Archive for the ‘Health Care’ Category

Quick Long-Term Care Planning Calculator

Thursday, December 23rd, 2010

The following link, from the U. S. Department of Health and Human Services, is a very useful tool  for assessing your financial capacity to cover the cost of long-term care.

U.S. Dept of Health & Human Services Calculator

It calculates the projected cost of long-term care (using your selected state’s average costs) and compares this to your projected savings. This gives you a ballpark number of the critical gap between the cost of long term care and what you are able to fund yourself.

This is of course, a preliminary first step in planning for your long term care needs. If you have a “sizeable” financial gap, you need to explore other options available to you, BEFORE you enter into what is called a “crisis planning” mode. You need to talk to an Elder Law Attorney who specializes in Long-term Care Planning, and who also has expertise in utilizing public programs such as Medi-Cal (Medicaid) benefits, and the Veteran’s administration Aid and Attendance Program.

Here at the California Elder Law Center, we specialize in helping seniors finding money to pay for their long-term care needs. So if you live in the Palm Springs area (Coachella Valley) or in the greater Los Angeles area, don’t hesitate to call us and make an appointment to discuss you own situation. Our toll free number is (888) 500-6700.

Medicare Scams: Watch Out!

Thursday, December 16th, 2010

This the second video on Medicare fraud. It’s an excellent intro on the types of scams created by the bad guys.

Preventing Medicare Fraud

Friday, December 10th, 2010

This a great video about health care fraud from SMP, and how to avoid being victimized…

7 Simple Tips to Prevent Medicare Fraud

Friday, December 3rd, 2010

In the previous post, we alerted you about the possible dangers relating to Medicare fraud, and how that can seriously impact the care you need, when you need it…

Here are some practical tips that can help prevent a disaster for you or your loved ones.

1) Protect your Medicare card, like you would a credit card of Social Security card. Do not ever give your Medicare  number when talking to someone you don’t know over the phone. Any kind of stranger who asks for your Medicare number is suspect — even if they claim to be conducting a government-sponsored health care survey.

2) Never allow a friend or relative to use your card. They may be trustworthy, but your number can be stolen from them. And of course, should you lose your card, you should report it immediately. Time is of the essence.

3) Never accept offers for medical equipment, supplies, or services that you do not need – or that you are already currently using. For example, you or loved one might be receiving dialysis treatment and be approached by someone offering “free supplies.” If you unwittingly give that person access to your name, address, and Medicare information, you may indeed receive these “gifts” and have Medicare  fraudulently billed without you knowing. When this happens, report it immediately.

4) Do not give your insurance information to anyone offering a free medical service. They do not need your insurance information (except of course to scam you by harvesting your Medicare number to commit fraud on your account!)

5) Check your Medicare statements regularly.  Review them carefully (just like you would check your credit card bill). Be on the lookout for suspicious charges — for example, bogus charges for doctor visits that didn’t occur, provider names that you don’t know, or any equipment or supplies that you have never received. Check with you physician or health provider first, just to rule out honest mistakes in billing or accounting. If you have an “unexplained,” suspicious entry, report it immediately.

6) Keep a log of your doctors visits and other medical services you receive, so that way you can check it against your statements. Buy a 50 cent spiral notebook and write this information down (see tip number 5).

6) Be careful of enrollment periods — this is the time when criminals victimize seniors by peddling bogus prescription plans. Sometimes these swindlers offer products and services that aren’t even covered by Medicare, to entice the unsuspecting senior. Go check out this link to see if the insurance plan you are considering is legitimate. If they are not listed here, be specially wary. Investigate further.

7) Review you credit reports regularly. If you find out that you have unpaid medical bills, that may very well be a result of a fraudulent transaction billed to your name.

Write the following phone  number down, and tape it on your refrigerator. This is the number you need to call if you suspect or encounter fraudulent activity:

(1-800-447-8477) or 1-800-HHS-TIPS

Their email is HHSTips@hhs.gov

In addition, you can go this link to find the Senior Medicare Patrol in your state (which is part of the State Health Insurance Counseling and Assistance Program.)

Beware of Medicare Fraud!

Monday, November 29th, 2010

Last October,  more than 40 members of a crime syndicate were arrested and charged in an extensive Medicare fraud case. The suspects stole the identities of thousands of physicians and patients, and used these information at more than 100 fake health clinics in 25 states to bill Medicare for more than $100 million. In another case, a Miami mental health organization was charged with filing $200 million fake claims for therapy sessions.

These are the large scale scams that make the news.

However, there is a lot of fraud happening below the radar, so to speak, that can affect us directly.

For example, criminals often offer unsuspecting patients medical equipment and supplies they don’t even need, or even qualify for, to collect Medicare information. These swindlers then bill for other supplies and services the patients never received and pocket the reimbursements. Sometimes they even offer “free services” like cholesterol screening or diabetes check-ups, to get Medicare numbers. Though seniors trapped in these criminal set-ups rarely face financial liability, the fact is their medical records get compromised. This can negatively affect their health benefits in the future, without them even knowing that something bad has happened to their file.

