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…
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…
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…
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…
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…
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…
Caring for an elderly parent can be stressful for families. Siblings may disagree over how to provide care or where a parent will live, and if these squabbles escalate into a guardianship battle, it can cost the family thousands of dollars. To avoid this, lawyers have begun drafting sibling agreements (also called family care agreements)….
