Long Island’s Signature Elder Law, Special Needs and Estate Planning Law Firm
Medicare – Medicaid
Do we understand the difference?
People are still confused.
Let me make this very clear. Medicare does not pay for Long Term Care (assistance with activities of daily living). Medicaid does but there are strict eligibility rules. Planning for eligibility may be necessary.
My Planning Tip of the Day is:
Have us help you get the coverage you need to pay for long term care.
Hi
I also saw your NY Times Q&A's, and have a comment.
I sometimes work for clients with Long Term Care insurance policies. Often, these types of policies have dollar limits.
One of my husband-wife clients did some research into this, and found that their policy covered care by state-licensed individuals, as well as licensed agencies. This refers to CNA's (like myself).
They looked a little further and found that many other LTC policies, including those offered through the AARP, also have that same provision for reimbursing for use of licensed individuals.
The client simply sent in a reimbursement form, indicating my license number, etc, and they were paid directly. From that payment, they then paid me our negotiated rate -- which was lower than they would have paid through an agency or other corporate provider.
They would not be able to do this with unlicensed caregivers, but since CNA pay rates are usually the same as those paid to unlicensed providers, and considerably less than rates paid to companies offering these services, there was a real opportunity for them to stretch coverage.
That's what's possible, anyway, but I would add some points:
1. Clients should use legitimately licensed, self-employed caregivers (to prevent any possible 'employer liability' issues)
2. Clients should check that the CNA they use has her own malpractice insurance policy
3. Follow the normal safe-guards that would apply to any home care agency or individual
4. Whether considering licensed caregivers or agencies, or nursing or assisted living facilities, clients should ideally educate themselves to indicators of quality of care.
(http://www.aarp.org/community/groups/displayContent.bt?group=InsuranceandMedicare&contentTypeId=4&pageNum=1)
Anyway, by checking into the actual criteria designated in the policies (or in states like Florida, specified by the state) there may be simple and effective ways for clients to stretch their benefit dollars.