For example, one senior needed a wheelchair, but was denied one by Medicare.  Her records indicated that she already had a wheelchair for the last five years. In fact, the individual’s Medicare number had been already compromised — and she didn’t even know when it happened!

Sometimes, Medicare recipients apply for long-term care, and their application gets denied due to that fact that their medical records are full of bogus tests and medical treatments. This affects not only these individuals directly in need of these services, but also the rest of the population. Fraud raises premiums. Also, whenever there are “crackdowns” to assuage the public about the rising incidence of these scams, it makes it extra difficult for people with true medical needs to apply for the care they require and deserve.

In our next post, we will cover some practical steps you can take to prevent these kinds of  abuse…

Key Facts on Alzheimer’s Disease

Friday, November 12th, 2010

As Elder Law attorneys, we are witness to the painful and ravaging impacts of this disease.

A  2009 report from the University of California  projected a dramatic rise in the number of Alzheimer’s cases in the state. A task force has been formed  to develop a plan on how California can best respond to an impending Alzheimer’s epidemic.

Joshua Chodosh, a UCLA geriatrician who researches dementia and health services utilization, was named co-chair of the state’s Alzheimer’s disease plan task force, which will present its findings to the state in early 2011.

“As the baby boomer generation ages and as people live longer, Alzheimer’s disease has become an urgent issue,” said Patrick Fox, co-director of the UCSF Institute for Health and Aging and an author of the report.

He noted that among California’s baby boomers age 55 and older, one in eight will develop Alzheimer’s.

Here are the key findings from UCSF’s Institute for Health and Aging report for the Alzheimer’s Association:

• The number of people in California with Alzheimer’s will nearly double from 588,000 today to nearly 1.1 million by 2030.

• One-tenth of the nation’s Alzheimer’s patients reside in this state.

• The number of California’s Latinos and Asians living with the disease will triple by 2030, and the number of African Americans will double.

• The annual cost for caring for Californians with the disease could soar to nearly $100 billion in the next 20 years.

• Some 1.1 million Californians today take care of people with Alzheimer’s. Three-fourths of these caregivers are family members.

• Alzheimer’s is now the sixth leading cause of death in the state.

You can go to this link to the University of California article that discusses the scientific inroads to Alzheimer’s diagnosis.

Basic Planning Steps for Seniors

Friday, November 5th, 2010

We all know that long-term care can be very expensive. Many of us will be surprised to learn that Medicare and most health insurance plans, including Medigap policies (Medicare supplemental insurance), do not cover long-term care. State Medicaid (Medi-Cal in California) cover some long-term care services only for people who have a low income and few resources.

Costs for a nursing home averages to more than $6,000 a month, which means that it can cost seniors upwards of $70,000 a year out-of-pocket. People who receive long-term care services at home spend can be spending more than $1,600 per month.

Some seniors can cover the long-term care they need in the future with long-term care insurance, savings plan annuities, certain life insurance policies, and reverse mortgages. The optimum solution really depends on one’s personal finances and family situation. Planning for disability or incapacity is something that we can’t afford not to do.

There are basic steps every one can take to start thinking about how to provide for health care as we all age:

1. Estimate how much of the cost of long-term care you could afford on your own.

2. Talk with you independent financial planner for more information about your financial situation.

3. Ask your current or former employer if you are eligible for group long-term insurance, savings plan annuities, or similar long-term care benefits.

4. Do some research and learn about long-term care insurance, trusts, annuities, reverse mortgage or other options for financing long-term care needs.

5. Call your local Area Agency on Aging to finds out about other programs that might help pay for long-term care. Look under “aging” or “Human Services” in the local government blue pages of the phone book for the number. You can also call 1-800-677-1116, which is the toll-free information line for the Eldercare Locator. (This is a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.)

6.  If you have low income, you may qualify for Medicaid (or Med-Cal in California). If you live in California, you can go to the Department of Health Care Services Medi-Cal page to get more information about the program.

7. Last but not the least, if you happen to live in Southern California, you can call the Cal Elder Law office to make an appointment for a consultation: (562) 920-6100. As elder law attorneys, our expertise is in helping seniors plan for their their long-term care needs, at the same time protecting their hard-earned savings and assets.

Planning for Long-Term Care

Friday, October 29th, 2010

Planning for long-term care helps identify what service options are available in your community, as well as what special conditions may apply for receiving services (e.g., age, cost, payment options). Obtaining this information is good preparation for the time when a person will be needing long-term care. It will help you understand what choices you have, and control over what, where, and how you receive the services you will need.

