What Medicare Open Enrollment is so Important for Family Caregivers
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Medicare Open Enrollment: The Time is Now
&nbsp;
&ldquo;Spending a little time now is paying off for all of next year,&rdquo; says a message from Medicare.gov, the official website for Medicare, and it&rsquo;s a very good piece of advice. This is the season of Medicare open enrollment, and it ends on December 7.&nbsp;
This is the time of year when Medicare recipients can change their plans. Your loved one&rsquo;s health might have changed. A new illness could send them to new doctors. Their medications may have been changed. There might be a change in their finances, with less money to pay for medical bills. The government gives you a special time each year to enroll in a new plan to accommodate for these changes each year during open enrollment.
&nbsp;
What Plan is your Loved One on?&nbsp;
Most people on Medicare are enrolled in Medicare Advantage plans, where you get your care within a network of doctors and hospitals.&nbsp;&nbsp;
Traditional Medicare is more expansive and expensive. You can go to any doctor or hospital enrolled in Medicare, but it costs more than Medicare Advantage. You need to pay a Part B premium for doctor bills, a Part D plan to buy your drugs, and a Medicare supplemental plan (also called Medi-gap), which will cover your 20% co-payment when you go to the hospital.
During Open Enrollment, someone over 65 who is enrolled in Medicare can keep their current plan or make a switch. Most people won&rsquo;t change plans. Maybe the process seems too complex. Maybe they worry about doing the wrong thing. But this isn&rsquo;t always the best option.&nbsp;
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The Caregiver&rsquo;s Role During Open Enrollment
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As a caregiver you can&rsquo;t be passive during Open Enrollment. Especially this year, when a flood of television commercials is pouring out promises, with relentless promotions from heroes of the Baby Boom generation. There is an unusual amount of promotion this year because there are additional plans and their promises are expanding in new ways. For example, for the first time, some plans are offering transportation to take you to a doctor&rsquo;s appointment or shopping.
Your loved one may be swayed by celebrities like Joe Namath and Joe Montana, or George&nbsp; Foreman, or William Shatner telling them to call a number, where an agent will sign them up with a plan that has a plethora of new benefits. New plans can sound appealing: Perhaps the plan will provide someone who will drive your loved one to a doctor's appointment, or go out and pick up some groceries. Many plans will boast free dental care and a free gym membership, benefits you can't get under traditional Medicare.
Sorting through the different plans is confusing, and most people don't know what to do. As a result, they default to doing nothing, and they often don&rsquo;t spend any time comparing plans. More than 50 million people are enrolled in Medicare Advantage plans, and 70% of them did nothing when enrollment was open in 2018 for the 2019 benefit year, according to the Kaiser Family Foundation.&nbsp;
Alternatively, some people can choose to switch without understanding the full picture. Some people are excited at the prospect of saving money and may pick a plan that excludes the doctors they are now seeing. Some people might have lost their doctors and their coverage for specific drugs because&nbsp; their current plans made changes. Plans are difficult to understand, with each one having its own network of doctors and hospitals. It&rsquo;s important to be careful that you don&rsquo;t enroll your loved one in a plan that causes them to lose coverage for their doctors.&nbsp;
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What are the Top Reasons You Should Help Your Loved One Compare Plans?
&nbsp;
1. Your Loved One&rsquo;s Doctors May Not Be Covered Next Year&nbsp;
Your loved one&rsquo;s doctors may have moved. They might be in the plan they have this year, but not in the new one where they are being enticed to enroll. The commercials look appealing and your&nbsp; loved&nbsp; one may call the number to get all those extra benefits. However, when the insurance agent makes a pich, tell them you want to keep all your doctors and to find a plan that will include them for the next year. Be sure to tell them where you live and the names of your doctors.
Don't sign up for anything until you are sure the new plan will include your doctors. Even then, don't take anyone's word for it. Call the doctor's offices, tell them which plan you are considering for 2022, and find out if they are participating in it
&nbsp;
2. Your Loved One&rsquo;s Mobility has Declined
Perhaps your loved one&rsquo;s mobility has become limited, and they can't drive safely anymore. You and their other caregivers don&rsquo;t live nearby to take them shopping or to the doctor's office.&nbsp; Some of the Medicare Advantage plans now offer transportation as a benefit. Check the plans to see which ones offer the benefit in your neighborhood.
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Tips for Helping Your Loved One Compare Plans
Remember the average Medicare beneficiary has access to more than 30 different plans. New plans may be offering cheaper monthly premiums or even zero premiums. Sorting through them won&rsquo;t be an easy task. The best thing you can do as a caregiver is to help your loved ones navigate Medicare&rsquo;s tricky river of plans.
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<ul>
<li style="font-weight: 400;" aria-level="1">If your loved one wants to call the numbers promoted in the commercials, tell them to get the name of the plan but hold off on enrolling.</li>
<li style="font-weight: 400;" aria-level="1">As the caregiver, help by doing the detailed work of checking the plan that seems so appealing.</li>
<li style="font-weight: 400;" aria-level="1">Go to <a href="https://www.medicare.gov/">Medicare.gov.</a> Click on Find 2022 Health &amp; Drug Plans. Look at the plans and their benefits. There will be a phone number to contact the plan.</li>
</ul>
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Remember: You need to be sure your doctors and your drugs are still covered and any other benefits you depend on are still in your current plan.&nbsp;
&nbsp;

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Senior Finance Reporter with 40+ years of experience, specializing in issues of aging, such as Medicare, Social Security, Pensions, IRAs, and Assisted Living. \r&quot;}" data-sheets-userformat="{&quot;2&quot;:769,&quot;3&quot;:{&quot;1&quot;:0},&quot;11&quot;:4,&quot;12&quot;:0}">Bob Rosenblatt is a Senior Finance Reporter with 40+ years of experience, specializing in issues of aging, such as Medicare, Social Security, Pensions, IRAs, and Assisted Living.

The government allows changes to medicare plans to accommodate for financial, medical and personal changes each year during the open enrollment period.

Medicare Open Enrollment: How You Can Help Your Loved One | Ready Set Care

Medicare Open Enrollment: How You Can Help Your Loved One

As a caregiver you may help your loved one file their taxes. Alternatively, you may file them under your own taxes as a dependent. Either way, a big part of filing is determining whether it&rsquo;s best to take the standard deduction, or itemize expenses individually to include a deduction for medical charges.&nbsp;&nbsp;&nbsp;&nbsp;
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There are two choices when filing taxes:&nbsp;
&nbsp;
1. Take the standard deduction
The standard deduction varies, but for a couple (both over 65), the deduction is&nbsp;$27,800 for the 2021 tax return.&nbsp;
&nbsp;
2. Itemize Deductions
Calculate individual deductions by adding medical expenses to other deductions such as property taxes, state and local taxes, home mortgage interest and charitable contributions.
&nbsp;
How do I know which one is better?
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The decision of whether to take the standard deduction or itemize expenses depends on the amount of expenses and income.
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For example, suppose your parents had an adjusted gross income of $75,000 for 2021. Their medical expenses for the year, when your father had major heart surgery and was in the hospital for three weeks, and your mother needed a wheelchair and someone to help her bathe at home, were $27,000.&nbsp;&nbsp;
&nbsp;
The deduction for medical expenses is any amount above 7.5% of adjusted gross income.&nbsp;
&nbsp;
Calculations show 7.5% of&nbsp; $75,000 is $5,625, meaning your parents total spending over the 7.5% threshold was $21,375. ($27,000 - $5,625 = $21,375). This means their deduction for medical expenses alone for 2021 could be&nbsp;$21,375.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
&nbsp;
Your parents already have a large potential medical deduction of $21,375. (Not yet reaching the $27,800 standard deduction) However, if additional deductions, such as mortgage interest payments, state and local taxes, and charity contributions, put them over the standard deduction for a couple over 65 ($27,800), it makes sense for you to itemize deductions for them when you prepare their taxes. If they do not have additional deductions to reach the $27,800, it makes sense for them to take the standard deduction.&nbsp;
&nbsp;&nbsp;
Here are some of the major items you can deduct as medical expenses:
&nbsp;
<ul>
<li>Monthly premiums you pay for health insurance
<ul>
<li style="font-weight: 400;" aria-level="2">For those with traditional Medicare, this would include Part B, Medicare supplemental coverage (also called Medi-gap), and Part D plans that cover prescription drugs&nbsp;</li>
<li style="font-weight: 400;" aria-level="2">For those with Medicare Advantage, which has a network of approved doctors and hospitals, there may be a separate monthly premium</li>
<li style="font-weight: 400;" aria-level="2">NOTE: If the person you&rsquo;re caring for is your dependent, you can deduct their Medicare premiums.&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="2">(For a loved one to be recognized as your dependent for tax purposes, you have to provide more than 50% of their support for the year, and they have to have an adjusted gross income of less than $4,300.) &nbsp; &nbsp; &nbsp; &nbsp;</li>
</ul>
</li>
</ul>
</li>
</ul>
&nbsp;&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="1">Any additional charges under hospital and physician charges not covered by Medicare&nbsp;</li>
<ul>
<li style="font-weight: 400;" aria-level="2">These could be co-payments for surgery, care in rehab centers, or expensive medications</li>
</ul>
</ul>
&nbsp;&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="1">Premiums for private long-term care insurance&nbsp;</li>
<ul>
<li style="font-weight: 400;" aria-level="2">These policies cover care for people who may need help with dressing, feeding, and bathing</li>
</ul>
</ul>
&nbsp;&nbsp;&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="1">Dental charges not covered by Medicare</li>
<ul>
<li style="font-weight: 400;" aria-level="2">Includes routine exams, fillings, crowns, surgery, implants, and false teeth</li>
</ul>
</ul>
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<ul>
<li style="font-weight: 400;" aria-level="1">Equipment and devices&nbsp;</li>
<ul>
<li style="font-weight: 400;" aria-level="2">Wheelchairs, walkers, and canes&nbsp;</li>
<li style="font-weight: 400;" aria-level="2">Special mattresses to help people who have severe arthritis</li>
<li style="font-weight: 400;" aria-level="2">Oxygen equipment</li>
<li style="font-weight: 400;" aria-level="2">Blood sugar test kits</li>
<li style="font-weight: 400;" aria-level="2">Eyeglasses</li>
<li style="font-weight: 400;" aria-level="2">Hearing aids</li>
</ul>
</ul>
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<ul>
<li style="font-weight: 400;" aria-level="1">Travel to get medical care allows a charge of 17 cents a mile&nbsp;</li>
<ul>
<li style="font-weight: 400;" aria-level="2">For example: Suppose you drive your mother to and from the doctor&rsquo;s office or a rehabilitation clinic. Tally the miles you go for the trips. &nbsp;ou can claim a transportation cost of 17 cents per mile. You do not have to keep a record of how much you spent for gasoline. To make it simple, the IRS allows the mileage charge.</li>
</ul>
</ul>
&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="1">The cost of home improvements and modifications to provide necessary care&nbsp;</li>
<ul>
<li style="font-weight: 400;" aria-level="2">For example: Suppose your loved one has arthritis and a heart condition and cannot climb stairs or get into a bathtub. If their doctor advises them to install a bathroom with a shower stall on the first floor of their two-story rented house, the full cost is eligible for a medical deduction.&nbsp;</li>
</ul>
</ul>
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Lastly, something new was added to the list this year (2021): The cost of face masks and other protective equipment to protect against COVID is fully deductible.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
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Additional Tools and Resources to Help Calculate Your Deduction&nbsp;
See the full list of deductible items listed by the IRS <a href="https://apps.irs.gov/app/IPAR/resources/help/MedDentExpenseTypes.html">here</a>.&nbsp;
The IRS also has a tool for personally estimating the possible deduction, accessible <a href="https://www.irs.gov/help/ita/can-i-deduct-my-medical-and-dental-expenses">here</a>:
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

Bob Rosenblatt has been a reporter for 40 years, specializing in aging issues, such as Medicare, Social Security, Pensions, IRAs, and finding Assisted Living.

Filing your taxes can be complicated when determining whether you should use a standard deduction, or itemize expenses individually to include a deduction for medical charges.

