When you go into a nursing home and want Medicaid to pay the bill, you must be below the governments asset thresholds. Unfortunately, you essentially must go broke before the government will help pay for your care.  When someone with assets goes into a nursing home, they must pay privately for care or take other legitimate actions to get the countable assets low enough for eligibility. The process of decreasing assets to become eligible for benefits is called Medicaid Spend Down. This is not a Do-It-Yourself project.Unfortunately, the Medicaid eligibility rules are extremely complex. Many families make mistakes during this process and end up losing their hard-earned assets. Other families are too fearful to take any action at all. They simply use up all their resources on care.The proper approach is to get competent legal advice on what steps a Medicaid applicant is allowed to take according to the rules. Simply stated, if you follow Medicaids rules, there may be legitimate strategies to protect assets. If you break their rules it will cost your family substantial funds.Certified Elder Law Attorneys can help your family understand the governments rules. Perhaps more importantly, they also know some exceptions to the rules. A good elder law attorney guides you through the spend down process and helps you file the Medicaid application. Then, if necessary, the attorney will contend with Medicaid on your behalf.If you have a loved one paying privately for a nursing home, give us a call at (724) 564-6615.

When signing up for Medicare, some people have other insurance, such as coverage from a current employer, or retirees or military insurance. Beneficiaries of Original Medicare or Medicare Advantage may keep their additional coverage, as the providers work together to bear health care costs.Can You Have Medicare and Private Insurance?People may have Medicare and other insurance simultaneously for several reasons. Some Medicare enrollees have retiree health coverage through their (or a spouses) former employer.Others remain in the workforce past 65 and are on employer-backed insurance or are enrolled in their working spouses insurance.Younger people with disabilities can receive Medicare coverage while also on their employers insurance.Active and retired service members and their families can get health coverage through Tricare while also enrolled in Medicare.Qualifying individuals with limited income and resources can obtain Medicare and Medicaid coverage at the same time. This is called being dually eligible.Allocating Coverage People with more than one insurance provider may receive more coverage, as the providers allocate costs. Depending on the situation, Medicare might be the primary payer, or the other insurance provider may act as the principal insurer. Once the primary payer has covered the maximum amount, the secondary payer contributes to the remaining costs. Each insurance source will determine what and how much coverage it provides for services and treatments.Though the coverage can be greater with multiple providers, you may be responsible for outstanding fees that neither program fully includes.For those with two insurance providers, the Medicare & You handbook as well as the guide to Who Pays First (both in PDF format) explain the protocol that determines which provider is the primary payer.In general, Medicare pays first when people have retiree health coverage or receive coverage from a smaller organization. An employers coverage typically takes precedence when it originates from current employment at a larger organization.Covering costs first, Medicare is the primary insurance for those who also have retiree health coverage.Medicare is also the first insurer for older adults with current employer health coverage when the company has less than 20 employees.It's also the primary payer for younger people with disabilities with current employer coverage from establishments with fewer than 100 workers.In other instances, Medicare is the secondary payer.The employers insurance pays first for those who receive insurance because they or their spouse currently works at a larger business (more than 20 employees). Then Medicare covers the remaining costs.For disabled people with coverage based on their or their family members current employment at a larger organization (more than 100 employees), the employers insurance is the primary payer.Tricare is the primary insurer for individuals on active duty or those receiving care in a military hospital, clinic, or federal health care provider. Others on Tricare get Medicare coverage first.How Medicare and Medicaid Work Together Those who qualify for Medicare as well as Medicaid can receive assistance from both programs. When people benefit from both programs, Medicare is the primary payer. If both Medicare and Medicaid cover the same service or treatment, Medicare pays first, and Medicaid contributes to any remaining costs.Sometimes, Medicaid will pay for expenditures that Medicare doesn't cover. Medicare Part A bears hospital fees, Part B extends to outpatient medical costs, and Part D applies to prescription drugs. However, Medicare generally doesn't take care of nursing home expenses, which Medicaid can cover.Speak to an elder law attorney to learn how having other insurance coverage affects Medicare.