About 70 percent of people over the age of 65 require some services. The likelihood of needing care increases as we age. Planning is critical because the cost of long-term care services often exceeds what the average person can pay from income and other resources. If you plan ahead, you may be able to save your assets and income for uses other than long-term care.

With effective planning, there is of course greater likelihood of being able to preserve your estate for your loved ones, by minimizing the costs of paying for long-term care. It also translates to less financial stress and emotional wear-and-tear on you and your family. The chances of being able to stay at home as long as possible and within your community will be much greater. Most importantly, it helps ensure a greater degree of independence if and when you need care.

Despite the importance of planning, a lot of people fail to do so. There are many reasons for this shortcoming. People have a natural tendency to avoid thinking of unpleasant things, of being dependent on others as we age. We don’t like to think about getting older, being disabled, becoming less independent, or needing help with our own personal care. There is also a lot of existing misinformation about long-term care needs, as well as their costs and payment options associated with these services.

For example, most people have no idea how expensive long-term care can be, and how it is paid. Many seniors don’t realize that health insurance, Medicare, and/or disability coverage do not pay for most long-term care services. Medicaid (Medi-Cal) pays for some long-term care services, but only if one qualifies due to income  and financial resource limitations.

Planning for long-term care is a difficult subject of conversation in most families. Adult children may hesitate to bring up the subject, for fear that they may be patronizing their parents. They may think that their eagerness to bring up this topic may be misconstrued as not wanting to provide care for their parents “when the time comes.” Parents may not want discuss the details of their financial life with their children. It may also be as simple as not knowing how to go about the planning process itself.

In future posts, we will talk about some of the key information and resources you need to know in order to plan ahead…

New Regulation to Aid Vietnam Vets Exposed to Agent Orange

Thursday, September 2nd, 2010

This past Tuesday (August 31) the VA published its final regulation related to Vietnam vets exposed to Agent Orange. This means that Parkinson’s disease, ischemic heart condition, and B-cell leukemias are now classified as service-connected disabilities. The reg gives a 100% disability rating for Parkinson’s, as well as retroactive veteran and survivor payments for qualifyings vets.

This means that if a vet served in Vietnam between January 9, 1962 to May 7, 1975, and has been diagnosed with Parkinson’s disease, they are presumed to have been exposed to toxic chemicals. They no longer have to prove that a connection between their disease and their military service. This speeds up the application process for disability compensation.

More than 150,000 Veterans are expected to submit Agent Orange claims in the next 12 to 18 months, many of whom are potentially eligible for retroactive disability payments based on past claims.  Additionally, VA will review approximately 90,000 previously denied claims by Vietnam Veterans for service connection for these conditions.  All those awarded service-connection who are not currently eligible for enrollment into the VA healthcare system will become eligible. For pending claims and claims prviously denied, the VA may pay benefits retroactive to the date it received the claim.

Please note that even though the final regulation is published, it is still subject to a 60-day review period by Congress before the VA can begin paying benefits for new claims. The Senate Veterans Affairs Committee is scheduled to hold a hearing on September 23 to review the rule.

You can find out more about this issue from the VA’s Office of Public Health and Environmental Hazards.

You can click here to reach the Agent Orange Disability Compensation page.

Fight for Your Right to Choose Life-Sustaining Treatments!

Tuesday, August 24th, 2010

Long-term health care planning is a dodgy process in that you must stand firm about how you expect to be cared for in the event of your incapacitation or inability to make critical medical decisions. This process helps people think about the kind of care they wish to receive should you need a spouse, loved one or friend to make these life and death decisions for you. In California, a Power of Attorney for Health Care, also referred to as PACH, is the legal document that allows patients to choose who will speak for them should they become unable to speak for themselves.

Sadly, a health care provider who confronts an emergency situation may lack the time and opportunity to communicate with a terminally ill patient’s chosen representative. For this reason, California law permits treating physicians to confer with their patients to define acceptable types of life-sustaining treatment should a medical decision involving issues of life support arise.

The Physician Orders for Life-Sustaining Treatment, or POLST, converts the patient’s wishes regarding life support into a formal medical order. To make sure that the order has full force and effect the POLST must:

  • Be completed by a health care provider based on the patient’s preferences and medical indications
  • Be signed by the treating physician and either the patient or the patient’s legally recognized health care decision maker
  • Be prepared on a brightly colored pink form that is easily recognized by emergency care providers and hospital staff
  • Be filed on the first page of the patient’s medical file and transferred with that file to all future health care providers.

Doctors are required by law to honor the preferences of those patients who have chosen to use this legal document as a guideline that defines appropriate future care. However, the POLST may be changed or even revoked by the physician, patient, or patient’s health care decision maker at any time should the circumstances warrant it.

Do you feel prepared for this type of emergency medical decision-making? If not, contact a qualified Elder Law attorney who can walk you through the process of preparing for this type of situation and avoiding medical mistakes that may  mean the difference between life and death.