How to Maximize Your Loved One's Tax Deduction | Ready Set Care

How to Maximize Your Loved One's Tax Deduction

The Medicare population has been severely impacted by COVID-19. More than 900,000 people have died as a result of the virus, and 76% of them were 65 or older. Early on in the pandemic, the federal government declared a state of public health emergency in order to provide better care for the 60 million people enrolled in Medicare. The public health emergency has just been extended to April 16.&nbsp;
Here&rsquo;s some of the new and existing ways you can get help from Medicare during this time:&nbsp;
&nbsp;
Getting Covid Tests
Starting in early spring, everyone enrolled in Medicare will be able to get eight over-the-counter COVID tests each month without charge. The kits will be available at local pharmacies and other sites.&nbsp;
Meanwhile, Medicare beneficiaries and all other Americans can now request four free kits for home testing at <a href="covidtests.gov">covidtests.gov</a>. If you want to go to a facility for a free test, the link is <a href="hhs.gov">here</a>.
&nbsp;&nbsp;
Going Outside Your Health Plan Network
About 40% of people on Medicare are enrolled in Medicare Advantage Plans. Under normal circumstances, you are restricted to the plan&rsquo;s network of doctors and hospitals. If you go outside the network, the plan won&rsquo;t pay for your care. This rule is now waived. If you go to an outside provider, your plan must pay for the care at the same rate it pays for care in the network. You will not have any additional charges. This gives people access to a much larger group of doctors and hospitals.
&nbsp;
Going to the Hospital
Medicare typically only pays for a semi-private room in the hospital. However during COVID, Medicare will cover a private room when it is considered a medical necessity.&nbsp; For example, if someone needs a private room to be under quarantine because of COVID, the cost of that room should be covered.
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Going from the Hospital to a Skilled Nursing Facility (SNF)
SNFs are rehabilitation facilities where you go to recover after a hospital stay. Typically, Medicare covers care without charge for 30 days with the caveat thatyou must stay in a hospital for three consecutive days before you qualify for the coverage.
Now, according to the Federal Center for Medicare Services (CMS), this rule is waived &ldquo;if you are affected by the Coronavirus public health emergency.&rdquo; For example, if the hospital becomes overcrowded and patients must be moved, the move to a rehab facility would be fully covered. Or if a patient needs special rehab care because of a serious medical issue coverage would be immediate and without charge.
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New Treatments Under Telehealth
Telehealth visits have become common since the COVID outbreak began in 2020, with patients being seen by doctors through computer visits. Historically, services were limited to certain medical professionals,but now the list has been expanded to cover telehealth treatments by Occupational Therapists and Speech Language Pathologists. Their telehealth visits will now be fully covered by Medicare.
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Going to Visit a Loved One in a Nursing Home
The strict rules against visit have been drastically changed, with the government admitting the policy did considerable harm to nursing home residents and family members.
&ldquo;While CMS guidance has focused on protecting nursing home residents from COVID-19, we recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones,&rdquo; CMS said in its revised rules. &ldquo;CMS understands that nursing home residents derive value from the physical, emotional and spiritual support they receive through visitation from family and friends.&rdquo;
The new policy says a nursing home resident has unrestricted rights to &ldquo;receive visitors of his or her choosing at a time of his or her choosing.&rdquo;
Nursing homes cannot limit the frequency or length of visits, and cannot require any advance scheduling for visits.
&nbsp;
Getting Medications
Medicare plans often have limits on the supply for a prescription drug. These quantity rules are suspended because of COVID. All drug plans, whether in Medicare Advantage or Part D under traditional Medicare, must now cover a 90-day supply of the medicine when the patient requests it. There are still limits in place for opioids, which can be addictive.
&nbsp;
Getting the Vaccine at Home
Some people may not be able to go to a doctor&rsquo;s office to get a vaccine. Medicare will pay for a doctor to come to your home to administer the shot. Contact your regular physician and request a home visit. If the doctor is unavailable, you can check the following resources:&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="1">Hotline for Medicare recipients at 1-800-633-4227 (TTY 1-877-486-2048)</li>
<li style="font-weight: 400;" aria-level="1">Your <a href="cdc.gov">state health department</a> or call 211</li>
<li style="font-weight: 400;" aria-level="1">Disability Information and Access Line (DIAL) 1-888-677-1199</li>
<li style="font-weight: 400;" aria-level="1">Services for older adults and their families <a href="eldercare.acl.gov">Eldercare Locator </a>or 1-800-677-1116</li>
</ul>
&nbsp;

Bob Rosenblatt has been a reporter for 40 years, specializing in aging issues, such as Medicare, Social Security, pensions, IRAs, and finding assisted living.

Early on in the pandemic, the federal government declared a state of public health emergency in order to provide better care for the 60 million people enrolled in Medicare.

Extended Medicare Coverage During COVID-19 | Ready Set Care

Extended Medicare Coverage During COVID-19

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Certified Senior Advisor with 20+ years of experience in Geriatric Care Management. She focuses on the senior housing industry, especially assisted living, nursing, and specialty memory care. She is also an Accredited Agent with the U.S. Veterans Administration, licensed to represent claims before the Office of General Council, and a licensed insurance agent in life, health, and annuity products for the state of Virginia.&quot;}" data-sheets-userformat="{&quot;2&quot;:15171,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;9&quot;:0,&quot;11&quot;:4,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:5197647},&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">A Certified Senior Advisor with 20+ years of experience in Geriatric Care Management. She focuses on the senior housing industry, especially assisted living, nursing, and specialty memory care. She is also an Accredited Agent with the U.S. Veterans Administration, licensed to represent claims before the Office of General Counsel, and a licensed insurance agent in life, health, and annuity products for the state of Virginia.

It's essential to understand Medicaid facts versus myths in order to not be taken advantage of later down the line. Learn more about receiving Medicaid coverage here.

10 Medicaid Myths Debunked: Fact Vs. Fiction | Ready Set Care

10 Medicaid Myths Debunked: Fact Vs. Fiction

There are several questions surrounding the topic of Medicaid Long-Term Care.&nbsp;
Let's dive into frequently asked questions and provides detailed answers to each.
<h2> 7&nbsp; Questions Frequently Asked Regarding Federal Medicaid</h2>
&nbsp;
<h3 style="padding-left: 36pt;">1. Will Medicaid take my house from me?</h3>
While Medicaid does have a right to recover assets in the event that the applicant has countable assets available, the Medicaid division of the Department of Health and Human Services is not in the business of acquiring Medicaid applicants&rsquo; homes.
In fact when an individual moves from their home and into a Medicaid Long term care facility or nursing home, the applicant&rsquo;s residence is typically protected for a period of six months. During this time the applicant may have full coverage through the Department of Medicaid Services.&nbsp;
However, at the end of the six-month period of time, the applicant must provide evidence that they are making a concerted effort to list and sell the home for fair market value.
While the applicant may have been considered low-income in order to qualify for Medicaid services, once the home is sold the Medicaid applicant may then have excess resources that will need to be spent before Medicaid coverage will resume.
So again, the Federal Government is not going to acquire an applicant's home. However, the state Medicaid program in your area may very well expect that you make an effort to sell the home for fair market value within 6 months of otherwise qualifying for Medicaid coverage. 
<h3 style="padding-left: 36pt;">2. Can I gift $16,000 (2022) per year to an individual and still qualify for Medicaid?&nbsp;</h3>
Per the Internal Revenue Service an individual is able to gift up to $16,000 per person without the need to file a gift tax receipt, however, this same gifting that is allowed by the IRS can potentially still have a negative impact on an individual's ability to qualify for Medicaid services.
The person who gave the monetary gift needs to apply for Medicaid services within the five years post the date that the gifting took place, Medicaid would count the gift as an uncompensated transfer and assign a penalty during which time the Medicaid applicant would be ineligible to receive Medicaid benefits.
Typically the penalty is calculated by taking the total value of the gifts that were made and dividing that figure by what is referred to as the Divestment Penalty Divisor (DPV) (DPV) for your specific state.&nbsp;&nbsp;
The Divestment Penalty Divisor is usually equal to the market private pay rate for the state or region. Once the value of the gift is divided by the DPV that figure will equal the amount of time (months) that the applicant will be ineligible for Medicaid benefits. 
<h3 style="padding-left: 36pt;">3. Will Medicaid leave my spouse indigent?</h3>
Many years ago married couples would file for divorce in order to financially protect the healthy spouse/community spouse when the ill spouse needed to apply for Medicaid services.&nbsp;&nbsp;
Thankfully, today, there are spousal protections that have been put in place to ensure that only part of the marital assets will have to be spent in order for the ill spouse to qualify for Medicaid coverage.
Specifically, there is a Community Spouse Resource Allowance (CSRA) and a Community Spouse Monthly Maintenance Needs Allowance (CSMANNA) that is calculated to ensure that the healthy community spouse will have the funds needed to live in the community while the ill spouse applies for and receives the medically required services through the Department of Medicaid.
Typically the Community Spouse gets to keep 50% of the joint marital assets and the institutionalized spouse/ill spouse must spend 50% of the joint marital assets down until their assets are equal to no more than $2,000.00 (2022)/asset limit. Please keep in mind that this asset limit may vary based on the state that you live in. 
The CSMANNA&nbsp; is calculated by a specific formula with which the Department of Human Services/Department of Medicaid Services evaluates the Community Spouses' income (if any), the household living expenses including utilities, and rent or mortgage. Then the CSMANNA evaluates how much of the institutionalized spouse's income may need to be carved out and given to the Community Spouse for daily living expenses.
The Community Spouses&rsquo; income is not taken into consideration.
<h3>&nbsp;</h3>
<h3 style="padding-left: 36pt;">4. Will I receive sub-par care if I apply for Medicaid?&nbsp;</h3>
This is a common misconception.&nbsp; 
While the Medicaid reimbursement rate for services is far less than what the private pay market rate is, there is no difference in the quality of care that is provided. Frankly, if the care being provided is poor that is independent of the payer source.&nbsp;&nbsp;
With the above being said, there are instances when a service provider accepts more Medicaid reimbursement clients than they should, resulting in a negative trickle-down effect of lower pay for staff and disrepair of facilities.
Before you select a dually certified nursing home for yourself or a loved one be sure to consult with a professional geriatric case manager or research the facility's recent inspection reports on Medicare&rsquo;s government website.
<h3>&nbsp;</h3>
<h3 style="padding-left: 36pt;">5. I transferred money to my revocable living trust five years ago. Will the funds in that trust be protected from Medicaid?</h3>
Unfortunately, the language of a revocable living trust does not provide the protection of assets necessary to trigger the five-year look back required by Federal Medicaid Laws.
The fact that the trust is by title, revocable, indicates that the assets in the trust are available to the grantor (the person creating the trust) and therefore would be counted as an asset to the Medicaid applicant.
An Irrevocable Trust is typically used as an asset protection trust to trigger the penalty period for Medicaid qualification purposes.&nbsp;
However, an Irrevocable Trust must be specific in stating that the assets held in trust are not to be used for the benefit of the grantor during his or her lifetime, but are actually to be used for the beneficiary&rsquo;s benefit.&nbsp;&nbsp;
Medicaid planning is very specialized and irrevocable trusts should be drafted by an attorney that understands both Federal and local Medicaid Laws.
<h3>&nbsp;</h3>
<h3 style="padding-left: 36pt;">6. Do I get to choose the care facility once I qualify for Medicaid?&nbsp;</h3>
It is advantageous to still have the ability to privately pay for a few months at the normal market rate before seeking to apply for Medicaid benefits. This allows you to be more selective than you would otherwise be able to be if you were in immediate need of Medicaid and seeking admission from home or a hospital or rehabilitation setting.
If you do not have assets to privately pay for a few months at a care facility before qualifying for Medicaid it would be advisable to wait until your Medicaid application coverage is approved before transferring to a more desirable location. You can change locations if you desire to do so.
Please keep in mind that most Medicaid nursing homes have very limited availability and that availability can change daily. Most nursing homes prioritize residents that are already in-house and completing their spending down over those seeking admission from outside of the facility.&nbsp; 
<h3 style="padding-left: 36pt;">7. Does Medicaid only provide long-term care assistance to the elderly?</h3>
Medicaid can actually provide community-directed care, routine health insurance coverage, and custodial living care for: 
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400; text-align: justify;" aria-level="1">Children</li>
<li style="font-weight: 400; text-align: justify;" aria-level="1">Young adults</li>
<li style="font-weight: 400; text-align: justify;" aria-level="1">The elderly (If they meet specific medical or financial criteria as set forth at both a Federal and local/state level). </li>
</ul>
</li>
</ul>
<h2>Educate Yourself Before Applying For Medicaid </h2>
It is clear to see that there are many questions and assumptions erroneously made concerning Medicaid services.&nbsp;&nbsp;
Over time, the application process for the Medicaid program has become increasingly challenging. It is very important that you educate yourself and seek appropriate counsel before attempting to obtain coverage.
You can find a qualified elder law attorney to assist with your matter by visiting <a href="http://www.naela.org">The National Academy of Elder Law Attorneys (NAELA)</a>.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Certified Senior Advisor with 20+ years of experience in Geriatric Care Management. She focuses on the senior housing industry, especially assisted living, nursing, and specialty memory care. She is also an Accredited Agent with the U.S. Veterans Administration, licensed to represent claims before the Office of General Council, and a licensed insurance agent in life, health, and annuity products for the state of Virginia.&quot;}" data-sheets-userformat="{&quot;2&quot;:15171,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;9&quot;:0,&quot;11&quot;:4,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:5197647},&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">Christina Drumm-Boyd is a Certified Senior Advisor with 20+ years of experience in Geriatric Care Management. She focuses on the senior housing industry, especially assisted living, nursing, and specialty memory care. She is also an Accredited Agent with the U.S. Veterans Administration, licensed to represent claims before the Office of General Council, and a licensed insurance agent in life, health, and annuity products for the state of Virginia.

Are you struggling to understand the Federal Medicaid Program? This article answers commonly asked questions regarding Medicaid Long term care.