Forget What You Think You Know and the Stereotypes of Marijuana. Social isolation. Concern over the health of loved ones. Worries about money and maybe even losing your job. Top it off with uncertainty about how long all this is going to last. With all the stressors that people have to deal with right now during the COVID19 crisis, is it any wonder that more people than ever are suffering from an anxiety disorder? Many people dont want to take medication to ease their suffering because of chemicals, side-effects or the fear of its being habit-forming. But there is a safe, effective alternative that you may not have considered: Medical Marijuana. While Cannabis and its related products are still a mystery or taboo to some, they are fast becoming more mainstream for treating not only anxiety disorder but a host of other ailments. In fact, there are now 23 chronic medical conditions that qualify for Medical Marijuana use. Many people are confused about whether or not they qualify for the Medical Marijuana ID card required for dispensaries, and the process to obtain one has traditionally been long and confusing. But Medical Marijuana Specialists, based in Western Pennsylvania, is committed to changing all that. We are the states only one-stop-shop to guide and support patients through the entire medical marijuana certification process, says Nurse Shelly, owner of the organization. Their team helps patients obtain their medical records, registers them on the Pennsylvania state website, connects them via telemedicine with a certifying physician, and even assists with the state processing fee for getting their ID card. Get Certified Fast & Easy Without Leaving Home. Medical Marijuana Specialists is now offering certifications and renewals via telemedicine to all Pennsylvania residents and a free nurse hotline for questions. People can call or sign up on their website at www.GetYourIDCard.com and be connected virtually instantly with a professional. Telehealth appointments from 9am to 9pm, 7 days a week. Get your ID card in as little as one week with a simple process and guidance from Medical Marijuana Specialists. Editors Note: This article was submitted by Shelly Hutchison, RN, and owner of Medical Marijuana Specialists. Nurse Shelly may be reached at 833/667-4665.

The Centers for Medicare & Medicaid Services (CMS) has released the 2023 federal guidelines for how much money the spouses of institutionalized Medicaid recipients may keep, as well as related Medicaid figures.What Are Spousal Impoverishment Rules?Spousal impoverishment is a concern for older couples when there is one spouse who requires long-term care and applies for Medicaid. Before the federal government enacted spousal impoverishment protections, many healthy spouses faced poverty when their partners needed long-term care. The spousal impoverishment rules are based on the idea that spouses will provide for each other.Community Spouse Resource AllowanceIn 2023, the spouse of a Medicaid recipient living in a nursing home (called the community spouse) may keep as much as $148,620 without jeopardizing the Medicaid eligibility of the spouse who is receiving long-term care. Known as the community spouse resource allowance (CSRA), this is the most that a state may allow a community spouse to retain without a hearing or a court order. While some states set a lower maximum, the least that a state may allow a community spouse to retain in 2023 will be $29,724.Monthly Maintenance Needs AllowanceMeanwhile, the maximum monthly maintenance needs allowance (MMMNA) for 2023 will be $3,715.50. This is the most in monthly income that a community spouse is allowed to have if their own income is not enough to live on and they must take some or all of the institutionalized spouse's income. The minimum monthly maintenance needs allowance for the lower 48 states will be $2,288.75 ($2,861.25 for Alaska and $2,632.50 for Hawaii) until July 1, 2023.In determining how much income a particular community spouse is allowed to retain, states must abide by this upper and lower range. Bear in mind that these figures apply only if the community spouse needs to take income from the institutionalized spouse. According to Medicaid law, the community spouse may keep all their own income, even if it exceeds the maximum monthly maintenance needs allowance.The new spousal impoverishment numbers (except for the minimum monthly maintenance needs allowance) take effect on January 1, 2023.Home Equity LimitsIn 2023, a Medicaid applicants principal residence will not be counted as an asset by Medicaid if the applicant's equity interest in the home is less than $688,000. States have the option of raising this limit to $1,033,000.