who were satisfied with their plan in 2011 need to review their options for 2012, particularly because things are still in flux due to changes brought on by the health care law. Prescription drug plans can change their premiums, deductibles, the list of drugs they cover, and their plan rules for covered drugs, exceptions and appeals. Medicare Advantage plans can change their benefit package and as well as their provider network.

According to the federal Centers for Medicare and Medicaid Services (CMS), Medicare Advantage premiums are expected to decrease by an average of 4 percent next year from this year, while Part D plan premiums will likely increase about 2 percent to $30 a month, on average.

"There's no doubt that a lot of seniors are in the wrong plan," Ross Blair, the CEO of PlanPrescriber.com, a site that compares Medicare plans, told SmartMoney. "A lot of them could save hundreds of dollars a year by switching."

Reaching for the Stars

One change beneficiaries using the Medicare Plan Finder will notice this year is CMS's enhanced five-star rating system. Plans that have achieved a five-star rating from CMS are identified with a "gold star" icon. Those that have received a low overall quality rating for the past three years are identified with a "warning signal" icon. Another new innovation is that there is no time limit to switch into a five-star Advantage or prescription drug plan. Medicare beneficiaries have one opportunity to switch to one of these top-rated plans anytime during 2012. (For more on the significance of the star rating system, see "Medicare Plans See Dollars in the Stars.")

If you want out of your Advantage plan after December 7, you can "disenroll" between January 1 and February 14. At that point you can return to traditional Medicare and add a Part D plan, or move into a five-star Advantage plan. But if you return to traditional Medicare you may not be able to buy Medigap coverage at that point, although the rules vary by state.

If you take no action, you will remain in your current plan unless your Medicare Advantage or drug plan is terminating its Medicare contract. Also, if you receive the Low-Income Subsidy (LIS) to help pay for some or most of your Part D drug costs, you may be randomly reassigned to a different plan. (For more on the LIS program, also known as "Extra Help," click here.)

Some factors to consider when evaluating your drug plan include:
  • What is the monthly premium?
  • Does the plan continue to cover necessary drugs?
  • Does the plan provide coverage for drugs in the "doughnut hole" or coverage gap?
  • What pharmacies are covered under the plan?
Some factors to consider when comparing Medicare Advantage plans include:
  • What is the monthly premium?
  • What is the cost-sharing for doctor visits?
  • Which doctors and hospitals are covered?
  • Is prescription drug coverage included?
  • Are any other extra benefits included and will they be useful to you?
(For a MarketWatch article on picking an Advantage plan, click here.)

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals' personal financial information. Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls selling Medicare-related products or services or showing up on their doorstep uninvited. If you think you've been a victim of fraud or identity theft, contact Medicare. For more information on Medicare fraud, click here.

Here are more resources for navigating the Open Enrollment Period:
For more about Medicare, click here.

As always, before making any final legal decisions, please contact a qualified South Florida Elder Law Attorney who is also an experience South Florida Medicaid Planning Attorney.

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Tuesday, November 22, 2011

 

Florida Elder Law: Multigenerational Families On the Rise

Just read an interesting article in the Chicago Herald, about how "Extended families are making a comeback" and thought it would be worth a read for our clients.

The article makes some really salient points, including "The recession and its aftermath have pushed extended families to share space at a time when the average age at first marriage has climbed to 28.7 for men and 26.5 for women. And life expectancy — now 75.7 for men and 80.6 for women in the USA — continues to rise."

This means that making plans for long term care insurance and getting your estate plan in order has never been more important or more necessary. Before making any final plans, please contact an qualified Florida elder law attorney.

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Tuesday, November 8, 2011

 

Florida Elder Care: Celebrating Family Caregivers

Debbie turned the ringing alarm off. It was 6:00AM and time to get herself ready for the day. Her son would be there soon to help her shower and dress her husband Jim. Her son came every day before work to help because Debbie, at 75 years old and suffering with arthritis, could not lift Jim out of bed or help him to the shower. This has been the daily routine since Jim’s stroke a year ago. When her son leaves for work, Debbie spends the day caring for Jim’s needs.

