Andrew Ewalt's Law Blog

Nursing Home Alternatives

I had the opportunity to read a rather funny take on alternatives to the nursing home.  I will pass along one I thought was very ingenious.  Let me know what you think. 

"No  Nursing Home for Me"


About 2  years ago my wife and I were on a cruise
through  the western Mediterranean aboard a  Princess
liner.  At dinner we noticed an elderly lady sitting
alone  along the rail of the grand stairway in the main 
dining  room. I also noticed that all the staff, ships
officers,  waiters, busboys, etc., all seemed very
familiar  with this lady.

I asked  our waiter who the lady was, expecting to be
told  that she owned the line,but he said he only knew 
that she  had been on board for the last four cruises,
back to  back.

As we  left the dining room one evening I caught her
eye and  stopped to say hello. We chatted and I said,
"I  understand you've been on this ship for the last 
four  cruises". She replied, "Yes, that's true." I
stated,  "I don't understand" and she replied, without
a pause,  "It's cheaper than a nursing home".

So,  there will be no nursing home in my future. When I 
get old  and feeble, I am going to get on a Princess
Cruise  Ship. The average cost for a nursing home is
$200 per  day. I have checked on reservations at
Princess  and I can get a long term discount and senior
discount  price of $135 per day. That leaves $65 a day
for: 

1.  Gratuities which will only be $10 per day.
2. I  will have as many as 10 meals a day if I can
     waddle  to the restaurant, or I can have room service
     (which  means I can have breakfast in bed every day of
     the  week).
3.  Princess has as many as three swimming pools, a 
      workout  room, free washers and dryers, and shows every
      night. 
4. They  have free toothpaste and razors, and free soap
     and  shampoo.
5. They  will even treat you like a customer, not a
     patient.  An extra $5 worth of tips will have the
     entire  staff scrambling to help you.
6. I  will get to meet new people every 7 or 14 days. 
7. T.V.  broken? Light bulb need changing? Need to have
     the  mattress replaced? No Problem! They will fix
     everything  and apologize for your inconvenience.
8. Clean  sheets and towels every day, and you don't
     even  have to ask for them.
9. If  you fall in the nursing home and break a hip you 
     are on  Medicare; if you fall and break a hip on the
     Princess  ship they will upgrade you to a suite for the
     rest of  your life.

Now hold  on for the best! Do you want to see South
America,  the Panama Canal, Tahiti,  Australia, New

Zealand,  Asia, or name where you want to go? 
Princess  will have a ship ready to go. So don't look
for me  in a nursing home, just call shore to ship.

PS. And  don't forget, when you die, they just dump you
over the  side at no charge.

Long Term Care Insruance

Do you have a plan for your Long Term Care?  Will you end up in a nursing home and outlive or severely deplete your financial resources?  Too often people avoid facing reality of the Long-Term Care threat, avoid taking action while they still can and avoid communicating their Long-Term Care game plan to their loved ones.

The odds of falling prey to Long-Term Care are staggering and the cost can be even more so.  A year in a Connecticut Nursing Home averages more then $90, 000.00.  Unfortunately,  Many Americans hold the mistaken belief that Medicare and Medicare Supplemental Insurance will cover Long-Term Care  but at best, Medicare will only cover a part or all of the first 100 days of care.  The lions share of all Long-Term Care costs is paid out of your own pocket.  Once those assets have been spent down to the applicable poverty level an individual may qualify for Medicaid...a government Long-Term Care program.

Against this backdrop, Long-Term Care Insurance (LTCI) has become one of the fastest growing insurance products in the country. Fortunately LTCI can be designed to fit almost any budget. Most LTCI policies share some common features you should know and should be looking for:

1.  Benefit Amount: How much will the policy pay?

2.  Benefit Triggers:  When will the policy pay benefits?

3.  Inflation Protection:  Will the purchasing power increase?

4.  Level of Care: Are Custodial and Intermediate Care covered, along with Skilled Nursing Care? Is Home Health Care covered?

As with any form of insurance, the policy is only as good as the ability of the insurance company to pay your claim.  Check out the financial strength and reputation of the insurance company and seek competent legal counsel to interpret the contractual provisions of any LTCI policy before you sign on the dotted line.

Will You Lose Your Home If Your Spouse Enters A Nursing Home?

The odds of falling prey to Long-Term Care are staggering. There is a 43% chance that someone age 65 or older will eventually enter a nursing home during his or her lifetime.  On Average most of these nursing home stays will last about 2 1/2 years .  And such care is not cheap. A year in a nursing home can average more than $100,000.00 in Connecticut. Unfortunately, many hold the mistaken belief that Medicare and Medicare Supplemental Insurance will cover their Long-Term Care expenses. At best, Medicare will pay for all or part of the first 100 days of care. That's all.  The lions share of all Long-Term Care cost is paid from the assets of the individuals needing the care.  Because the cost of Long -Term Care can be so Staggering many people are legitimately concerned they will lose everything they have worked so long and so hard to acquire.  What's more troubling is even Medicaid will only begin to help out when an individual has become impoverished meaning an individual only has a net worth of $1,600.00.