Frequently Asked Questions Regarding Federal Medicaid Long-Term Care | Ready Set Care

Frequently Asked Questions Regarding Federal Medicaid Long-Term Care

Navigating Medicare coverage isn&rsquo;t always easy. It can be challenging to understand the ins and outs, what&rsquo;s covered, and what isn&rsquo;t. There are differences in coverage depending on what exactly your loved one has. Because of this, it can be easy to overlook the benefits that your loved one is entitled to. Here, we&rsquo;ll explore Medicare Part A and B, and examine what types of durable medical equipment can be covered by your loved one&rsquo;s plan.&nbsp; 
<h2>Medicare Part A vs. Medicare Part B: What&rsquo;s Included?</h2>
Medicare has a variety of plans that cover different aspects of healthcare. This allows an individual the flexibility to choose which parts will be beneficial to them, and which are affordable for their situation. Both Medicare Part A and Medicare Part B are insurance plans offered to any older adult over age 65 in the United States. Medicare Part A is also offered to any individual with specific disabilities, whereas Part B is strictly for older adults. Part A and Part B provide coverage for different areas of healthcare.&nbsp;
<h3 style="padding-left: 36pt;"> Medicare Part A </h3>
Medicare Part A covers inpatient medical care, meaning that a patient must be admitted to the hospital for Medicare Part A to be utilized.&nbsp;
Medicare Part A may also cover some skilled nursing facility care, surgeries, or hospice care provided the care recipient has been admitted to the hospital prior to receiving the service. <a href="../articles/options-for-post-hospital-release">Medicare Part A may cover some in-home care services if they are following hospitalization and only for a short period of time.</a> 
<h3 style="padding-left: 36pt;">Medicare Part B</h3>
Medicare Part B covers outpatient healthcare services including doctor&rsquo;s appointments, some preventative care, and durable medical equipment.&nbsp;&nbsp;
In this guide, we&rsquo;ll be focusing on Medicare Part B. Keep in mind that your loved one may have coverage through other insurance companies as coinsurance which may have additional benefits. There is a part b deductible charged annually to the medicare beneficiary.
Other types of Medicare coverage include Part C and D which cover prescription drugs. These may also be referred to as Medicare Advantage Plans. Generally, after you have completed enrollment for a medicare program, you do not need to re-enroll annually.
&nbsp;
<h2>What Is Durable Medical Equipment (DME)?</h2>
Durable Medical Equipment or DME refers to products that are ordered or prescribed by a healthcare provider to address a medical need that can be used for an extended period of time.&nbsp;
Defined by the <a href="https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage">Centers for Medicare &amp; Medicaid Services (CMS)</a>, types of equipment that are classified as DME and covered by Medicare Part B include:
<ul style="text-align: justify;">
<li style="font-weight: 400;" aria-level="1">Hospital Beds&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Assistive devices such as canes, walkers, or wheelchairs (including manual wheelchairs and power wheelchairs, and scooters)</li>
<li style="font-weight: 400;" aria-level="1"><a href="../articles/what-to-know-about-diabetes">Diabetes care</a> such as glucose (blood sugar) monitors and test strips</li>
<li style="font-weight: 400;" aria-level="1">Oxygen equipment <a href="../articles/tips-for-caring-for-someone-with-copd">(may be required for people with COPD)</a></li>
<li style="font-weight: 400;" aria-level="1">Commode chairs</li>
<li style="font-weight: 400;" aria-level="1">Infusion pumps</li>
<li style="font-weight: 400;" aria-level="1">Nebulizers</li>
<li style="font-weight: 400;" aria-level="1">Orthotics</li>
<li style="font-weight: 400;" aria-level="1">Prosthetics</li>
<li style="font-weight: 400;" aria-level="1">CPAP (continuous positive airway pressure) machines </li>
</ul>
These devices, along with others, are referred to as DME items and are covered by Medicare Part B when your loved one has a medical condition requiring the use of one or more of the aforementioned devices.&nbsp;
In many cases, this type of equipment can allow your loved one to spend more time aging in place, safely and improve their overall health outcome. Medicare covers these devices when they come from a DME supplier.
&nbsp;
<h2>Where To Find DME For Your Loved One</h2>
 In some circumstances, you may be renting the equipment. If this is the case, there are often local centers for borrowing DME. In these circumstances, you may be responsible for paying out of pocket and then receiving reimbursement from Medicare. Other times, the healthcare provider prescribing the equipment will order it for you through a contract supplier.
Before making any purchases, it&rsquo;s important to confirm that both the provider and supplier are covered by Medicare. 
To confirm coverage,<a href="https://www.medicare.gov/coverage"> check out the Medicare website.</a>
&nbsp;
<h2>Does Your Loved One Require A Device Not Offered By A DME Supplier?</h2>
The cost of Durable Medical Equipment is set by DMEPOS (durable medical equipment and prosthetics, orthotics, and supplies) through the <a href="https://www.medicare.gov/what-medicare-covers/what-part-b-covers/competitive-bidding-program">Competitive Bidding Program</a>. They will determine a medicare approved amount. If you need a device or brand of device that is not offered by a medicare supplier, your healthcare provider can provide documentation explaining the medical necessity for that specific device.
&nbsp;
<h2>Still Uncertain About DME &amp; What Medicare Covers?</h2>
If you have questions regarding your loved one&rsquo;s enrollment in their Medicare Plan, connect with your town&rsquo;s senior center. Oftentimes, the senior center has volunteers available to provide support with navigating Medicare plans, options, and benefits.
With the costs of senior care rising, it&rsquo;s important to fully understand your loved one&rsquo;s insurance plan and what benefits they are entitled to.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Laurel McLaughlin has over a decade worth of experience in various sectors of the elder care field- home care, senior living, and non-profits. She has a Master&rsquo;s in Gerontology and is a certified dementia practitioner.&quot;}" data-sheets-userformat="{&quot;2&quot;:769,&quot;3&quot;:{&quot;1&quot;:0},&quot;11&quot;:4,&quot;12&quot;:0}">Laurel McLaughlin has over a decade worth of experience in various sectors of the elder care field- home care, senior living, and non-profits. She has a Master&rsquo;s in Gerontology and is a certified dementia practitioner.

Did you know that certain durable medical equipment (DME) is covered under Medicare? In this article, we’ll explore what’s covered and what’s not.

Does Medicare Cover Durable Medical Equipment (DME)? | Ready Set Care

Does Medicare Cover Durable Medical Equipment (DME)?

The Medicare Annual Enrollment Period runs from October 15th to December 7th every year. The Medicare Annual Enrollment period allows existing Medicare enrollees to make changes to their coverage. Any changes made during the 2022 Medicare enrollment period will affect your 2023 plan, beginning January 1, 2023. During the Medicare Annual Enrollment period you can change Original Medicare, Medicare Advantage, or Medicare Part D plans, you may also switch between plan types and add prescription drug benefits.&nbsp;
This period of time is important in making sure that you have the health benefits you need for the upcoming year. 
&nbsp;
<h2 style="text-align: justify;">4 Questions To Ask Yourself Before Changing Your Medicare Plan &nbsp;</h2>
Before making changes to your current Medicare plan or adding prescription drug benefits, you will want to ask yourself the following questions: 
<h3 style="padding-left: 36pt;">1. What new Medicare plans are available for 2023?&nbsp; </h3>
Each year, the availability and cost of Medicare plans change. Reviewing your Medicare plan options annually ensures you get the best deal and the best coverage. Keeping your current coverage is an option as well and your Annual Notice of Changes will tell you how your current plan is changing for the new year. 
<h3 style="padding-left: 36pt;">2. Does my Medicare coverage match my medical needs? 3. Do I have any gaps in my prescription drug coverage?</h3>
Depending on if your medical situation has changed, updating your policy can help you save money in the long run. An important step in comparing plans would be to look at the total cost of healthcare and insurance. For instance, if you expect to need significant medical or dental care in the upcoming year, a more expensive Medicare Advantage plan with better coverage can reduce your total health care spending. 
<h3 style="padding-left: 36pt;">3. Do I have any gaps in my prescription drug coverage?&nbsp;</h3>
During the Annual Open Enrollment period, you have the option of switching to a policy that has better coverage for the medications you need. You may be able to change Medicare plan companies and have access to different formulary which will improve your benefits. 
<h3 style="padding-left: 36pt;">4. Am I happy with Original Medicare or Medicare Advantage?</h3>
If you&rsquo;re unhappy with Original Medicare or Medicare Advantage you can switch to a different plan during open enrollment. Medicare Advantage plans include more benefits for prescription drug coverage, dental vision, hearing aids, and more.&nbsp; 
<h2> What Are Some Tips When Signing Up For Medicare?</h2>
People age 65 or older are automatically enrolled in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). If you don&rsquo;t receive Social Security benefits and are not ready to apply for them yet, you should sign up for Medicare three months before your 65th birthday (IEP), you&rsquo;ll have a seven-month window of time to sign up for benefits. You pay a premium for Part B coverage which you can turn down, however, if you decide to sign up for Part B later, your coverage can be delayed.
To apply for Medicare benefits you can fill out an online application at<a href="http://www.secure.ssa.gov/"> </a><a href="http://www.secure.ssa.gov">www.secure.ssa.gov</a>. Here are a few tips to consider when signing up: 
<ul>
<li aria-level="1">Make sure you meet Medicare requirements before processing an application. Medicare requires you to be 65 or older to enroll in coverage. </li>
</ul>
<ul>
<li aria-level="1">To enroll you are required to login into your existing Social Security account or attempt to create one. To create an account, you will be asked a series of identity questions for verification. </li>
</ul>
<ul>
<li aria-level="1">Have certain items on hand to be prepared for additional security questions such as but not limited to a mobile phone (for the purpose of receiving texts and emails), credit card, W-2, and tax forms. </li>
</ul>
<ul>
<li aria-level="1">You will be required to fill out your Date and Place of Birth. Note: If you were born outside the United States or its territories you will need to fill in your birth country at the time of your birth, and your Permanent Resident Card number (if you are not a U.S citizen) </li>
</ul>
<ul>
<li aria-level="1">You will fill in your Medicaid Number (State Health Coverage) if applicable. </li>
</ul>
<ul>
<li aria-level="1">You may also fill out employment information. If you have current health insurance coverage through a Group Health Plan you will indicate the Start and End date of coverage for your plan (or spouse&rsquo;s employer) through your current employer.&nbsp; </li>
</ul>
Once you&rsquo;ve gathered all of the necessary items to enroll, you will then click on &ldquo;Apply for Benefits&rdquo; and follow the prompts on the screen.&nbsp; 
<ul>
<li style="text-align: justify;" aria-level="1">You can also Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.</li>
</ul>
<ul style="text-align: justify;">
<li aria-level="1">Contact your local Social Security office.</li>
</ul>
<ul>
<li style="text-align: justify;" aria-level="1">If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772. </li>
</ul>
<h2>What Happens After Applying For Medicare?</h2>
 After applying for Medicare benefits you will be mailed a &ldquo;Welcome Package&rdquo; within 2 weeks of signing up. If you receive Medicare automatically based on disability, you&rsquo;ll get this package about 2 weeks after Social Security approves your benefits. Your &ldquo;Welcome Package&rdquo; will include your Medicare card (Part A and Part B) showing when your coverage starts. 
<ul>
<li style="font-weight: 400; text-align: justify;" aria-level="1">Medicare Part A (Hospital Insurance) helps cover hospital care, skilled nursing care, and more. Most people don&rsquo;t need to pay a premium for Part A Medicare coverage.</li>
<li style="font-weight: 400; text-align: justify;" aria-level="1">Medicare Part B (Medical Insurance) helps cover doctor&rsquo;s services, outpatient care, and more. Part B Medicare is optional, and you pay a monthly premium for it. </li>
</ul>
If you sign up for Medicare Part B at a later time and aren&rsquo;t eligible for the Special Enrollment Period, you&rsquo;ll pay 10% more for each full 12-month period you could&rsquo;ve had Medicare Part B coverage but didn&rsquo;t take it. You will have to pay this late enrollment penalty each time you pay your premiums, for as long as you have Medicare Part B coverage. Note: The penalty increases the longer you go without Medicare Part B coverage.&nbsp;
Now if you&rsquo;re already signed up for Medicare Part B you don&rsquo;t need to do anything. You will automatically be deducted a premium for Medicare Part B from your monthly Social Security or Civil Service benefit payments. If your benefits aren&rsquo;t enough to cover your premium, and you don&rsquo;t get benefits, you&rsquo;ll be billed for your Medicare Part B premium every 3 months. If you don&rsquo;t want Medicare Part B coverage now you can sign up at a later time, however, you may have to wait for your coverage to start and pay a monthly penalty.
Another thing to think about when signing up for Medicare Part B is purchasing Medicare Supplement Insurance from private insurance companies to help you pay your out-of-pocket costs. In addition, you&rsquo;ll have the option of adding a Medicare Part D prescription drug plan, and Medicare Advantage (also known as Medicare Part C) which are Medicare-approved plans from private companies that bundle your Medicare Part A, Medicare Part B coverage, and usually drug coverage (Medicare Part D). Some of the plans offer extra benefits like vision, hearing, and dental services.&nbsp;
If you don&rsquo;t have prescription drug coverage on your Medicare plan, or the coverage you have isn&rsquo;t at least as good as Medicare drug coverage (creditable coverage), you should consider signing up for a Medicare Part D plan. Your plan will tell you each year if your drug coverage is creditable coverage. If you want Medicare drug coverage, you can join a Medicare drug coverage plan or a Medicare Advantage Plan that includes drug coverage. You have up to 3 months after your Medicare coverage starts to join a Medicare Part D plan. If you don&rsquo;t sign up for Medicare drug coverage when you&rsquo;re first eligible for Medicare, and you don&rsquo;t have a creditable prescription drug plan, you may have to pay a late enrollment penalty. If you join at a later time, you&rsquo;ll pay this penalty for as long as you have Medicare drug coverage. The longer you wait to join the penalty goes up. 
<h2 style="text-align: justify;">Dates &amp; Time Frames To Keep In Mind </h2>
<ul>
<li style="font-weight: 400; text-align: justify;" aria-level="1">
<h3>From October 15th to December 7th: </h3>
You can join, switch, or drop a Medicare Advantage Plan or a Medicare drug plan during this period each year. Your new coverage will begin on January 1 of the following year. </li>
<li style="font-weight: 400; text-align: justify;" aria-level="1">
<h3>From January 1st to March 31:</h3>
If you&rsquo;re enrolled in a Medicare Advantage Plan then you can change to a different Medicare Advantage Plan or switch to a Medicare-only plan (Original Medicare )and enroll in a stand-alone Medicare drug plan once during this time. </li>
<li style="font-weight: 400; text-align: justify;" aria-level="1">
<h3>The Special Enrollment Period (SEP):</h3>
 This perios applies in certain situations, you may be able to join, switch or drop Medicare Advantage or Medicare drug plans when certain events happen in your life, such as moving or losing coverage. Your enrollment generally lasts for a calendar year.&nbsp; </li>
</ul>
<h2 style="text-align: justify;">What To Remember About Medicare&nbsp;&nbsp;</h2>
 Original Medicare pays much, but not all of the cost for covered health care or supplies. If you decide to enroll in an Original Medicare plan, you may be able to buy a Medicare Supplement plan (Medigap) from a Private Insurance company which will help pay out of pocket costs in Original Medicare. Medigap cover can cover costs such as coinsurance, copayments, and deductibles. Medigap offers coverage for services Original Medicare doesn&rsquo;t cover, such as medical care when you travel outside of the U.S. However they generally don&rsquo;t cover long-term care (care in a nursing home), vision, dental, hearing aids, private-duty nursing, or prescription drugs.
For questions and inquiries about signing up for Medicare visit<a href="http://socialsecurity.gov/"> socialsecurity.gov</a>, or call Social Security at 1-800-772-1213.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Shelia Benson was born and raised in Las Vegas, Nevada. She comes from a family of insurance professionals and has 12 years of experience in the insurance industry as a licensed agent and is also certified in Medicare. It's her passion to be of service to consumers turning 65 or coming onto Medicare for the first time. During her free time, she loves to spend time with family and her dog, working out, hiking, trying out new restaurants, and going to concerts. Shelia's goal is to educate the Medicare eligible about how Medicare works.&quot;}" data-sheets-userformat="{&quot;2&quot;:15105,&quot;3&quot;:{&quot;1&quot;:0},&quot;11&quot;:4,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:2236962},&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">Shelia Benson was born and raised in Las Vegas, Nevada. She comes from a family of insurance professionals and has 12 years of experience in the insurance industry as a licensed agent and is also certified in Medicare. It's her passion to be of service to consumers turning 65 or coming onto Medicare for the first time. During her free time, she loves to spend time with family and her dog, working out, hiking, trying out new restaurants, and going to concerts. Shelia's goal is to educate the Medicare eligible about how Medicare works.

