Trustees of special needs trusts are increasingly relying on “administrator-managed prepaid debit cards,” such as True Link cards, when disbursing funds to beneficiaries.  These cards offer trust beneficiaries greater independence and the ability to get what they need more quickly.  But such cards existed in a regulatory gray area as far as the Social Security…

How to Appeal a Medicare Prescription Drug Denial

If your Medicare drug plan denies coverage for a drug you need, you don’t have to simply accept it. There are several steps you can take to fight the decision. The insurers offering Medicare drug plans choose the medicines — both brand-name and generic — that they will include in a plan’s “formulary,” the roster…

Are Medicare Advantage Plans Steering Enrollees to Lower-Quality Nursing Homes?

A new study has found that people enrolled in a Medicare Advantage plan were more likely to enter a lower-quality nursing home than were people in traditional Medicare. The study raises questions about whether Medicare Advantage plans are influencing beneficiaries’ decisionmaking when it comes to choosing a nursing home. Medicare Advantage plans, an alternative to…

Long-Term Care Insurance Policyholder Wins Suit Against Company for Hiking Premiums

A long-term care policyholder has successfully sued her insurance company for breach of contract after the company raised her premiums. At age 56, Margery Newman bought a long-term care insurance policy from Metropolitan Life Insurance Company. She chose an option called “Reduced-Pay at 65” in which she paid higher premiums until she reached age 65, when…

Tailoring a Will and Power of Attorney for Multiple States

If you own property — whether houses, bank accounts, or vehicles — in more than one state, do you need estate planning documents for each state? The answer is probably no, but you need to do some planning if you want to avoid going through probate in each of the states. A lawyer can generally draft…

Once a child reaches age 18, it is presumed that she has the ability to make decisions on her own, regardless of her abilities. At this point, many parents of children with special needs who cannot live independently go to court to become the child’s legal guardians so that they can continue to make important…

More state Medicaid agencies are shifting to or considering managed care models to provide long-term care services, sparking a growing backlash from disability and elder rights advocates. Traditionally, state Medicaid agencies paid individual health care providers on a fee-for-service basis. This model has long been criticized as cost-inefficient because it gives providers an incentive to order unnecessary treatments. The…

Supplemental Security Income (SSI) is a federal program that helps people with disabilities and very low incomes pay for food, clothing and shelter. SSI is often confused with Social Security Disability Insurance (SSDI). One of the main differences between the two programs is that SSDI is available to people with disabilities no matter how much…

Managing Medical Bills and Insurance Paperwork

Do you become frustrated and overwhelmed when managing medical bills and filing health insurance claims? Managing and filing insurance claims can be a complex, frustrating, stressful, confusing and time-consuming process, particularly for families who have children with special needs. But, given the high cost of health care today, it is critical that claims be filed…

Long-Term Care Insurance Policies

While long-term care insurance costs are up in general, some policies are going down in 2018, according to the 2018 Long Term Care Insurance Price Index, an annual report from the American Association for Long-Term Care Insurance (AALTCI), an industry group. A married couple who are both 60 years old would pay an average of $3,490 a…

© 2015 MATTHEW L. MERCER | Attorney at Law

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