One would think that everyone understands their Medicare and Social Security coverage. We find the opposite to be true and in many cases our clients do not truly understand their own coverage and what they actually have in terms of coverage. Our staff is experienced in assisting clients to work out coverage issues before they become problems.
We work with Special Needs Trusts for SSI clients to make sure that receipts of income or assets do not interfere with valuable medical coverage. We assist individuals who may not be able to obtain needs-based coverage but who may be unable to pursue gainful activity. We work with parents of disabled children to make sure their children will have the care they need in the event that the parents are unable to provide this care.
Medicare FAQ’s
What is a Medicare Advantage Plan? This is a Medicare plan that permits a private insurance company to manage Part A and B benefits. Typically, they are managed plans that seek to be lower cost alternatives to regular Medicare and Supplement coverages.
What is the best Medicare plan? We find that traditional Medicare plus a good Supplement (Plan C or better) offers the best options for seniors albeit for a larger premium.
What is the difference between Medicare and Medicaid? Medicare pays for skilled medical care and Medicaid (at least for seniors) pays for long term non-skilled care.
Does Medicare pay for long term care? No it does not.
What is a “gap” policy? An insurance policy that pays for the gaps in Medicare such as co-pays. The most significant cost to our clients is the co-pay from the 20th to the 100th day of inpatient nursing home rehab that costs about $150 per day.
How does my Medicare coverage affect my long term care? It doesn’t affect it so much as it works in conjunction with it. A nursing home patient may have periods of time where they are in a long term care bed and periods of time where they require skilled care. Medicare will kick in when there is medical care required. If a patient is on Medical Assistance, medical expenses such as the premiums for Medicare and supplement policies are permitted as a deduction against what is paid to the nursing home. You should never drop health insurance when going into a long term care facility.
Does Medicare pay for 100 days in a rehab? Technically you can get up to 100 days but it is rare that you do. Once there is sufficient progress made in rehab, Medicare will terminate coverage. There is the opportunity to appeal this termination. The typical time on rehab is fairly short unless there is a lingering medical condition.
Contact Us Today!
The Elder Law Attorneys at Shober and Rock represent clients with a wide range of needs. Call (215) 345-4301 today to consult with our experienced Social Security Lawyers or a disability attorney in Doylestown, PA.