Everything you need for caregiving all in one place. Personalized care solutions and resources to help you provide better care.

How To Sign Up For Medicare (Tips) | Ready Set Care

How To Sign Up For Medicare (Tips)

With the costs for caregiving services rising, sometimes steeply, it can be worthwhile to cast a wide net when seeking resources that can help cover these costs. With inflation increasing the cost of living, a single source of income such as social security is often no longer able to pay these costs. Besides taking steps such as looking for <a href="https://www.readysetcare.com/resources/articles/how-to-maximize-your-loved-one-s-tax-deduction">tax breaks</a>, there are a number of other sources for <a href="https://www.readysetcare.com/resources/articles/how-to-get-paid-as-a-family-caregiver">caregiving funds</a>, including <a href="https://www.readysetcare.com/resources/articles/most-overlooked-senior-benefits">overlooked senior benefits</a>.&nbsp; 
<h2>5 Financial Resources To Cover Caregiving Costs</h2>
Five of the more commonly used sources of funds for covering costs associated with caregiving services are detailed below. 
They include: 
<h3 style="padding-left: 36pt;">1. Reverse Mortgages</h3>
Originally designed as a method of enabling the elderly to remain in their homes, a reverse mortgage loan allows homeowners over a certain age to tap their home equity to generate funds to pay for their expenses, including caregiving services.&nbsp;
A reverse mortgage typically works best for seniors who have significant equity in their homes and want to use some of that equity to receive cash, either as a lump sum or regular payments, typically monthly.&nbsp;
Each payment made by the lender under a reverse mortgage increases the amount owed under the reverse mortgage. These monthly payments increase the balance which must be paid to the lender either by the senior or by his or her heirs after they pass, or the bank will own the house.&nbsp;
This <a href="https://www.hud.gov/program_offices/housing/sfh/hecm/hecmlenders">link</a> from the U.S. Department of Housing and Urban Development allows you to search for reverse mortgage lenders approved by the Federal Housing Administration (FHA). There are different types of reverse mortgages.&nbsp;
Reverse mortgages insured by the FHA are known as home equity conversion mortgages (HECM). A HECM converts the equity in the house into a payment stream from the reverse mortgage.
To qualify for a reverse mortgage, seniors must typically meet the following requirements:
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">62 years or older</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">Home appraisal by the bank to determine the payment amount based on the age of the senior taking the loan and the value of the home</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">The home must be owned by the senior, generally without debt or with only a small mortgage outstanding in relation to the appraised value</li>
</ul>
</li>
</ul>
&nbsp;
<h3 style="padding-left: 36pt;">2. Home Equity Loans</h3>
Homeowners can also pull equity out of their homes through a home equity loan, or HELOC, which they then make monthly payments to repay. These loans are typically taken on a borrower&rsquo;s primary residence, often in the form of a line of credit, and can be used for a variety of purposes, including home improvement or paying for general expenses such as caregiving.&nbsp;
Generally, a borrower receives the borrowed funds in a lump sum, unless a line of credit is being used, and must pay a home equity loan back in a few years, unlike a mortgage which can extend for up to 30 years.&nbsp;
This option typically works best when there is significant home equity in the house, otherwise, combined payments on the loan and the mortgage may be beyond the ability of the borrower to pay.
&nbsp;
<h3 style="padding-left: 36pt;">3. Medicaid</h3>
Most states allow Medicaid recipients to hire a family member as a paid caregiver through a Medicaid waiver program: <a href="https://www.medicaid.gov/medicaid/ltss/self-directed/index.html">Medicaid waiver self-directed long-term services and supports (LTSS) programs</a>. States offer a variety of self-directed caregiving options, including <a href="https://www.medicaid.gov/medicaid/hcbs/authorities/1915-j/index.html">self-directed personal assistant services</a>, which enable participants to choose and pay their providers.&nbsp;
These Home &amp; Community-Based Services (HCBS) fall under the waiver program. To determine if a person qualifies for Medicaid, contact your state&rsquo;s Medicaid office.
&nbsp;
<h3 style="padding-left: 36pt;">4. Long-Term Care Insurance</h3>
Long-term care insurance can be an effective way to cover the costs associated with care over and above hospital treatment. Not every long-term care policy will cover long-term care, however, some will.&nbsp;
The downside to long-term care policies is that most of them don&rsquo;t allow purchases after a certain age. As a result, these policies must generally be purchased when a person is younger to be an effective option for covering caregiving costs.
&nbsp;
<h3 style="padding-left: 36pt;">5. Annuities</h3>
Annuities can be a good option for paying for caregiving costs because they enable purchasers to choose income options that can provide for long-term, or even lifetime, income payouts.&nbsp;
Sums received from annuities are not considered to be assets when a senior applies for Medicaid, and income received from them is not restricted&mdash;meaning it can be used for any purpose including paying caregiving costs.
Annuities typically enable you to grow the funds invested in the annuity over time on a tax-deferred basis and then offer a variety of options for pulling income from the contract when the time comes. This income might be for a period certain, such as 10 or 20 years, or for the rest of the senior&rsquo;s life.&nbsp;
Either way, this income can prove very helpful in paying for caregiving costs.

Joshua Iversen is a Registered<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Registered Investment Advisor Representative and Senior Planning Specialist with 30+ years of experience. As President and Chief Investment Officer of Santa Ana-based Syzygy Financial LLC, he helps seniors deal with all financial and healthcare aspects of the senior experience, including Social Security claiming strategies, Medicare, Medigap, long-term care, and overall financial planning strategy.&quot;}" data-sheets-userformat="{&quot;2&quot;:8963,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;11&quot;:4,&quot;12&quot;:0,&quot;16&quot;:11}">&nbsp;Investment Advisor Representative and Senior Planning Specialist with 30+ years of experience. As President and Chief Investment Officer of Santa Ana-based Syzygy Financial LLC, he helps seniors deal with all financial and healthcare aspects of the senior experience, including Social Security claiming strategies, Medicare, Medigap, long-term care, and overall financial planning strategy.

Learn some of the ways to find resources that can help pay for caregiving services, including reverse mortgages, home equity loans and more