President Barack Obama, in his Presidential Proclamation of National Family Caregivers Month -2011 states:
“Across our country, millions of family members, neighbors, and friends provide care and support for their loved ones during times of need. With profound compassion and selflessness, these caregivers sustain American men, women, and children at their most vulnerable moments, and through their devoted acts, they exemplify the best of the American spirit.”
Statistics from the Administration On Aging show that the population 65 and older is expected to grow from its current 13% to 19% of the total population by 2030. With the older population increasing, the need for elder caregiving will continue to increase. Family caregivers play a vital role in filling these caregiving needs. Who better than family can understand the needs and ensure the best care of their loved ones.
Caregiving can be very stressful and demanding. In the case of a healthy spouse or a child living with the disabled person at home, caregiving can be a 24 hour, 7 day a week commitment. But even for the caregiver not living in the home, looking after a loved one or friend can consume all of the caregiver's free time.
Surveys and studies consistently show that depression is a major problem with full-time informal caregivers. This is typically brought on by stress and fatigue as well as social isolation from family and friends. If allowed to go on too long, the caregiver can sometimes break down and may end up needing long term care as well.
A typical pattern may unfold as follows:
  • 1 to 18 months--the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
  • 20 to 36 months--the caregiver is taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
  • 38 to 50 months--Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate.  Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.  It is often at this stage that family or friends intercede and find other solutions for care.  This may include respite care, hiring home health aides or putting the disabled care recipient in a facility.  Without intervention, the family caregiver may become a candidate for long term care as well.
Since most family members go into informal caregiving without training or counseling, they often aren't aware of the possible outcome described above. It is therefore extremely important to seek counseling and to formulate a plan of action prior to making a caregiving commitment.

According to the National Care Planning Council:
" In 1965, Congress passed the Older Americans Act which provides guidance and funding to the States to give help to caregivers. All states offer programs at no cost or very low cost which might include: counseling, caregiver training, respite care, adult day care, meals, support groups and much, much more. It is vital for the health and longevity of all caregivers to make use of these services." (www.longtermcarelink.net)
In 1994 President Clinton proclaimed a week in November as National Family Caregivers week to be observed with appropriate programs and activities.  It has since been changed to the whole month of November with each President giving a yearly proclamation for its observance.
Government assistance is available all over the country.  Area Agencies on Aging and local senior centers give aid and support to family caregivers.  Numerous religious and community organizations also lend their support.

This month of November 2011, as individuals, we can take note of those around us, in our families and community, who are family caregivers.  A note of acknowledgement of their service, a gift of thanks or even an offering of our time to give them a needed break would let them know their service is recognized and appreciated.

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Tuesday, November 1, 2011

 

Florida Elder Law: Senior Cohousing-A Retirement Alternative

Seniors want to remain at home as long as possible, but with family spread out all over the country, it isn't always easy to do so. "Senior cohousing," a relatively new concept, allows older Americans to age at home in a supportive community. Senior cohousing consists of a group of houses or condos that are individually owned by seniors and are clustered around a common area. The design usually includes a common house that can hold guest rooms, a kitchen for group meals, and any other common areas the residents agree on (e.g., a gym, media room, or art room). The residents pay a monthly maintenance fee and meet regularly to make decisions as a group. Cohousing can be beneficial for someone who is looking to downsize. The residents share amenities and common area maintenance costs, so expenses are reduced. The biggest benefit may be that individual residents have control over how things are run -- unlike at a continuing care community, which has a management board. Residents can decide whether to hire a gardener or a cook for the community or even whether to have a nurse visit regularly. While cohousing developments don't usually offer 24-hour nursing care, the neighborhood becomes a community where everyone knows each other and neighbors can help out if one resident becomes sick. There are hundreds of multi-generational cohousing communities in the United States that welcome seniors, but senior-only cohousing is relatively new. There are currently five senior cohousing projects, in California, Virginia, Colorado and New Mexico, but others are in the works. One downside is that developing a cohousing development can take years. The process involves finding land, working with an architect and developer, and dealing with financing and zoning. In addition, because all the residents must reach a consensus, the decision-making process can take time. Before making any final decisions, consult a Florida Elder Law Attorney.

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