Open enrollment for Medicare D prescription drug plan starts early

Open enrollment for Medicare Part D, the prescription drug plan, and the supplements for Medicare health insurance, and the specialized plans, like the HMO or PPO, begins in OCTOBER 15 and ends on DECEMBER 7.

These plans change every year, some of them drastically! Call your local Area Agency on Aging and find out the location of enrollment events near you. Specially trained staff are on hand to guide you through this very intense and complex scheme of plans. Any other decision you make may be like financial "Russian Roulette!"

For more information, go to this website to find your local AAA and go to this website to find your local SHIP counselor.

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My mom and dad's house is in jeopardy!

The short of a really long story I heard today, and many other days, is this: Mom goes into the nursing home, Dad is home and doing well. The nursing home says that they have to sign a lien on the home over to Medicaid for Dad's care. Is this true?

ANSWER: NO! Unfortunately, the nursing home staff, no matter how well intentioned, are not attorneys, and do not know what those of us who devote many hours of our time researching the legal intricacies that define the long term care planning area. - in fact, most attorneys cannot answer this question with any accuracy - it's simply very complex and highly specialized.

The short answer, without knowing how many other avenues might be available, spouses can ALWAYS transfer property of any kind to the other spouse without any penalty. What many will hear is that: "the spouse can live there with no problem his whole life with the lien on it.". While technically true, let me phrase it like this: "Mr. Smith, would you rather than your heirs receive the equity in your property upon your death, or would you rather give that equity to the state Medicaid agency?". I haven't had one client yet offer the latter.

So, what do you do? Again, with the caveat that there might be better options available, you have Mom transfer her interest in the property to Dad, immediately. Dad can use a power of attorney for this if he holds one for Mom, as could any other person who holds the power. Dad cannot give it away to anyone else, but what he can do is omit Mom in his will. Now, depending upon the state rules, typically the state will require that a portion of Dad's estate be given to Mom under the state's elective share or similar provisions, if Dad does not survive Mom. But, it's certainly an improvement over giving ALL of the equity away.

For those who are wondering if this applies to you, or your parents, you should run, and not walk, to the office of your local Elder Law attorney. Good Luck!


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Stuck in your Medicare HMO or Advantage Plan? February 14, 2011 deadline!

Just a quick note for seniors who are in a Medicare Advantage plan (a plan that is NOT traditional Medicare and a supplement) like an HMO or PPO, have until February 14, 2011 to disenroll and rejoin original Medicare and get a supplement and stand alone drug plan.  Consult your local State Health Insurance Program (SHIP) counselor to find out if you can switch, and make sure you know your options.  You should do this right now in order to protect your rights.  The SHIP program operates under a grant from the federal government, and is an all volunteer organization of experts who can assist you with making a decision without any bias.  Please contact your SHIP counselor  today or call 1-800-MEDICARE.

Help! My parents can't take care of themselves! What do I do?

'Tis the season, unfortunately.  I know that the holidays are a busy time for me!  Often, parents do not want to worry their children so the first sign of trouble tends to come up during holiday visits.  The first thing to do is an assessment - almost like medical triage.  Do either of them need immediate medical help?  If so, then visit their primary physician if possible or the emergency room or urgent care facility if it is a holiday or weekend.  If hospitalization is not necessary, continue with the assessment.  Continue with health issues, and try to gather as much information as possible, including names and phone numbers of physicians, dates of treatment, types and dosages of medicines prescribed.  Get your parents to sign a release for each doctor so you can talk directly to the staff and get medical records.  Gather all insurance information.  If they are underinsured, call for an appointment to a SHIP counselor, which is free Medicare counseling, to see what their options might be.  Make sure you have the ability to assist them, by getting a durable power of attorney executed for each of them and if appropriate, a health care power of attorney and living will.  Find out as much financial information you can, including bank accounts, types and amounts of insurance, debts owed, sources and amounts of income, location of assets, etc.  Find out if their bills are current.  It is not unusual for people who are suffering from adverse health consequences to forget to pay utility bills, even if they have plenty of money in the bank.

Next, have a family conference.  Lay out the information you have gathered and request ideas and assistance.  Make all family members equally responsible by assigning duties if necessary.  This is a crucial part of the care, as hard feelings may drive family members away.  Finally, meet with an elder care attorney to go over potential care plans and financial plans.  Call your Area Agency on Aging to find the best attorney to assist you and your family at 1-800-677-1116.