5 Financial Resources To Help Pay For Caregiving Services | Ready Set Care

5 Financial Resources To Help Pay For Caregiving Services

Family caregivers are a critical part of the American healthcare system, providing ongoing support to aging parents or loved ones with disabilities. Caregivers are often providing long-term care to people within their own homes, with the role frequently lasting for <a href="https://www.caregiver.org/resource/caregiver-statistics-demographics/">4 years or even longer</a>.&nbsp;
Caring for a loved one can also be intense, both practically and emotionally, and caregivers often struggle to still earn at their normal levels. Indeed, many caregivers must give up their jobs or cut down their hours to be able to support their loved ones.&nbsp;
Other ways of earning need to be found, which is why we&rsquo;re looking at how you can get paid as a family caregiver. There are plenty of ways to do so, along with some complexities to think about. 
<h2>How To Get Paid To Support Your Family Member</h2>
Below are five resources to consider to get paid as a family caregiver: 
<h3 style="padding-left: 36pt;">1. Medicaid Programs</h3>
Medicaid offers a variety of <a href="https://www.medicaid.gov/medicaid/long-term-services-supports/self-directed-services/index.html">self-directed programs</a>, often through the home and community-based services (HCBS) waiver programs. Some of these are personal assistance services (PAS) programs, which focus on the activities of daily living, such as toileting and dressing. These programs provide valuable human services that help seniors to stay in their own homes for longer.&nbsp;
These Medicaid programs generally focus on home care, although there are some situations where they may apply to group home situations instead.&nbsp;
Seniors eligible for such Medicaid programs have control over some aspects of their care, including who provides it. The self-direction aspect of these programs often gives seniors the chance to hire family members as paid caregivers.&nbsp;
Bear in mind that the processes can take a while. As <a href="https://www.aarp.org/caregiving/financial-legal/info-2017/you-can-get-paid-as-a-family-caregiver.html">AARP points out</a>, self-directed care typically involves assessment, planning, budgeting, and selection steps. Planning can be particularly detailed, as this can involve considering the level of care needed and developing a care plan.&nbsp;
Each of those steps take time, which may leave your loved one without support for longer than you would like. As such, it&rsquo;s important to start early and look into home health care and financial assistance before doing so feels essential.
There is also the Medicare-Medicaid program, PACE, which has a consumer-directed focus, giving seniors more control over the care providers they use and the specific personal care services. In some situations, this program may pay for family caregivers as well.&nbsp;
<h4 style="padding-left: 72pt;">Differences Between States</h4>
Most states offer some type of self-directed program. However, the names of the programs vary from one state to the next, as do the specifics. There can be differences in services supported, the amount that caregivers are paid, and whether adult children or spouses can act as caregivers.&nbsp;
As a result, you&rsquo;ll need to do some digging into state Medicaid programs. You&rsquo;ll need to learn what&rsquo;s available in your local area, along with the different program requirements. Local area agencies on aging (AoAs) can help to guide you, as they already have plenty of resources for the local area. <a href="https://eldercare.acl.gov/Public/Index.aspx">The government&rsquo;s Eldercare Locator</a> also makes it easy to find local services.&nbsp;
Finding local experts can also help you to navigate the complexities of the different Medicaid programs, as they vary in their requirements and how you apply. Someone who knows the ropes can help you to make the best use of your time and increase the likelihood of success.&nbsp;&nbsp;
<h4 style="padding-left: 72pt;">Requirements For These Programs</h4>
Because these programs run through Medicaid, Medicaid eligibility plays strongly in determining whether seniors are eligible or not. These criteria differ from state to state, so they&rsquo;ll be determined by where you live.&nbsp;
There are functional criteria too, which look at the senior&rsquo;s current abilities and the level of care they need.&nbsp;
If the senior isn&rsquo;t eligible for Medicaid due to their finances, they may qualify for <a href="https://www.nolo.com/legal-encyclopedia/how-does-medicaids-medically-needy-program-work.html">Medicaid&rsquo;s Medically Needy Program</a>. This program takes medical expenses into account when considering Medicaid eligibility and could allow some people to be eligible who weren&rsquo;t before.&nbsp;&nbsp; 
<h3 style="padding-left: 36pt;">2. Non-Medicaid Programs</h3>
Many states also have additional programs that aren&rsquo;t associated with Medicaid. These vary even more dramatically than the Medicaid-based ones.&nbsp;
You&rsquo;ll see differences in what these programs are called, how they&rsquo;re funded, who is eligible, and the services they offer. For example, some programs may only offer support for people who need nursing home-level care, others may focus on people with disabilities, while still others may even provide services for healthy seniors.&nbsp;
With so many differences, it&rsquo;s crucial to pay close attention to your local area. This is where the relevant programs are. Pay attention to where the information comes from as well, as many sites have out-of-date details, which might mean you don&rsquo;t get a complete picture of eligibility requirements or all the benefits of a given program.&nbsp;
Here at Ready Set Care, we have a collection of <a href="../../resources/explorer/caregiver-compensation">state-specific caregiver compensation articles</a>. Each of these provides details about the current programs that help caregivers to get paid. For example, <a href="../../resources/articles/caregiver-compensation-california">California has just one option</a>, In-Home Supportive Services (IHSS), while <a href="../../resources/articles/caregiver-compensation-texas">Texas has three</a>. These articles can help you learn about your local choices, giving you a starting point for seeking services.&nbsp;&nbsp; 
<h3 style="padding-left: 36pt;">3. Veterans Benefits</h3>
For those who have served their country and meet all the criteria, The Department of Veterans Affairs (VA) <a href="../../resources/articles/how-to-learn-about-veterans-benefits">provides additional support</a>.&nbsp;
A key area is <a href="https://acl.gov/programs/veteran-directed-home-and-community-based-services/veteran-directed-home-community-based">the Veteran Directed Care Program</a>. This was once known as Veteran-Directed Home and Community-Based Services and has a strong person-centered emphasis. The program allows veterans to direct the long-term care services and supports they receive, which includes being able to hire and pay caregivers.&nbsp;
There are also VA pension benefits that may help veterans to pay family caregivers, especially as these can <a href="https://www.va.gov/pension/">scale based on need</a>. For example, the VA Aid and Attendance Benefit are designed for disabled pensions who need regular support with activities of daily living. Such VA benefits can make a large difference, although some families may not be eligible.&nbsp;
Some of these benefits apply not just to veterans, but also to surviving spouses.&nbsp; 
<h3 style="padding-left: 36pt;">4. Long-Term Care Insurance</h3>
Long-term care insurance can be a valuable option. As the name suggests, this specifically provides for long-term care, which can include care in a facility or home-based care. Some health insurance policies also have the option of a long-term rider. This allows seniors to use some of their death benefits to pay for long-term care while they are still alive.&nbsp;
There are some limitations though. First, the senior needs to be eligible for the insurance, which isn&rsquo;t always the case. Some will be rejected, especially if they are in poor health. Even if the senior is accepted, long-term care insurance often comes with high premiums. It may simply be out of the reach of some people.&nbsp;
Also, long-term care insurance requires planning ahead. Seniors need to be paying into it before they start to need long-term support. As such, this mightn&rsquo;t be viable for seniors who are starting to need long-term services and haven&rsquo;t looked at the insurance angle.&nbsp;
You&rsquo;ll also need to find out about the specific benefits of the insurance. Will the insurance pay for caregiving directly or give the senior money that they&rsquo;re able to use for caregiving? Some policies may not even support family caregiving, so it&rsquo;s crucial to check first.&nbsp; 
<h3 style="padding-left: 36pt;">5. Personal Care Agreements&nbsp;</h3>
Personal Care Agreements go by a few names, including a caregiver contract, elder care contract, or personal care agreement. The idea is to make a formal agreement within the family, so the caregiver can be paid regularly. The agreement may also act as a care plan, so everyone is on the same page about how the senior will be supported.&nbsp;
The agreement should outline the specific care services that are provided, compensation, and any other important areas. For example, what happens if home modifications are needed or the required level of care increases?&nbsp;
It&rsquo;s helpful to get other people involved in the process, including professionals, to make sure that everything is reasonable and legal. Doing so is important for any type of family care situation, as it&rsquo;s easy for things to get emotional and complicated.
Personal care agreements are often made between the senior and the adult child who will be the caregiver. However, other arrangements can be made as well, such as where non-caregiving children contribute financially to help pay the family caregiver.&nbsp;
Creating such a formal document with family members may feel a little strange. Still, doing so is important, as having everything in writing prevents problems later on.&nbsp;
<h4 style="padding-left: 72pt;">How Can Seniors Raise Funds?&nbsp;</h4>
Personal care agreements are often the most viable option for adult children and their aging parents. Many families simply aren&rsquo;t eligible for government programs or find that the application process and waiting lists take far too long.&nbsp;
However, seniors often don&rsquo;t have much money, so this approach can be difficult. As AARP highlights, one approach is to focus on the home. Many older adults could easily downsize, a process that may earn them money and also mean that they&rsquo;re in a safer environment (which is incredibly important for housebound seniors). Downsizing might even decrease the need for home modifications, which is relevant for safety too.&nbsp;
It's also possible to get a home equity loan or reverse mortgage. While those approaches can be helpful, they should be approached carefully, as there are risks.&nbsp;
&nbsp;
<h2>What Is The Pay Rate For Family Caregivers?</h2>
The pay rate for family caregivers varies depending on the state and the program, but it&rsquo;s never particularly high. You&rsquo;re often looking at close to the minimum wage for your state.&nbsp;
Some states are also more generous than others. For example, California is one of the most powerful states for caregiving support, while many other states provide less.&nbsp;
There may also be a cap on the number of hours per month. You&rsquo;ll only get paid for care up to that threshold. If you go beyond it, the extra hours are generally unpaid.&nbsp; 
<h2>Will Social Security Pay For A Caregiver?&nbsp;</h2>
Social Security doesn&rsquo;t directly pay for caregiver services. However, an aging parent might use their Social Security income to pay a family member for assistance.
This may be a necessary approach if the senior isn&rsquo;t eligible for any of the programs highlighted on this list. However, many seniors have limited income, so the amount they can pay may be low.&nbsp; 
<h2>What About Supplemental Security Income (SSI)?&nbsp;</h2>
Similarly, SSI doesn&rsquo;t directly pay for caregiving, but seniors can use the money to pay family members if they choose.&nbsp;
Of course, SSI is an income-based program, so seniors who are eligible for SSI may also be eligible for some of the other programs highlighted on this list, including Medicaid waiver programs.&nbsp; 
<h2>Other Sources Of Support &amp; Income For Family Caregivers</h2>
Getting paid as a caregiver isn&rsquo;t your only option. You can also look for assistance programs, including ones that focus on caregiver support.&nbsp;
Respite care is a fantastic approach. Respite care means that someone else looks after your loved one for a while, providing you with a break and a chance to focus on your own mental health.&nbsp;
You can turn to your job as well. Some companies offer paid leave for caregiving. This could be perfect if you&rsquo;re still working and only occasionally need time off to help your loved one.&nbsp;
There are also programs that won&rsquo;t pay you to be your loved one&rsquo;s caregiver but will pay someone else to do so (often someone from a home care agency). This is still incredibly helpful, as it frees up some of your time and energy. If someone else is doing some of the caregiving tasks, then you can use that time to rest and regroup, or to earn money.&nbsp;
Doing so could be even more powerful than getting paid as a caregiver. After all, caregiving is an exhausting role that can lead to physical and mental health problems. It might be wise to allow someone else to do some of the caregiving tasks, then just help out where you can.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Angelica P. Herrera-Venson, DrPH is a gerontologist, public health and Medicare expert, and published researcher in family caregiving and chronic health conditions. She is the author of The Multicultural Guide to Caregiving and has held prestigious fellowships, including the Health Policy &amp; Aging program and Geriatric Psychiatry fellowship from the National Institute of Mental Health. Angelica was an Associate Director at the National Council on Aging and has worked extensively with Medicare and Medicaid dual-eligible patients. She is currently the owner of Kapok Aging &amp; Caregiver Resources, a hub for caregivers from around the world.&quot;}" data-sheets-userformat="{&quot;2&quot;:15171,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;9&quot;:0,&quot;11&quot;:4,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:1907741},&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">Angelica P. Herrera-Venson, DrPH is a gerontologist, public health and Medicare expert, and published researcher in family caregiving and chronic health conditions. She is the author of The Multicultural Guide to Caregiving and has held prestigious fellowships, including the Health Policy &amp; Aging program and Geriatric Psychiatry fellowship from the National Institute of Mental Health. Angelica was an Associate Director at the National Council on Aging and has worked extensively with Medicare and Medicaid dual-eligible patients. She is currently the owner of Kapok Aging &amp; Caregiver Resources, a hub for caregivers from around the world.

Supporting a loved one gets expensive fast. Getting paid as a caregiver is a powerful way around the problem. Learn five ways to get paid as a family caregiver.

5 Ways To Get Paid As A Family Caregiver | Ready Set Care

5 Ways To Get Paid As A Family Caregiver

Healthcare costs are on the rise and many Americans find themselves struggling to make payments for medical care. Medicare and Medicaid are two types of medical insurance programs sponsored by the government to offset the cost of care services.&nbsp;
Medicare and Medicaid are oftentimes used interchangeably, even within the eldercare field. 
However, there are important differences between these medical insurance programs. While both are government health insurance programs, they offer different benefits to different groups of people.
In this article, we will review the unique benefits of each plan, as well as an overview of who may be eligible for each program.&nbsp;
&nbsp;
<h2>What is Medicare?</h2>
Medicare is a federal health insurance program for people over age 65 years old, or younger with specific disabilities, such as End-Stage Renal disease. There are four parts of Medicare and two avenues to access these parts.&nbsp;&nbsp;
The parts of Medicare include: 
<h3 style="padding-left: 36pt;">Medicare Part A</h3>
Most people do not pay a premium for Medicare Part A. Medicare Part A covers hospital stays, skilled nursing care (both at home and within a skilled nursing home), and <a href="../articles/what-to-know-about-hospice">hospice care.</a>&nbsp; 
<h3 style="padding-left: 36pt;">Medicare Part B</h3>
Medicare Part B covers general doctor visits and other outpatient services, including preventative care and some <a href="../articles/durable-medical-equipment-covered-by-medicare-part-b">durable medical equipment.</a> Medicare Part B premiums are dependent on your income. 
<h3 style="padding-left: 36pt;">Medicare Advantage Plan (also known as Medicare Part C) </h3>
Medicare Part C refers to a Medicare-approved plan from a private insurance company. While Medicare Part C has a premium that the patient will need to pay - it often comes with additional benefits.&nbsp; 
<h3 style="padding-left: 36pt;">Medicare Part D </h3>
Medicare Part D covers the cost of most prescription drugs - including <a href="../articles/guide-to-senior-vaccines" target="_blank" rel="noopener">vaccinations</a>. Original Medicare refers to a plan in which the patient pays for services as needed from Part A and Part B.&nbsp;
&nbsp;
Medicare Part A and Part B generally do not have copayments, however, you may have a copayment if you have supplemental insurance.
Some individuals will purchase supplemental or co-insurance to cover services and providers not covered by Original Medicare. These plans are purchased through a private insurance company.
Individuals who qualify for Medicare because of a disease, versus their age will receive a Medicare Special Needs plan, also known as a Medicare SNP.
If a person applies for social security or disability benefits, they will automatically be applying for Medicare. If not, they will have to submit an application online. Enrollment for Medicare can happen when the person becomes qualified (turning age 65 for example). However, there is also a yearly Open Enrollment period in which you can adjust plans. This period is from October- December.
In addition to the different Medicare parts listed above, there are also four Medicare Savings Programs for low-income individuals who need extra help. If eligible, these programs may cover the costs of copayments, deductibles, and premiums. You can find the applications for these programs through your state. The four <a href="https://www.medicare.gov/basics/costs/help/medicare-savings-programs">Medicare Savings Programs</a> are:
<ul>
<li style="font-weight: 400;" aria-level="1">Qualified Medicare Beneficiary Program (QMB) and QMB plus</li>
<ul>
<li style="font-weight: 400;" aria-level="2">Individuals with QMB plus receive full Medicaid benefits</li>
</ul>
<li style="font-weight: 400;" aria-level="1">Specified Low-Income Medicare Beneficiary Program</li>
<li style="font-weight: 400;" aria-level="1">Qualifying Individual Program</li>
<li style="font-weight: 400;" aria-level="1">Qualified Disabled Working Individual Program</li>
</ul>
If you&rsquo;re unsure which health plan from Medicare would benefit you and your loved ones the most, it can be helpful to work with a <a href="https://www.shiphelp.org/">SHIP or SHINE counselor</a> (same concept, different names). These counselors are government-trained volunteers, typically based at a senior center, to help guide you in the Medicare application process. With research and understanding, Medicare coverage can benefit your loved one and save money in the future. 
<h2>What is Medicaid?</h2>
Medicaid is a health insurance program sponsored by both the federal government and individual state governments. Medicaid eligibility is determined primarily by financial status. It is designed for low-income individuals.
The Affordable Care Act re-established the way in which eligibility is determined. Medicaid financial eligibility is determined by the individual&rsquo;s Modified Adjusted Gross Income (MAGI).&nbsp;
It&rsquo;s important to understand that the benefits of Medicaid vary from state to state. However, there are some mandatory benefits required by the federal government to cover.
<a href="https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html">Some of these benefits include:</a>
<ul>
<li aria-level="1">Inpatient &amp; Outpatient hospital visits</li>
</ul>
<ul>
<li aria-level="1">Early &amp; Periodic Diagnostics and Testing</li>
</ul>
<ul>
<li aria-level="1">Skilled Nursing Facilities (including long-term care and nursing home care)</li>
</ul>
<ul>
<li aria-level="1">Lab work &amp; X-Rays</li>
</ul>
<ul>
<li aria-level="1">Transportation to medical care </li>
</ul>
Applying for the Medicaid program must be done within the state of residence. It can be beneficial to work with a Medicaid Planner or Elder Law Attorney when navigating the Medicaid application process - especially if the individual has assets that may deem them ineligible.&nbsp; 
<h2>What is Dual Eligibility?</h2>
Some individuals may be eligible for both Medicare and Medicaid due to their age and financial status. These individuals are considered &ldquo;Dual Eligible&rdquo;. In this case, Medicaid would cover the cost of Medicare&rsquo;s premiums and deductibles. Dually eligible individuals also participate in one of the Medicare Savings Plans.
Dual-eligible beneficiaries would receive all the benefits under Medicare, but their Medicaid coverage would be dependent on their income.
Understanding Medicare and Medicaid can help ensure your loved one gets the care and support they need for the best cost.&nbsp;

Understanding the eligibility requirements for Medicare and Medicaid will help you understand if you or a loved one qualify. Learn the differences between Medicare and Medicaid to determine the right care path.

