Aug 03, 2015
By estate planning and elder law attorney Rick Law of the Estate Planning Center at Law Elder Law, located in Aurora, IL.
One problem commonly encountered when someone needs to apply for nursing home Medicaid assistance is that many people have not signed up for Medicare Part D at its inception. It’s often the case that the cost of the insurance was more than they were paying for drugs at the time. There was a specific enrollment period and many people simply did not enroll.
A nursing home resident who is applying for Medicaid must have a Medicare Part D plan in order to have their pharmacy costs covered. There is open enrollment to a nursing home resident, but the family must work with a social worker or go to the Medicare website and enroll the resident. Copayments, deductibles, and the infamous “donut hole” are waived when the individual is dual eligible—enrolled in both Medicare and Medicaid.
So do people who have not yet enrolled in a Medicare Part D plan need to do so if they are applying to receive Medicaid benefits for nursing home costs? Not so fast. If they did not enroll in Medicare Part D because they have insurance coverage as part of their pension plan and drug coverage is part of their supplemental coverage through that plan, this can cause a very interesting dilemma.
If they applied for a Medicare Part D plan, the insurance company would discontinue all coverage under the pension plan. In several instances, the nursing home resident was the husband, and if he enrolled in a Medicare Part D Plan, the company was not only dropping him from coverage, his wife would lose her insurance coverage as well. This can happen under very good insurance plans from reputable companies.
So what are the options? Don’t enroll in Medicare Part D and just continue to use the pension plan and pay copays and deductibles? Drop the insurance and buy Medicare supplement plans along with the drug plans for both husband and wife? Neither seems very appealing. However, for those who chose option one, they could deduct any amount they paid for the drugs from whatever they were contributing from the income portion. Problem solved? Maybe, but what if they didn’t have any income contribution? Each family’s situation is different and it is important to be able to discuss options with a qualified Elder Law attorney.
Too many families needlessly lose everything they have. Don’t let that be you. If you need help paying the overwhelming cost of long term care, give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now, because when you’re out of money, you’re out of options!
Rick L. Law, Attorney, Estate Planner for Retirees.
Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!
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