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ELDER LAW UPDATE: Medicaid Community Based Care Look Back Period Extended to April 2021

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 As a result of the continued pandemic, the Secretary of Health and Human Services has continued to renew the declaration that a public health emergency exists. The most recent renewal extends the PHE through until late April, 2021. Due to the requirement for states to maintain Medicaid benefits through the Public Health Emergency, no changes to Medicaid benefits can go into effect until July 1, 2021.

For New York State residents and families contemplating a Medicaid application for community home care, this is welcome news. The lookback requirements were to have changed to require applicants to submit to a 30 month financial lookback to ensure eligibility for Medicaid community home care.

As a result of this additional renewal of the PHE, there is additional time for seniors and family members to conduct Medicaid planning for community home care. It is now possible to make gifts, transfer assets and utilize other planning techniques, but only if your Medicaid Application is filed before July 1, 2021.

This is a unique opportunity and one that should be taken advantage of if at all possible.

For decades, Medicaid community home care applicants did not have to worry about any kind of lookback period. This changed in 2020, but the Covid-19 pandemic has created a window of opportunity.

We encourage you to contact our office at 516-307-1236 if you or a loved one anticipates filing for community Medicaid or Medicaid home care.

 

 

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Medicare Doesn't Cover Everything

What’s Not Covered by Medicare?

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Medicare provides health insurance for retirees, but it doesn’t cover everything. In fact, there’s a lot that Medicare does not cover, and many of these are health care costs that can consume a nest egg. Here are the top five healthcare costs that should be part of your retirement preparations:

Medicare and Long Term Care Costs

Long Term Care is one of the biggest budget busters for retirees. Long term care can easily cost tens of thousands of dollars a month. Medicare does offer some skilled nursing care coverage, but it’s very limited. If you are eligible, in terms of age, health and finances, buy a long-term care insurance. Sometimes a long-term health insurance policy is folded into a life insurance policy. Talk to your insurance broker—this is something you need, as much as an estate plan.

Alternative or Chiropractic Care

If your healthcare includes alternative or chiropractic care, Medicare is not yet fully evolved to pay for these services. The monthly massage that you know keeps headaches or crippling joint pain at bay is not covered, regardless of how effective it is for your well-being. There are some Medigap or Medicare Advantage plans that do cover specific kinds of alternative therapies, so do your research.

Dental and Oral Health

Medicare does not connect your healthy smile with your overall health. Despite studies that clearly demonstrate the connections between good oral health and overall health, especially cardiovascular health, Medicare is not paying for your dental treatment, unless they are “medically necessary” for you before your physician will allow you to undergo covered procedures.

But in most cases, you have to pay for your own dental care. And if you’ve ever needed a crown or root canal work, you know these procedures can cost several thousand dollars. Best to set aside some assets for dental work.

Glasses and Vision Care

The same goes for vision care. The cost of an eye exam, glasses and contact lenses must be paid by you. There are more options today than there were ten years ago (i.e., online, or big box prescription glasses and contact lenses) but it’s still an expense that you need to cover yourself.

Hearing Aids

Hearing aids are the bane of many retiree’s financial life. They are extremely expensive, and Medicare doesn’t cover the audiology exam that is needed before you can be fitted for them or the devices themselves, some of which can cost as much as $10,000. A federal law was passed in 2017 that directed the U.S. Food and Drug Administration to ease the financial barriers to purchasing a hearing aid, but the self-fitted, less expensive devices don’t work for everyone.