However, not all is lost for Connecticut couples facing the prospects of Long-Term Care costs. Medicaid rules also act to protect the spouse living in the community from impoverishment. This means that under the law a community spouse will be able to keep some of his or her assets. In Connecticut a community spouse is allowed to keep among other things the primary residence, an automobile, personal assets and jewelry, household effects and potentially up to more then $100,000.o0 in additional liquid assets. Unfortunate, everything else may be subject to Medicaid spend down requirements.

Hopefully, this information has waylaid your immediate concerns about losing your home and all of your other assets if your spouse needs Long-Term Care in a nursing home. On the other hand, there are many resources that might help increase the total assets that could be preserved. Through the use of a Long-Term Care Insurance Policy or advance planning with the assistance of an elder law attorney, much more, if not all of the couples assets could be protected. Too often people avoid facing the reality of the Long-Term Care threat and avoid taking action while they can still make a difference. Planning in advance is the key to avoiding the devastating effects of the cost of Long-Term Care.

8 Most Common Hospital Billing Errors

I just read a great article (written by Peter Davidson at Bankrate.com) outlining the 8 most common hospital billing errors.  Here is what was found:

1.  Duplicate billing: Make sure you haven't been charged twice for the same service, supplies or medications.

2. Number of days in hospital: Check the dates of your admission and discharge. Were you charged for the discharge day? Most hospitals will charge for admission day, but not for day of discharge.

3. Incorrect room charges: If you were in a semi-private room, make sure you're not being charged for a private.

4. Operating-room time: It is not uncommon for hospitals to bill for more OR time than you actually use. Compare the charge with your anesthesiologist's records.

5.  Up coding:  Hospitals often shift the charge for a lower-cost service or medication to one that's more costly.  For example, the doctor orders a generic drug, but the patient is charged for a pricier brand name.

6.  Keystroke error: A computer operator accidentally hits the wrong key on a keyboard. It can cost you hundreds of dollars and result in an incorrect charge for a service you didn't get.

7.  Canceled work:  Your physician ordered an expensive test, and then canceled it, but you were charged anyway.

8.  Services never rendered:  Did you get every service, treatment and medication for which you are being billed.

If you find errors, contact your provider's billing office and your insurer. If they are of no help and the discrepancies are significant, you may want to turn to trained professionals who will help you analyze the bill and negotiate for you.

Medical Billing Advocates of America (http://www.billadvocates.com/ ) is one of them, or you can try searching the web under "hospital bill review"

But be careful because these firms often work on a contingency basis, meaning they get paid a percentage of the amount they save you. So do your homework and be sure to understand the charges before you put a service to work.

Medicare Part D Benefits Comparison Website

If you are still unsure what benefits are offered through Medicare Part D the National Counsel on Aging offers a great site which provides comparisons between private and government programs, including Part D.  It only takes 10 to 15 minutes.  You can find the site at www.benefitscheckup.com

Medicare Part D Deadline

All seniors receiving Medicare Part A and/or Part B should be considering the new federal prescription drug program called Medicare Part D.  However, the deadline to sign up for the Medicare Part D prescription drug plan is May 15th,  a week from today.  If you currently do not have a prescription drug plan, please consider Medicare Part D.  After the May 15th deadline you will have to pay a penalty in the form of higher premiums for not signing up on time.

Medicaid: Changes In Eligibility Rules

In 2005 Congress passed some the most sweeping changes to Medicaid in history. President Bush signed the bill into law on February 8, 2006.  Here are some of the many changes that will effect future applicants for Medicaid.

1.  Exemption limits on the value of an applicant's home.

2. Restricts the use of annuities.

3.  Changes the look-back period to 60 months (5 years).

4.  Changes the start of the penalty period.

5.  Expands the long term Care "Partnership" program to all 50 states.

Medicare Part D: Prescription Drug Coverage

As the new year (January 1, 2006) approaches Medicare may be able to help pay for certain prescription drugs under a new section of Medicare called Part D.  For those Medicare participants who qualify it will be necessary to sign up for the plan.

It is also important that people understand that not all drugs are covered and there are many different plans to choose from.  If you are a Medicare participants considering Medicare Part D it is very important to begin doing research now.  For this first year only, enrollment in the program begins on November 15, 2005 and goes through May 15, 2006. 

If you are interested in more information about Medicare Part D and other issues related to Medicare, Medicaid and access to health care visit the Center for Medicare Advocacy (a Not- For -Profit organization committed to advocacy and education in these areas). www.medicareadvocacy.org.