No, really, he seems like an honest insurance salesman...Public Service Announcement

Its open enrollment season for Medicare, boys and girls and yes...that nice guy at the door isn't selling vacuum cleaners anymore...  My favorite question today at work was:  "is it ok for me to sign up with the HMO before I talk to you next week?"  NO!  If you simply remember this one line, you'll be ok:  "If I didn't ask for it, I shouldn't buy it."   It has become open season on seniors and their wallets. 

Medicare plans have become so complex that you need to seek expert advice.  The insurance salesman is an expert..on his own plan.  He also gets a free trip to Vegas if he books enough, etc.  So...here are some resources for you if you are on Medicare and either have or need a supplement that is not through your retirement or have or need a prescription drug plan that is not through your retirement:

First, ask a SHIP counselor.  Its the State Health Insurance Program and the federal government underwrites this free, all-volunteer powerhouse who are specially trained to help you pick the best plan. And they don't have a stake in it, they will continue to not get paid no matter who you pick.  Go to ShipTalk.org to find your local counselor and set up an appointment.

Next, if you are somewhat tech savvy, go to Medicare.gov and try to compare plans yourself.  Since you don't get specialized training on the latest changes in the plans, which change all the time, you are doing this at your peril. 

You only have until December 31 to pick a new drug plan, or to get on a Medicare Advantage program with a drug plan, or else you get to wait until next October to check plans again.  Keep in mind that each year, the insurance companies are monitoring what they spend and adjusting their premiums and coverage accordingly.  A number of these plans have made major changes, so don't assume that your plan was great this year so it will be next year. 

Run, now, to a SHIP counselor near you!

My wife is going in a nursing home. Do I have to divorce her so we don't lose everything?

Not a fun topic, but a question that comes up frequently.  I'm sorry that you're going through such a tough time.  If it is a long term marriage, the answer is probably not, since the outcome may be better to stay together.  Alabama Medicaid requires that the divorce be equitable in this case, so it would simply result in a property division, with the nursing home spouse having to spend theirs on the nursing home.  In most cases, the long term couple will be better off following rules for couples.  The spouse at home (community spouse) can keep all of their income or, if the spouse in the nursing home (institutionalized spouse) has the higher income and the community spouse has much less, often a portion of the institutionalized spouse's income is diverted to the community spouse each month, up to a certain amount.  The community spouse can keep the home, and should have the institutionalized spouse's portion transferred to himself in this case.  The community spouse can also keep at least $25,000.00 in assets.  If the assets are more than $50,000.00, but less than $219,020.00, then those assets are split, with one half paid for nursing home care, and the community spouse retaining the other half. 

For those in a second or later in life short term marriage, if the community spouse brought in an overwhelmingly larger amount of assets to the marriage, then divorce might be an option to preserve them.  All people contemplating a later in life marriage should have a prenuptial agreement in place for this very reason. 

I hope you don't have to go this route, but its certainly something older couples should think about ahead of time, and do some disability planning to avoid an emotionally upsetting and expensive venture into domestic court.  Call an elder law attorney in your area to see how your state handles this issue, and keep in mind that many states will have different laws and rules governing these problems, but community property states will handle this issue quite differently.   Go here to find your local Area Agency on Aging, who should be able to get you in touch with an experienced elder law attorney.

Good luck and thank you for your question! 

My mother has been diagnosed with Alzheimer's disease and the doctor says we need to get a power of attorney. How can we do that? Will it make me responsible for her bills?

Thanks for your question and I'm sorry to hear of your mother's diagnosis.  I'm not sure from your question what your mother's present state of mind is -- whether or not she would be competent to sign a power of attorney.  I would get your doctor to state in writing his opinion about her competence right away.  If she is not competent, or for whatever reason she will not sign a power of attorney, then you may need to go to court to get a guardianship established.

A durable power of attorney would give you the ability to handle your mother's affairs for her, such as paying bills, obtaining documentation from her bank or pension company, or sign documents such as a deed, mortgage, tax return or other paper that requires her signature.  It is "durable" because it will still be valid if she loses competency at a later date.  To answer your last question, no, you are not responsible for bills personally that you sign for using your mother's power of attorney.  In fact, the power of attorney would prevent you from having to possibly be a guarantor at an assisted living facility or independent living home, etc., since you are signing her name.

To obtain a power of attorney, call an attorney, preferably one who specializes in handling senior issues, or at least someone who handles wills and trusts, as they should be knowledgeable about your state's laws regarding the language required for the durable power of attorney.  A good resource is your local Area Agency on Aging, who should have a contract with a local elder law attorney who can provide a durable power of attorney for free.  If you are unsure who to call, you can go to this website to find area agencies on aging.

Thanks for your question!  I hope this helps.