2016 Medicare Premiums

On Tuesday, November 10, 2015, the Centers for Medicare & Medicaid Services (CMS) announced the 2016 premiums and deductibles for Medicare Parts A & B:

 

• Most people with Medicare Part B will be "held harmless" from any increase in premiums in 2016 and will pay the same monthly premium as last year, which is $104.90.
• Beneficiaries not subject to the "hold harmless" provision will pay $121.80.
• The annual deductible for all Medicare Part B beneficiaries will be $166.00 in 2016.
• The Medicare Part A deductible that beneficiaries pay when admitted to the hospital will be $1,288.00.  The Part A deductible covers beneficiaries' share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.

Resource Assessments

When a married couple apply for Medicaid assistance assets are looked at differently from a single person.  Married couples (well-spouse) can keep up to $119,220 and the applicant $2,000.

In order for these amounts to be allowed a resource assessment needs to be completed by the State workers.  While this seems an easy feat it is not.

A customer does not have to make application for ALTCS/Medicaid benefits to request a resource assessment. However, a first continuous period of institutionalization must be established before a resource assessment can be completed.

This means a medical assessment will have to be completed by the State or if the applicant has been in a community/receiving in home care or other type assistance that can be used to determine what month the State will be looking at to determine how much of the total assets will be assigned to the well-spouse.

Assets owned by either spouse, jointly owned or individually owned will be used to determine the amount to be calculated.

Example:  

The customer and community spouse completed a resource assessment in 3/13. At that time the minimum CSRD was $23,181 and the maximum CSRD was $115,920. Their combined countable resources were $140,000 and the spousal share was $70,000. The couple was notified that they qualified for the CSRD of $70,000. In February 2014 the customer applies for ALTCS, show proof of assets below the $70,000 Community Spouse Resource Deduction and are approved.

Burning bridges

One of the things about being your own boss is that you have to be careful about what you say and do.  No one likes to be offended or ignored.

Most people need something from just about anyone and once you have denied that person the privileged you can forget about getting a good referral from them.

I saw a post on Facebook about a poor gentleman having an accident at as eating establishment inside a dept. store. He was rudely treated by the workers and he probably had Alzheimer's or dementia but most people would not know it and treated him rather rudely.

I do not shop at this store because of their lack of customer service so when I saw this post on Facebook I was not surprised.  Hopefully, someone took action and apologized to this gentleman or family.

Always do your best and act the way you want to be treated. I have found that if you smile, are courteous and honest people respond well to you.

Medicaid applications in AZ

Most people think that when you hire a law firm or elder care specialist they are going to get the application done in no time.

Unfortunately, the State has a mind set of their own and it does not include anyone else.

 Per AHCCCS, MS 1006 states "The application period is 45 days for an ALTCS application.

In some situations, such as a referral made by an AHCCCS Health Plan on a customer who is hospitalized, the case must be treated as a priority and the PAS (medical assessment) must be completed as soon as possible."

While this appears to be set in stone it is not.  An application can take more than 3 months to complete depending on issues such as gifts, Trust reviews, resource assessments, etc...

You also have to consider holidays, vacation time, illness or workers working out in virtual offices.

So the bottom line, yes it is best to have assistance when applying as 73% of those that apply on their own will be denied.  The process will still be long but you will be approved.