Understanding Medicare and Medicaid: Who is Eligible? | Ready Set Care

Understanding Medicare and Medicaid: Who is Eligible?

When it comes to planning for your future, Medicaid is perhaps one of the most integral parts.
For many people, it&rsquo;s a whole new territory to navigate and it&rsquo;s often navigated in times of stress. Medicaid takes time and effort to understand and effectively plan for. 
This article will give you the basics of Medicaid and guidance on obtaining support with qualifying and applying for Medicaid. 
<h2>What to know before Medicaid Planning</h2>
Before planning for Medicaid, it&rsquo;s important to understand what Medicaid is and what benefits it can bring to you or your loved one.&nbsp;
Medicaid is a federal and state health insurance program for people with disabilities or adults over age 65 with low incomes. It&rsquo;s important to know that Medicaid eligibility and services vary from state to state.&nbsp; Medicaid is often confused with Medicare, a federal health insurance program for older adults of any health status and income.
Medicaid has a wide range of eligibility requirements. Qualification for Medicaid is dependent on marital status and the type of care being sought as well as finances.
The qualifications for married couples are different from those for individuals. There are also differences for married couples where one spouse lives in the community and the other lives in a nursing facility.
To determine financial eligibility, a person&rsquo;s assets, annuities, IRAs, and pensions are all taken into account at the time of application and within the look-back period (should one exist). 
<h2>Medicaid Benefits: What does Medicaid cover?&nbsp;</h2>
Medicaid coverage includes a range of services based on the state of residence, however, there are some services that are mandatory that they provide.<a href="https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html"> According to the</a><a href="http://medicaid.gov/"> medicaid.gov website</a>, these mandatory care services include:&nbsp;
<ul>
<li aria-level="1">Medical care services both inpatient and outpatient</li>
</ul>
<ul>
<li aria-level="1"><a href="../../resources/articles/20-interview-questions-to-ask-a-nursing-home">Nursing home services </a>(rehab &amp; long term care)</li>
</ul>
<ul>
<li aria-level="1">Physician services</li>
</ul>
<ul>
<li aria-level="1">Lab testing &amp; X-Ray imaging</li>
</ul>
<ul>
<li aria-level="1">Home health services </li>
</ul>
It&rsquo;s important to understand that while Medicaid may cover home health services, home health refers to nursing or <a href="../../resources/articles/what-to-know-about-hospice">hospice services</a> if a person is referred by their doctor. It does not cover respite care.
However, some states have Medicaid programs that may cover caregiver respite services, such as adult day programs, or programs that allow a <a href="../../resources/articles/how-to-get-paid-as-a-family-caregiver">caregiver to receive a stipend for providing care</a>. 
<h2>What is Medicaid Planning?&nbsp;</h2>
Medicaid planning is the preparation process behind qualifying for and enrolling in Medicaid. However, Medicaid planning may also refer to planning services provided by Medicaid experts who assist in this process.
An expert in Medicaid can offer planning strategies to ensure that your loved one has the future insurance coverage they need, while also protecting the assets of other family members. This can include protecting funds for a spouse or an adult child with a disability or special needs. They may do this through an irrevocable trust.
Medicaid planning may also include asset protection and determining if a &ldquo;spend down&rdquo; would be beneficial. The &ldquo;spend down&rdquo; refers to the use of funds that leave an individual over-qualified for Medicaid. Your Medicaid planner in this case can advise if there is a look-back period.
Because the eligibility requirements are so varied and complex, it is so valuable to have an expert on your side as you navigate the application process.&nbsp; 
<h2>Where to find a Medicaid Planner&nbsp;</h2>
Medicaid planning is generally done by an Elder Law Attorney, but may also be completed by a qualified case manager specializing in Medicaid Planning or a financial planner. An Elder Law Attorney is an attorney who specializes in legal services regarding senior care - including Medicaid planning. They are especially beneficial if your loved one needs to review and reorganize their finances in order to plan for Medicaid. 
An elder law attorney is different from an estate planning attorney, and it&rsquo;s important to ensure you&rsquo;re working with the correct attorney for your needs. An estate attorney focuses on documents such as wills - things needed after death while an elder law attorney focuses on documents for the living. 
Many Medicaid planners offer free consultations, so take advantage of this opportunity to ensure you feel you can trust the individual you choose to support you and your loved ones.&nbsp;
&nbsp;
<h2>Who should take part in Medicaid Planning?&nbsp;</h2>
The costs associated with care such as home care and nursing home are growing! For many people, it is not possible to cover the high costs of long-term care services out of pocket. Unfortunately, private insurance does not generally cover home care or nursing home services and very few people have long-term care insurance policies.&nbsp;
Medicaid planning is generally for individuals who have some income and assets, but not enough to privately pay for care, but too many assets to easily apply for Medicaid. In addition, Medicaid planning can protect a spouse residing at home (also known as a community spouse), if the other spouse needs a nursing home. 
<h2>Remember, Medicaid Planning takes time</h2>
If you or a loved one has been diagnosed with a terminal illness such as Alzheimer&rsquo;s disease, it&rsquo;s important to take action and plan for Medicaid as soon as possible. Medicaid planning should be completed when other long-term financial documents such as the power of attorney and health care proxy are put into place.
Taking time to ensure that everything is in order for your or your loved one&rsquo;s future care is key to decreasing stress in the future.

Learn more about how to apply for Medicaid and plan for senior care through Medicaid Planning. We will cover important facts you should understand for Medicaid Planning

What is Medicaid Planning? | Ready Set Care

What is Medicaid Planning?

Medicaid and Medicare are both important health-related programs in the United States. They provide financial support for many people, helping to cover medical expenses and ensure that needs are met.&nbsp;
However, the two programs are both complex and are often confused with each other.&nbsp;
This isn&rsquo;t surprising, as Medicare and Medicaid can both pay for many of the same types of services, albeit in different situations and with different criteria. So, what are the differences and similarities between the services? When might you use one over the other? We will cover the answers to these questions in this article.
&nbsp;
<h2>Medicare vs. Medicaid: What&rsquo;s the difference?</h2>
&nbsp;
<h3 style="padding-left: 36pt;">MEDICARE 101</h3>
Medicare is a type of insurance. People pay into it throughout their lives, then that fund is used to pay for a variety of medical expenses.&nbsp;
Medicare doesn&rsquo;t cover everything. Instead, Medicare users still pay part of their costs, often through deductibles and premiums.&nbsp;
Medicare is also a federal program. As such, it is run by a federal government agency (the Centers for Medicare &amp; Medicaid Services) and tends to be the same no matter where you are in the United States.&nbsp;
Importantly, Medicare isn&rsquo;t income-based. Instead, people over 65 can sign up, regardless of income. The same is true for other eligible groups, including those on dialysis, those with ALS, and people who are disabled.&nbsp;
Medicare is also more complex than Medicare, as it has four different parts and specific enrollment periods.&nbsp; 
<h4 style="padding-left: 72pt;">What Are The Different Parts Of Medicare?</h4>
Medicare has <a href="https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medicare">four main parts</a>.&nbsp;
<ul>
<li style="list-style-type: none;">
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">Medicare Part A is hospital insurance. Medicare Part A covers inpatient care in places like hospitals, hospices, and skilled nursing facilities. </li>
<li style="font-weight: 400;" aria-level="1">Medicare Part B is medical insurance. Medicare Part B covers outpatient care, some types of home health care, durable medical equipment, preventive services, and a variety of health care provider services, including doctor visits. Collectively Medicare Part A and Medicare Part B are known as Original Medicare. </li>
<li style="font-weight: 400;" aria-level="1">Medicare Part C refers to Medicare Advantage plans. Medicare Advantage plans are alternatives to Original Medicare. They&rsquo;re Medicare-approved and are provided by private insurance companies. Medicare Advantage plans typically provide most of the benefits of Medicare Part A and Part B, plus drug coverage. However, there are some differences, and the specific services are influenced by the plan you choose. </li>
<li style="font-weight: 400;" aria-level="1">Medicare Part D is coverage for prescription drugs and also covers <a href="../articles/guide-to-senior-vaccines">various vaccines and shots</a>. Members get medication coverage either by signing up for Medicare Part D or by choosing a Medicare Advantage Plan, many of which include prescription drug coverage. Finally, there is Medicare Supplemental Insurance, also known as Medigap insurance which comes from private insurance companies and aims to cover the areas that Original Medicare doesn&rsquo;t. It&rsquo;s only used for Original Medicare users, so it&rsquo;s not relevant if you&rsquo;re using a Medicare Advantage plan. </li>
</ul>
</li>
</ul>
</li>
</ul>
Original Medicare vs. Medicare Advantage
<a href="https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage">According to medicare.gov</a>, under Original Medicare, you&rsquo;re able to visit any doctor that accepts Medicare and generally don&rsquo;t need a referral for specialist visits. Medicare Advantage plans are often more restrictive, which may limit the specific providers you can use and mean you need a referral to visit a specialist.&nbsp;
Under Original Medicare, you first pay a deductible, then pay roughly 20% of the approved amount. This is known as co-insurance. Costs vary for Medicare Advantage plans which means&nbsp;that some services have lower out-of-pocket costs, while others have higher ones.&nbsp;
Original Medicare charges Part B premiums. You sometimes pay this under Medicare Advantage plans too (often with a fee for the plan as well), but other times there is no plan premium and some of your Part B premiums may be paid too.&nbsp;
Medicare Advantage plans often have a yearly cap. They cover all the crucial services included in Original Medicare, and some may provide extra services not found in Original Medicare.&nbsp;
The differences in price and services are strongly influenced by which Medicare Advantage plan you choose.&nbsp; 
<h4 style="padding-left: 72pt;">Signing Up for Medicare</h4>
Medicare eligibility begins three months before a person turns 65. Most people sign up for Original Medicare at this point, to avoid any penalties or gaps in service. However, <a href="https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Employers-and-Unions/FS3-Enroll-in-Part-A-and-B.pdf">there are some situations</a> where you might choose to delay signing up, such as if you still receive insurance from an employer.&nbsp; 
The initial period of eligibility lasts for seven months, ending three months after the month a person turned 65. Exactly when the coverage begins <a href="https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start">depends on the month</a> that you signed up for Medicare.
There is also a general enrollment period from January 1 to March 31 annually. People who missed signing up when they were initially eligible need to do so in this window.&nbsp;&nbsp;&nbsp;
Beyond this, there is a <a href="../articles/medicare-open-enrollment-how-you-can-help-your-loved-one">Medicare open enrollment period</a>. This doesn&rsquo;t refer to the Original Medicare. Instead, it&rsquo;s the time when people can swap from their Original Medicare to a Medicare Advantage plan, can change Medicare Advantage Plans, or go back to their Original Medicare.&nbsp;
The enrollment period here is in the fall, starting on October 15 and ending on December 7.&nbsp;
This window is particularly important if your circumstances have changed and you need to adjust your coverage or if your current plan isn&rsquo;t meeting your needs.&nbsp; 
<h3 style="padding-left: 36pt;">MEDICAID 101&nbsp;</h3>
In contrast, Medicaid is run by the federal government and by state governments. Due to this, requirements, services, and other factors can vary from one state to the next.&nbsp;
Medicaid is also an assistance program that focuses on supporting low-income people, regardless of their age. Co-payments are sometimes required for services, but these are typically low, as Medicaid beneficiaries have limited funds.&nbsp;
Medicaid covers a large range of services, including routine medical care, hospital visits, some types of screenings and preventative services, and even long-term care in some situations.&nbsp;
<h4 style="padding-left: 72pt;">Eligibility Requirements</h4>
While Medicare is available to anyone aged 65 and above, Medicare has strict eligibility requirements, including income thresholds. There is a <a href="https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels/index.html">comprehensive state-by-state table at medicaid.gov</a> that highlights the different income thresholds for each state.&nbsp;
Other criteria influence Medicaid eligibility too, including state residency and immigration status.&nbsp;&nbsp;
Assets are relevant to Medicaid eligibility as well, but you <a href="../articles/medicaid-myths-debunked">can&rsquo;t just give away assets</a> to be eligible for Medicaid faster.&nbsp;
<h4 style="padding-left: 72pt;">Covered Services</h4>
Medicaid covers many of the health care services that Medicare does and has greater support in some areas, including various types of preventative care and eyeglasses. Medicaid also provides pregnancy and family planning services, nursing facility services, home health, and more.&nbsp;
Some of the services <a href="https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html">are federally mandated</a>, but there are also many optional ones. States can decide which of these to offer, which is partly why Medicaid varies so much between states.&nbsp;
Medicaid is also more relevant for some types of long-term care, which can include in-home care and, in some cases, nursing home care. However, facilities aren&rsquo;t obliged to accept Medicaid, so you&rsquo;ll need to work out which ones do.&nbsp;
Medicaid is also able to pay for some Medicare fees, including the 20% of service charges that Medicare does not cover, plus the Medicare premium. As such, Medicaid can help people access Medicare who normally wouldn&rsquo;t be able to.&nbsp; 
<h2>What does it mean to be Dual Eligible?&nbsp;</h2>
People with both full Medicaid and Medicare are considered dually eligible. Dual-eligible beneficiaries still get the regular options for Medicare coverage and are able to choose Medicare Advantage plans.
There are even specific dual-eligible Medicare Advantage plans that are designed to make things easier.&nbsp;
When services are paid for, Medicare pays first. Medicaid is only used after Medicare and other types of health insurance.&nbsp;&nbsp; 
<h2>Final Take-Aways</h2>
Despite the similar names and focus on helping with health care costs, Medicare and Medicaid are two very services.&nbsp;
Medicare is a health insurance program that can come with monthly premiums, while the Medicaid program focuses on supporting low-income people and comes with fewer fees. Remember, because Medicaid is state and federally-managed, each state Medicaid program is different.&nbsp;

