With the new year came several important changes affecting seniors and their health care, elder law, and estate planning needs.
Intended to promote innovative treatment options, Medicare Advantage (MA) allows seniors eligible for Medicare to choose their own private health coverage. In 2019, the Trump administration issued new rules affecting the more than 21 million seniors enrolled in MA health plans that now permits the tailoring of available coverage to the specific needs of the patient, especially those with chronic illnesses.
"The old rules were originally created to foster uniformity of the benefits available so as to help ensure all participants would be treated the same by providing the same supplemental benefits at the same cost level," noted Enea, who has spent the past three decades protecting the rights of seniors, the disabled and their families. "Unfortunately, this undermined innovation in care delivery and discouraged patient-centered care. For example, if a patient needed a grab bar in the shower because of a physical infirmity or chronic illness, under the old rules he or she would not be able to receive said benefit due to the 'uniformity' requirement and 'primarily health related' standard, which limited the scope of benefits the plan could offer."
Enea continued, "Under the new rules, a class of persons who all experience a certain disease may be offered a benefit specific to that disease, so long as all other persons in the same class receive the benefit at the same level of cost sharing. Benefits can now be targeted to a patient's health status or disease state and applied to services that are medically related to each disease."
Another change that became effective on
"Since the federal exemption is portable between spouses, on the death of the first spouse the surviving spouse can elect portability and preserve the exemption available to the deceased spouse," explained Enea. "In
Also critical to have in place, says Enea, is a general durable power of attorney that gives the agent greater powers, including the power to create and fund a pooled income trust.
"If an individual applies for Medicaid home care, there is the ability to protect and utilize his or her income above
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