Author: Ty Ketlinski

Mr. Ketlinski has been practicing law for 20 years in Idaho. Although his legal background is expansive and diverse, he now limits his practice to estate planning, elder law, and probate.

Medicare and Medicaid: Unlocking the Mystery

Medicare and Medicaid have long been a mystery to many. In fact, it can baffle and confuse even some of the smartest citizens. You might have thought, “I don’t need to worry about this right now.” However, it is never too early to gain a little understanding and awareness that just might help you help an aging loved one or yourself down the road. As the saying goes, “Time flies,” and you will be there sooner than you think. Let’s break it down and learn some of the differences and basics of Medicare and Medicaid to unlock the mystery.

Medicare

Medicare is a health insurance program provided through the federal government. In order to receive Medicare, a person must meet certain requirements. A person must be 65 years old or older or have a severe disability. In order for a disabled person under the age of 65 to be eligible for Medicare, they must have received Social Security Disability Insurance (SSDI) for two years. In order to be eligible a person must have Social Security retirement benefits or Social Security disability benefits. Because Medicare is run and administered by the federal government, it is uniform from state to state. If a person meets Medicare eligibility requirements, they can receive Medicare no matter their income or assets. Costs for Medicare are based on the recipient’s work history. This means that costs are determined by the amount of time a person paid Medicare taxes. These costs like all insurance include premiums, copays, and prescriptions.

Medicare can be confusing because there are four parts. The commercials talk about Parts A, B, C, D. What does it all really mean? Parts A, B, and D can be somewhat simplified. Part A is hospital insurance, Part B is medical insurance, and Part D is prescription drug coverage. Parts A and B are covered in Original Medicare offered by the government. Part C is often called the Medicare Advantage Plan. This is a private health plan. The Medicare Advantage Plan or Medicare Part C plan are required to include the same coverage as Original Medicare but usually also include Part D as well. It is important to do your homework on these plans to find what works best and is most cost effective for you.

Medicaid

Medicaid is a health care assistance program. Its guidelines come from the federal government, but it is administered by each state. Medicaid is for people who cannot afford to pay for their care on their own. It is based on income and assets, and is available to people who belong to one of the eligible groups. The eligible groups are children, people with disabilities, people over age 65, pregnant women, and the parents of eligible children. Seniors who require nursing home care can qualify for Medicaid and only pay a share of their income for the nursing home. Medicaid then pays the rest.

Dual Eligibility

A person can be eligible for both Medicare and Medicaid and can have both. The two programs work together to help the recipient best cover the expenses of health care. For example, Medicare costs include premiums, copays, and deductibles. Full Medicaid benefits can cover the costs of Medicare deductibles and cover the 20% of costs not covered by Medicare. Medicaid can also help with Medicare assistance and may cover costs of premiums for Part A and/or Part B.

Although Medicaid and Medicare can be quite confusing, it is important at a minimum to know the basics. When you or someone you love is eligible or in need of the benefits, there are organizations willing to help and your elder law attorney is also a valuable resource.

If you have any questions about something you have read or would like additional information, please feel free to contact us.

Alzheimer’s 101 – Understanding the Basics

What is Alzheimer’s Disease?

Alzheimer’s disease is defined as an irreversible, progressive mental deterioration that can occur in middle or old age. It is the most common form of dementia.

What causes Alzheimer’s Disease?

Alzheimer’s disease is caused by a generalized deterioration of the brain. The disease is caused by a combination of factors, including genetic, lifestyle, and environmental factors. There are a variety of factors that put people at risk for Alzheimer’s disease. Age and genetics are risk factors. As people age or if there is a family history of Alzheimer’s, there is a greater risk of the onset of Alzheimer’s disease. People with Down Syndrome or mild cognitive impairment have a greater chance of having Alzheimer’s as they age. If a person has experienced past head trauma, this puts them at risk for Alzheimer’s.

The risk of Alzheimer’s is also related to lifestyle and heart health. Those with poor heart health and an unhealthy lifestyle put themselves at greater risk for the disease.

Finally, women are more likely to be diagnosed with Alzheimer’s than men. Some causes and risk factors of Alzheimer’s disease are impossible to change or control, but lifestyle and heart health are things that can be controlled.

What are the symptoms of Alzheimer’s Disease?

Alzheimer’s disease, in general, destroys memory and thinking skills. In the late stages, a person with Alzheimer’s is unable to carry out even the simplest tasks. A person who is experiencing the onset of Alzheimer’s will experience mild symptoms, which may include increasing forgetfulness or mild confusion. As the disease progresses, the memory loss increases, especially recent memories. The progressive nature of the disease causes memory to continue to deteriorate throughout the rest of the person’s life. The ability to think and reason are impaired until even performing familiar tasks can become impossible.

A person with Alzheimer’s disease often experiences changes in behavior. They may do things out of their character for them prior to the disease. Common changes in behavior include aggressive behavior, agitation and irritability. Alzheimer’s disease symptoms can include depression, mood swings, and difficulty sleeping. The deterioration of the brain causes a person to change in ways that are difficult and trying for all involved.

How is Alzheimer’s Disease diagnosed?

Alzheimer’s disease is complicated and getting to a diagnosis is a long process. If a person or their family suspects the onset of Alzheimer’s disease, it is important to understand that there will be many steps and visits with doctors to determine if in fact it is Alzheimer’s. There is no single test. The first step for the doctor will be to get a comprehensive medical history. The doctor can use this history to determine if the patient has risk factors for Alzheimer’s disease. The next step is to complete testing on mental status and mood of the patient. Beyond this there will be physical and neurological examinations. If the doctor suspects Alzheimer’s, the tests will continue with blood tests and brain imaging. The goal is to rule out other causes to be sure that Alzheimer’s disease is the correct diagnosis.

What treatment options are available?

Alzheimer’s disease has no cure. Treatment options are meant to delay or slow the progression of the disease. Medication is one treatment option. The medicines are used to treat the cognitive symptoms. As the disease progresses, symptoms continue to worsen. Medication is unable to stop the damage that Alzheimer’s disease causes to brain cells, it can help stabilize the patient or slow the progression for some time.

Behavioral symptoms can be treated with some medication as well, but there are other ways to address these symptoms. The first thing is to know and be aware of triggers. By knowing triggers, there are a variety of coping strategies that can be used. Some of these include avoiding confrontation, making sure the Alzheimer’s patient gets adequate rest, monitoring comfort, and creating a calm environment. Many are now looking at herbal remedies, dietary supplements, and “medical” foods as possible treatments to enhance memory. There is no conclusive evidence that these things work.

Alzheimer’s disease is complicated. The causes and symptoms vary from one person to the next as does the progression of the disease. Being educated about the disease and care options is the key to helping a loved one with Alzheimer’s disease. Doctors, therapists, and elder law attorneys can guide families through the difficult process of caring for a loved one with Alzheimer’s.

If you have any questions about something you have read or would like additional information, please feel free to contact us.

5 Things to Include in an Estate Plan

Estate planning is important for people of all ages, but as we age, the need for planning becomes even more critical. Many people avoid estate planning, because they do not want to think about the end of life, failing health or disability. Others believe that an estate plan is only for rich people. However, an estate plan is helpful for the senior adult and their families regardless of overall wealth.

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Top Three Reasons You May Want to Create a Trust and Avoid Probate

There are a lot of good reasons to set up a trust as part of your estate plan: providing for a special needs child, more control and flexibility in distributing your assets upon your death, greater control over incapacity planning, and estate tax avoidance.

But there is another great reason to create a trust:  to avoid probate court.

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