Elder Law

Medicare Coverage for Mental Health Treatment

Published on: September 26, 2018 | by Ettinger Law Firm

Medicare helps seniors pay for a whole host of mental health treatment services, including both inpatient and outpatient treatment services to help diagnose and treat mental health conditions. Depending on the type of care needed, beneficiaries may incur some out of pocket costs, including deductibles, and are subject to some limitations on the length of treatment you can receive at in patient centers.

Medicare Part A will cover inpatient mental health services at either a psychiatric hospital or a general hospital, depending on the type of care determined by the primary care doctor. Medicare will cover up to 190-days of treatment at a psychiatric hospital during a person’s lifetime and may cover additional inpatient care at a general hospital if necessary.

When receiving inpatient care with Medicare Part A, beneficiaries will need to pay an out of pocket deductible before they enter the facility. As of 2018, that cost is estimated to be $1,340. After paying the deductible, Medicare Part A will pay the first 60-days of inpatient treatment in full. The next 30-days require the patient pay a daily co-insurance of $355 and the remaining 90-days require a daily co-insurance of $670.

Creating a Living Trust While Your Home Has a Due on Sale Clause

Published on: September 20, 2018 | by Ettinger Law Firm

Creating a living trust is one common way individuals plan their estates and keep valuable assets like homes and other real estate out of the costly and timely probate process. For individuals own their home outright, a living or revocable trust is an easy way to instantly pass on a home but if there a mortgage or another lien on the property there may be a “due on sale” clause that requires the debtor to pay the lender immediately.

Typically, a due on sale clause is understood that the debtor must pay the bank the balance of a mortgage when the home is sold or otherwise transferred. While placing a home into a living trust is technically transferring the home from one owner to another, an important piece of legislation called the Garn-St. Germain Act allows individuals to transfer a personal residence to make “a transfer into an inter vivos (also known as “living”) trust in which the borrower is and remains a beneficiary and which does not relate to a transfer of rights of occupancy in the property.”

The exemption for due on sale clauses for these transfer rules allows the property to be placed into a revocable living trust so long as the loan is on residential properties containing less than five dwelling units. For New Yorkers, this is important because it can include homes such as a duplex, triplex, fourplex or even a coop and not just single family houses. So long as there is no change in occupancy to the estate, that is the person creating the trust stays in the home, the due on sale clause can not be enforced.

Look Out for the Signs of Elder Abuse

Published on: September 18, 2018 | by Ettinger Law Firm

Elder abuse occurs all too often and comes in many forms. While it may seem unfathomable, abusers can be the ones we rely on the most to take care of our beloved elders during the time in their adult lives in which they may be the most vulnerable. Although nothing can be done to undo the harm caused by elder abuse, family members can look out for the signs of its effects to immediately recognize and end the abuse.

According to statistics from 2011, over 260,000 older adults in New York State suffered from some type of elder abuse in just that year alone. In 2016, the state Office of Child and Family Services released a study that estimated financial exploitation of elders in New York costs a total of $1.5 billion a year. Another study looking into the issue estimated the national cost of elder abuse and exploitation at $36.5 billion per year.

For whatever reason, only an estimated one in 22 instances of elder abuse is reported. Many experts believe that one main reason may be this as many as nine in 10 times, that abuse is committed by family member and the victim may not want any legal or familial trouble for someone they otherwise love and care for. No matter the situation, family members need to convey to their elders that revealing the abuse is the way to end it.

CMS Expands Grace Period for Medicare Late Enrollments

Published on: July 25, 2018 | by Ettinger Law Firm

The Centers for Medicare and Medicaid Studies recently announced it has extended its grace period to remove or reduce financial penalties for those late to switching their insurance from plans on the Affordable Care Act (ACA) to Medicare. As a result of moving the deadline, seniors and those on disability now have until September 30, 2018 to switch over from their ACA marketplace insurance plans to Medicare without having to pay increased Medicare premiums or reimburse the federal government for ACA subsidies.

For most Americans, Medicare eligibility begins at age 65 and are automatically signed up if already receiving Social Security benefits but not if the individual is already receiving health insurance through their job or spouse’s employment. If neither of these scenarios apply, individuals need to enroll in Medicare within six-months (three-months before or after) turning 65-years old.

Failing to enroll in Medicare in a timely manner can lead to very expensive penalties including increases to Medicare Part B premiums as much as 10 percent for each full 12-month period the individual should have been enrolled. The Medicare Rights Center (MRC), a nonprofit consumer service organization that works to ensure access to affordable health care for older adults, estimates that if someone turned 65 in 2010 and delayed signing up for Medicare until 2018, premiums would be $227, which is 70 percent higher than the base Part B premium of $134.

New Jersey Congressman Introduces Proposal for Medicare Long Term Care Insurance Benefit

Published on: July 20, 2018 | by Ettinger Law Firm

Ranking Democratic member of the House Energy and Commerce Committee Frank Pallone, Jr. of New Jersey recently introduced a new proposal aimed at tackling the rising costs of long term health care insurance to give seniors a better life. Under the current system, Medicare only covers very limited long-term care and support for seniors until a senior eventually qualifies for the Medicaid program after they have depleted all of their financial resources.

If adopted, the The Medicare Long-Term Care Services and Supports Act would enact multiple measures to help seniors get the care they need without depleting their finances. Among other things, The Act would includes incentives for people to seek care at home and give much needed relief to overburdened family caregivers by compensating these individuals for lost income other retirement benefits, and career opportunities if they have to cut back on work hours or leave the workforce.