Despite being very different programs, Medicare and Medicaid are often confused. Learn the differences between Medicare and Medicaid.

What Is The Difference Between Medicare and Medicaid? | Ready Set Care

What Is The Difference Between Medicare and Medicaid?

In-home care is a powerful way to support senior health, but sometimes financial assistance is needed to make such care affordable.

Where To Find In-Home Care Financial Assistance? | Ready Set Care

Where To Find In-Home Care Financial Assistance?

Caring for a family member, whether they&rsquo;re a <a href="https://www.readysetcare.com/resources/articles/challenges-of-caring-for-a-parent">parent</a>, grandparent, child, or spouse, along with the <a href="https://www.readysetcare.com/resources/articles/how-to-cope-with-the-common-emotions-of-caregiving">emotional challenges</a> involved, can present financial challenges by keeping you from working full or even part-time. If you are serving as a family caregiver for your spouse, there are certain government programs that may offer compensation for the services you provide.&nbsp;
Additionally, there are programs available from a variety of entities that may offer other assistance for family caregivers in the form of access to resources or care services.&nbsp;
There may also be alternative options to consider for receiving compensation for caring for your spouse. For instance, alternative forms of financial assistance could come from: 
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<li style="font-weight: 400;" aria-level="1">A relative or friend who wants to contribute to your spouse&rsquo;s medical care.&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Your spouse&rsquo;s income from Social Security or SSI, if any, may be used for this purpose if feasible.&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">An employer may offer paid family leave to you to care for your spouse for a certain period of time. </li>
</ul>
Below we have listed a number of programs that may provide compensation or other assistance to spousal caregivers who help their loved one perform certain activities of daily living. 
<h2>4 Financial Assistance Programs For Spousal Caregivers</h2>
Some of these programs are sponsored by federal or national organizations, while others are sponsored by state governments, a combined federal/state effort, or other organizations. These sources, if applicable, can be combined with any other sources of support to deliver directed care and build personal care programs.
When using these and other resources to build a program of comprehensive assistance for family caregivers, it should be noted that qualification criteria differ from program to program.&nbsp;
The Medicaid program, for example, is generally mean- or condition-based, while qualifying for Medicare is based on the care recipient&rsquo;s age.&nbsp;
Programs that may offer compensation or other assistance to spousal caregivers based on the financial means or the medical condition of the person receiving care include:
<h3 style="padding-left: 36pt;">1. Medicaid&nbsp;</h3>
Most states allow Medicaid recipients to hire a family member as a paid caregiver through a Medicaid waiver program: <a href="https://www.medicaid.gov/medicaid/ltss/self-directed/index.html">Medicaid waiver self-directed long-term services and supports (LTSS) programs</a>. States offer a variety of consumer-directed caregiving options, including <a href="https://www.medicaid.gov/medicaid/hcbs/authorities/1915-j/index.html">self-directed personal assistant services</a>, which enable participants to choose and pay their health services provider. These Home &amp; Community-Based Services (HCBS) fall under the waiver program. To determine if a person qualifies for Medicaid, <a href="https://www.hhs.gov/answers/medicare-and-medicaid/who-is-eligible-for-medicaid/index.html">contact your state&rsquo;s Medicaid office</a>.
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<h3 style="padding-left: 36pt;">2. State Programs </h3>
In some states, programs that pay family caregivers stipends to care for a loved one may be available for those who don&rsquo;t qualify for Medicaid or when certain conditions are involved such as traumatic brain injury. For instance, in California, in-home supportive services (IHSS), provide resources to help qualifying individuals receive care at home. New York, Florida. New Jersey and Arizona have similar programs. To see if your state offers this type of program, you can contact your state&rsquo;s department of social services or human services, or Medicaid office.&nbsp;
<h4 style="padding-left: 72pt;"> State Health Insurance Assistance Program (SHIP)</h4>
<a href="https://www.shiphelp.org/">SHIP</a> operates on a national basis to provide counseling, resources, and assistance accessible to adults on Medicare, Medicaid, and Medicare supplemental insurance, also known as Medigap.
<h4 style="padding-left: 72pt;">Centers for Medicare &amp; Medicaid Services The <a href="https://www.cms.gov/">Centers for Medicare &amp; Medicaid Services</a> (CMS) provides several programs to eligible individuals, with different features from state to state. The CMS facilitates accessible and affordable options for care with Medicaid, Medicare, and Health Insurance Exchanges.</h4>
Programs that may offer assistance to caregivers based on the age of the individual receiving care include: 
Program of All-Inclusive Care for the Elderly (PACE)
PACE is a program sponsored by Medicare that covers some of the medical and social service expenses paid by adults who need nursing home care level at home.&nbsp;
The program&rsquo;s goal is to enable adults to live in their homes while receiving care rather than staying at a long-term care facility. This program is not available in every state. 
Eligibility for PACE in the states where it is offered requires the following:
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<li>55 or older</li>
<li style="font-weight: 400;" aria-level="2">Reside in the PACE service area</li>
<li style="font-weight: 400;" aria-level="2">Require a nursing home-level of care</li>
<li style="font-weight: 400;" aria-level="2">The PACE program will enable the person to live safely in the community&nbsp;</li>
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For Medicaid program participants, no monthly premium is charged for the long-term care aspect of PACE. If a PACE participant has Medicare, there is a monthly premium for the long-term care benefit as well as a premium for Medicare Part D drugs. To learn more, visit Medicare&rsquo;s <a href="https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/pace">PACE page</a>. 
Elder Affairs/Aging Department: Each state has a department focused on helping seniors, offering a variety of services.
Other programs which may offer assistance including compensation to caregivers include: 
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<li aria-level="1">Veterans Programs Military veterans may qualify for the <a href="https://acl.gov/programs/veteran-directed-home-and-community-based-services/veteran-directed-home-community-based">Veteran-Directed Home Care Program</a>, which provides funds for veterans to compensate family caregivers. Another program, <a href="https://www.va.gov/pension/aid-attendance-housebound/">Aid &amp; Attendance</a>, can also provide funds for caregiver services. </li>
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<li aria-level="1">The National Family Caregiver Support Program (NFCSP) The <a href="https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program">NFCSP</a> offers grants that states and territories can use as funding to support family and informal caregivers. The program offers: </li>
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<li style="font-weight: 400;" aria-level="1">Information to caregivers about available services</li>
<li style="font-weight: 400;" aria-level="1">Assistance to caregivers in gaining access to the services</li>
<li style="font-weight: 400;" aria-level="1">Individual counseling, organization of support groups, and caregiver training</li>
<li style="font-weight: 400;" aria-level="1">Respite care</li>
<li style="font-weight: 400;" aria-level="1">Supplemental services, on a limited basis </li>
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<h2>Can Long-Term Care Insurance Help With Caregiving Expenses?</h2>
A long-term care insurance policy could be another source of income for home health care services provided by a spouse caregiver. Such policies typically cover expenses for care that are not covered by health insurance, care needed for seniors who have Alzheimer&rsquo;s disease, a disability inhibiting their ability to perform daily personal care, or a chronic medical condition.
 If your spouse has a long-term care insurance policy, you can contact the insurance company that wrote the policy to see if they offer in-home care provider compensation.
In addition to government programs, long-term care insurance can be another option for receiving payment as a family caregiver. It typically covers expenses for care that is not covered by health insurance, cares needed for seniors who have Alzheimer&rsquo;s disease, a disability inhibiting their ability to perform daily personal care, or a chronic medical condition.
Tax deductions also may be available for those providing <a href="https://www.readysetcare.com/resources/articles/federal-and-state-tax-breaks-for-family-caregivers">family caregiving</a> services. One such option is the <a href="https://www.irs.gov/credits-deductions/individuals/child-and-dependent-care-credit">dependent care credit</a>, which can cover up to 35% of your qualifying expenses.&nbsp; 
<h2>Looking to be a Paid Caregiver For Your Spouse?</h2>
Caregiving for a spouse can be similar to working a full-time job.&nbsp;
As a result, if you are caring for a spouse, it can significantly cut into the time you have available to earn money through employment.&nbsp;
For this reason, it makes sense to look into the various programs offered by the government and other organizations that may provide caregivers with compensation or other resources. The programs listed above can provide just these types of resources for those who meet their eligibility requirements. Try calling your local <a href="https://acl.gov/about-acl/administration-aging">Administration on Aging (AOA) to learn what resources</a> are available to you that might help reduce certain caregiving costs. You can also search <a href="https://eldercare.acl.gov/Public/Index.aspx">Eldercare.gov</a> to find resources in your area that provide information and assistance for older adults and caregivers.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Registered Investment Advisor Representative and Senior Planning Specialist with 30+ years of experience. As President and Chief Investment Officer of Santa Ana-based Syzygy Financial LLC, he helps seniors deal with all financial and healthcare aspects of the senior experience, including Social Security claiming strategies, Medicare, Medigap, long-term care, and overall financial planning strategy.&quot;}" data-sheets-userformat="{&quot;2&quot;:8963,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;11&quot;:4,&quot;12&quot;:0,&quot;16&quot;:11}">Josh Iversen is a Registered Investment Advisor Representative and Senior Planning Specialist with 30+ years of experience. As President and Chief Investment Officer of Santa Ana-based Syzygy Financial LLC, he helps seniors deal with all financial and healthcare aspects of the senior experience, including Social Security claiming strategies, Medicare, Medigap, long-term care, and overall financial planning strategy.

Learn the programs available that may offer compensation to a family caregiver who is taking care of their spouse and meeting the relevant eligibility criteria.