The Act would establish a standard cash benefit within Medicare for anyone who is eligible for Medicare and those under the age of 65-years old who meet certain disability thresholds and begin after a two-year waiting period that functions as a deductible. The proposed legislation would allow individuals to use their self-directed benefits towards all long-term services and supports, including nursing facility care, adult daycare programs, home health aide services, personal care services, transportation, and assistance provided by a family caregiver.

Anthony Bourdain Leaves Bulk of Estate to Daughter but Wife Could Contest

Published on: July 16, 2018 | by Ettinger Law Firm

According to reports, celebrity chef Anthony Bourdain has left the bulk of his $1.2 million estate to his young daughter, which will be placed into a trust that will make two payouts over her lifetime. Bourdain’s estranged wife, on the other hand, was named executor to the estate will receive his personal effects including furniture, cars, books, and even his frequent flier miles which could be quite valuable given the deceased’s career as a professional traveller.

Documents filed with the Manhattan Surrogate’s Court indicate Bourdain’s estate was worth $1.21 million, including $425,000 in savings, $35,000 in brokerage money, $250,000 in personal property and $500,000 in “intangible property” which includes royalties. Media outlets report that Bourdain’s 11-year-old daughter is the primary beneficiary of his trust which will distribute assets when she is 25 and 30, and disperse the remaining balance when she turns 35 years old.

Establishing trusts for minors is a very common practice in estate planning as it is meant to these young persons do not become overwhelmed by receiving an inheritance all at once, which could lead to financial mismanagement. In the meantime, a guardian appointed by the Surrogate Court will safeguard the younger Bourdain’s estate until the final payouts are made. While all this may seem straightforward, experts reviewing Bourdain’s estate situation believe it may be subject to complications, including potential challengers by the spouse.

New York End-of-Life Agency Allows Refusal of Food and Water Directive

Published on: May 24, 2018 | by Ettinger Law Firm

Recently, the board for End Of Life Choices New York approved an aggressive new document that would allow individuals to stipulate in advance that they may refuse food and water should they develop dementia at some point. The goal of the directive is to allow individuals to speed up their death in late-stage dementia, if they so choose.

Despite being considered a terminal illness, states that already have end of life directives in place do not have laws that cover the condition, putting the new policy into uncharted ethical waters that have not been explored. The move comes as patients across New York and the rest of the country seek alternative options to address the very real possibility that they may become incapacitated with a severely debilitating condition.

The new document would allow patients one of two options should they find themselves in an assisted living situation with dementia. The first would allow patients to accept so-called comfort feeding by providing oral food and water if they patient appears willing to accept the nourishment. The second, would stipulate that the patient would receive no food or water, even if he or she appears to accept the feedings during the final stages of dementia.

HHS Secretary Asks Former CVS Executive to Help Agency Lower Drug Prices

Published on: May 20, 2018 | by Ettinger Law Firm

Health and Human Services Secretary Alex Azar recently tapped former CVS executive Daniel Best to lead the agency’s effort to help lower drug prices for millions of Americans on Medicare coverage. Best was most recently a vice president of industry relations for the company’s Medicare Part D business and included CVS’s prescription drug plans, Medicare Part D plans and other clients.

“Daniel Best recognizes what President Trump and I, and every American know: prescription drug prices are too high,” Azar said in a statement announcing the appointment. “He has the deep experience necessary to design and enact reforms to lower the price of medicines that help Americans live healthier and longer lives.”

At a March 19 speech in Manchester, New Hampshire, President Donald Trump reaffirmed his pledge to lower prescription drug prices. “If you compare our drug prices to other countries in the world, in some cases it’s many times higher for the exact same pill or whatever it is, in the exact same package made in the exact same plant,” President Trump said during the speech. “We’re going to change that.”

CMS Issues New ID Cards, Announces Increased Payments to Private Plans

Published on: May 17, 2018 | by Ettinger Law Firm

The Centers for Medicare and Medicaid Studies (CMS) recently made a pair of announcements regarding changes to some of the important services the agency offers to millions of seniors across the country. Both of which aim to improve customer experience for CMS enrollees and help combat the threat of identity theft against those seeking vital medical treatments paid for in part by the federal government.

To help protect seniors from identity theft, CMS has begun phasing in new Medicare cards that no longer display enrollees’ Social Security numbers. Pennsylvania residents will be among the first to receive the new cards that assign each person a randomly generated eleven-digit number.

Social Security numbers are vital for accessing key financial information, medical records, and legal documents and should a Medicare enrollee’s card fall into the wrong hands, it could result in a serious case of identity theft. The new cards are tied directly to existing accounts so those who receive the new cards will have all their medical information will still be available with their doctors.

Connecticut Man’s Challenge to Still Living Father’s Estate Fails

Published on: May 14, 2018 | by Ettinger Law Firm

A federal court in Connecticut recently dismissed a lawsuit brought by a Connecticut man who felt jilted after being excluded from his still-living father’s estate on the grounds the plaintiff had yet to suffer any actual injury. The case is a cautionary tale for both testators and heirs in situations where familial tensions can manifest themselves into lengthy and expensive court battles that may end up doing little to resolve tensions.

The petitioner in this case filed suit against his father, sisters, and PNC Bank which was acting as the trustee to the father’s living trust. The petitioner alleged his sister, who was acting as the testator’s health care proxy and using a general power of attorney to make financial decisions, asserted undue influence on the testator to exclude him from the estate.

Unfortunately for the plaintiff in the case, the federal judge ruled that his lawsuit failed to live up to the basic principles of when and why courts can hear cases. The judge determined that because the plaintiff’s father was still living and he had yet to be excluded from any expected inheritance, the testator’s last will and testament could not be invalidated as of yet.