Can A Spouse Be Paid As A Family Caregiver? (Tips, Programs, and Benefits) | Ready Set Care

Can A Spouse Be Paid As A Family Caregiver? (Tips, Programs, and Benefits)

If you are a family caregiver caring for a loved one with cancer, helping them access any available financial assistance can improve your ability to care for them. Even if a person has health insurance, the co-pays and other incidental costs associated with a cancer diagnosis can add up quickly.&nbsp;
As a result, it can be worthwhile to go beyond the typical sources of potential <a href="https://www.readysetcare.com/resources/articles/how-to-get-paid-as-a-family-caregiver">compensation for a family caregiver</a> and seek out sources of financial or other aid that can help defray costs for caregiving for cancer patients.
Many of these assistance programs offer a variety of aid in addition to financial help. If you are working with a social worker, they can also be a good source of referrals to available programs.&nbsp;
Some, but not all, of these programs are designed primarily to help low-income oncology patients. In some cases, they offer low-cost options for services and items that can otherwise be quite expensive.
In addition to looking for sources of <a href="https://www.readysetcare.com/resources/articles/caregiver-compensation-dc">caregiver compensation</a>, finding <a href="https://www.readysetcare.com/resources/articles/finding-family-caregiver-support-groups">family caregiver support groups</a> to share tips with can also be helpful if you are caring for a loved one with cancer. Caring for a cancer patient presents challenges that can be helped by discussing caregiving tips with others in similar situations.&nbsp;&nbsp;
While many health insurance plans cover cancer, paying deductibles associated with the coverage can result in hefty medical bills.&nbsp;
While several healthcare providers offer coverage for prescription drugs, the co-pays associated with purchasing them can also add up quickly. This is why many caregivers for cancer patients look for financial assistance programs that can help defray the out-of-pocket costs their patients face when seeking treatment. Whether these programs offer co-pay assistance or other benefits, every little bit helps in bringing the cost of treatment down.&nbsp;
For the uninsured, the costs of care can very quickly become ruinous without outside assistance. 
<h2>12 Financial Resources Available For Cancer Patients</h2>
The programs and resources listed below offer financial help and other support services to patients with cancer. Please note that a variety of eligibility requirements apply, such as financial need, and some of the programs are oriented towards people with a certain type of cancer such as breast cancer, blood cancer, etc.&nbsp;&nbsp; 
<h3 style="padding-left: 36pt;">1. The Financial Assistance Grant Program</h3>
The <a href="https://www.cancerandcareers.org/en/resource/financial-assistance-grants">Financial Assistance Grant program</a> was inaugurated in 2020 by Cancer and Careers to offer assistance in the form of a one-time $500 grant for a variety of situations in which financial support might be needed.&nbsp; 
<h3 style="padding-left: 36pt;">2. Needy Meds</h3>
<a href="http://www.needymeds.com">NeedyMeds</a>, is a nonprofit organization that maintains a website of free information on programs for people who aren&rsquo;t able to afford medications and/or healthcare costs.&nbsp; 
<h3 style="padding-left: 36pt;">3. Cancer Financial Assistance Coalition (CFAC)</h3>
The <a href="http://www.cancerfac.org/">Cancer Financial Assistance Coalition (CFAC</a>) is a coalition of financial assistance organizations joining forces to help cancer patients experience better health and well-being by limiting financial challenges, educating patients and providers about existing resources, and advocating on behalf of patients.&nbsp;
Among CFAC&rsquo;s member organizations are the American Cancer Society, CancerCare, the National Marrow Donor Program, and more.&nbsp;
While CFAC cannot respond to individual requests for assistance, the group maintains a database of resources searchable by diagnosis, type of aid (housing, expenses, prosthetics), and zip code.&nbsp; 
<h3 style="padding-left: 36pt;">4. Patient Access Network Foundation (PAN)&nbsp;</h3>
The <a href="https://www.panfoundation.org/">Patient Access Network Foundation (PAN)</a> helps people to afford copayments for cancer or chronic disease medications. Patients aided by PAN have insurance but lack the funds for out-of-pocket expenses.&nbsp;
To find out if you are eligible for PAN, call 866-316-PANF (7263). 
<h3 style="padding-left: 36pt;">5. Cancer Finances&nbsp;</h3>
<a href="https://cancerfinances.org/">Cancer Finances</a> is a partnership between Triage Cancer and the Samfund which provides an online toolkit to assist cancer patients and survivors in making sound financial decisions before, during, and after treatment.&nbsp; 
<h3 style="padding-left: 36pt;">6. CancerCare</h3>
<a href="https://www.cancercare.org/">CancerCare</a> is a nonprofit agency that operates nationwide and provides free support, information, and financial assistance to individuals with cancer and their loved ones.&nbsp;
The organization offers financial resources to help with the following:&nbsp;
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<li>Transportation</li>
<li>Lodging</li>
<li>Home care</li>
<li>Childcare </li>
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<h3 style="padding-left: 36pt;">7. Candlelighters Childhood Cancer Foundation (CCCF)</h3>
The <a href="https://candlelightersnyc.org/">Candlelighters Childhood Cancer Foundation (CCCF)</a>&nbsp;operates as a nonprofit organization offering information, peer support, and advocacy via publications and a network that includes support groups at the local level.&nbsp;
CCCF compiles a list of organizations families are able to apply to for financial assistance. The list contains multiple foundations in various states.&nbsp; 
<h3 style="padding-left: 36pt;">8. Leukemia &amp; Lymphoma Society (LLS)</h3>
The <a href="https://www.lls.org/">Leukemia &amp; Lymphoma Society (LLS)</a>&nbsp;is an organization providing information and financial aid to people&nbsp;who have leukemia, Hodgkin's disease, or multiple myeloma.&nbsp; 
<h3 style="padding-left: 36pt;">9. Patient Advocate Foundation (PAF)</h3>
The <a href="https://www.patientadvocate.org/">Patient Advocate Foundation (PAF)</a>&nbsp;offers a variety of services aimed at people with cancer, including education, legal counseling, and referrals with regard to financial issues, job discrimination, and debt crisis.&nbsp;
The PAF Co-Pay Relief Program is a unit of the PAF that offers financial assistance to patients who meet certain eligibility criteria. 
<h3 style="padding-left: 36pt;">10. Family Reach</h3>
<a href="https://familyreach.org/holidays?gclid=Cj0KCQjw6pOTBhCTARIsAHF23fJ6PqnyaNPqy1SC4WBaX8XElf2yCGLSfEM6qm_5jVS9zz5nvYqT6W0aAi5cEALw_wcB">Family Reach</a> has over 25 years of experience helping families of people with cancer deal with financial barriers. It helps cancer patients and their families with:&nbsp;
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<li style="font-weight: 400;" aria-level="1">Essential bills</li>
<li style="font-weight: 400;" aria-level="1">Housing payments</li>
<li style="font-weight: 400;" aria-level="1">Groceries</li>
<li style="font-weight: 400;" aria-level="1">Many costs of cancer </li>
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<h3 style="padding-left: 36pt;">11. Pink Fund</h3>
The <a href="https://www.every.org/thepinkfund?gclid=Cj0KCQjw6pOTBhCTARIsAHF23fJdfYbrctshFU2sl3TQujqjIM86eNRYGnhOk4o_-y44uTbxwMAABH0aAlh4EALw_wcB">Pink Fund</a> helps patients in active treatment for breast cancer by providing cost-of-living expenses. 
<h3 style="padding-left: 36pt;">12. Accessia Health</h3>
<a href="https://www.patientservicesinc.org/patients/?gclid=Cj0KCQjw6pOTBhCTARIsAHF23fI0EQHOBKRTQ5tJUR9scOrW7cRgj6M3uojfxl-x9XVfKsQrOUNQrw4aAmgKEALw_wcB">Accessia Health</a> (formerly Patient Services, Inc.) is an organization established by patients to assist other patients in dealing with the complexities of health care.&nbsp;
It provides education, financial assistance, specialized legal services, case management, and some counseling services. The programs offered by Accessia Health help with copays, prescriptions, health insurance premiums, infusion and nursing services, travel, etc. 
<h2>Are there any Federal &amp; State Health Agencies that can help?</h2>
In addition to nonprofit programs, there are government-sponsored programs that may offer direct help to people with cancer.
<h3 style="padding-left: 36pt;">Medicaid</h3>
<a href="https://www.medicaid.gov/">Medicaid</a> is&nbsp;a state-federal health program for people who require financial assistance for medical expenses.&nbsp;
At a minimum, states must provide home care services to people who receive federal income assistance such as Social Security Income&nbsp;or Aid to Families with Dependent Children.&nbsp;
Medicaid offers a variety of services, including part-time nursing, home care aide services, and medical supplies/equipment. &nbsp;&nbsp; 
<h3 style="padding-left: 36pt;">Medicare</h3>
<a href="https://www.medicare.gov/">Medicare</a>&nbsp;is a federal health insurance program for people 65 years or older, as well as&nbsp;disabled people under 65 and individuals who have permanent liver failure.&nbsp;
Medicare may provide reimbursement for certain home care services or coverage of hospice services for people in programs certified by Medicare.&nbsp;
&nbsp;
<h3 style="padding-left: 36pt;">Social Security Administration</h3>
<a href="https://www.ssa.gov/">Social Security Administration</a>&nbsp;is a government agency charged with managing Social Security and Supplemental Security Income (SSI).&nbsp;
Social Security offers a monthly income for eligible elderly and disabled people, while SSI supplement payments are offered for people who meet income eligibility limits. 
<h3 style="padding-left: 36pt;">Veteran Administration (VA)</h3>
The <a href="https://www.va.gov/">Veteran Administration (VA)</a>&nbsp;provides medical benefits, including cancer treatment at VA Medical Cancer centers for eligible veterans and their dependents.&nbsp;
Treatment for service-connected conditions is provided, while the availability of treatment for all other conditions is subject to a veteran's financial circumstances. 
<h2>Final Thoughts</h2>
With the cost of medical treatments on the rise in recent years, people with cancer need all the help they can get in affording these costs.&nbsp;
If you are a caregiver for someone with cancer, the programs and organizations listed above can offer help obtaining the resources needed to provide the person you are caring for with the ability to access the treatments they need.&nbsp;

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Registered Investment Advisor Representative and Senior Planning Specialist with 30+ years of experience. As President and Chief Investment Officer of Santa Ana-based Syzygy Financial LLC, he helps seniors deal with all financial and healthcare aspects of the senior experience, including Social Security claiming strategies, Medicare, Medigap, long-term care, and overall financial planning strategy.&quot;}" data-sheets-userformat="{&quot;2&quot;:8963,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;11&quot;:4,&quot;12&quot;:0,&quot;16&quot;:11}">A Registered Investment Advisor Representative and Senior Planning Specialist with 30+ years of experience. As President and Chief Investment Officer of Santa Ana-based Syzygy Financial LLC, he helps seniors deal with all financial and healthcare aspects of the senior experience, including Social Security claiming strategies, Medicare, Medigap, long-term care, and overall financial planning strategy.

Caregivers who are caring for cancer patients can look into these resources to see if financial assistance is available to the loved one they are caring for.

What Financial Assistance Is Available For Cancer Patients? | Ready Set Care

What Financial Assistance Is Available For Cancer Patients?

When shopping around for a Medicare Advantage plan this year, you may be wondering what the best plan is for you. It all depends on your personal situation, medical needs, how much you can afford, and other factors. This article will explore how to determine which Medicare Advantage plan is best for your situation.&nbsp;
<h2> What is a Medicare Advantage plan?</h2>
Medicare Advantage is a type of health plan offered by a private insurance company that contracts with Medicare to provide you with all benefits for Medicare Part A and Medicare Part B Coverage.&nbsp;
Medicare Advantage plans include health maintenance organizations, preferred provider organizations, private fee-for-service plans, and Special Needs Plans.
Medicare Advantage plans are offered through Private Insurance Companies which Medicare approves. These plans are often bundled together with two to three other parts of Medicare:
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Part A Benefits: Hospital Insurance, Hospice Care, Skilled Nursing Facilities
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Part B Benefits: Doctor and Outpatient Services, Annual Wellness Checks, Urgent Care
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Part D Benefits: Prescription Drug Plan 
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There are some Medicare Advantage plans that have some coverage for services not included in Original Medicare, such as Dental Care, Hearing Care, and Vision Care.&nbsp;
When choosing Medicare coverage from a Private Insurance Company, you&rsquo;ll have several plans to choose from in your geographic area.&nbsp; Note: Premiums, Co-Payments for Medical and Drug Coverage, Covered Drugs, and Provider Networks can vary from plan to plan.
Consider costs and coverage for your typical medical needs and prescription drugs when choosing a plan. Another important factor in choosing the right plan is checking to see if your provider(s) and facilities are included in the plan&rsquo;s network.&nbsp;
&nbsp;
<h2>Who can enroll in a Medicare Advantage plan?</h2>
You can join one of these Medicare Advantage Plans:
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Health Maintenance Organization (HMO)
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Preferred Provider Organization (PPO)
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Private Fee-for-Service (PFFS)
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Medical Savings Account (MSA) Plan 
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You will only be able to apply if:
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You live in the service area of the plan you want to join. Each plan will give you further information about its service area.
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You have Medicare Part A and Medicare Part B
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You&rsquo;re a U.S. citizen or lawfully present in the U.S.
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&nbsp;
<h2>What are the different types of Medicare Advantage Plans?</h2>
When selecting your Medicare Advantage plan, it&rsquo;s important to know the differences between each type of plan: 
<h3 style="padding-left: 36pt;">1. Health Maintenance Organization (HMO plans)</h3>
HMO plans are primarily focused on in-network healthcare services and will require a referral.
Facts on HMO plans:
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You will need to select a Primary Care Doctor.
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You will need a referral from your Primary Care Doctor to see a Specialist.
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If you get medical care or services from an out-of-network provider, you will have to pay the full cost. 
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</ul>
<h3 style="padding-left: 36pt;">2. Preferred Provider Organization (PPO) plans&nbsp;</h3>
PPO plans to charge different rates depending on whether the services are in-network or out-of-network.&nbsp;
Facts on PPO plans:
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This plan gives you more flexibility when choosing Primary Care Doctors, Specialist Providers, and Hospitals.
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You don&rsquo;t need a Primary Care Doctor.
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You can save money by selecting &ldquo;Preferred Doctors&rdquo;. 
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<h3 style="padding-left: 36pt;">3. Private Fee-for-Service (PFFS) plan</h3>
PFFS plans allow you to receive care from any Medicare-approved provider who accepts the approved fee from your plan.&nbsp;
Facts on PFFS plans:
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<li style="font-weight: 400;" aria-level="1">This plan determines how it will pay each Doctor, Other Health Care Providers, or Facilities. </li>
<li style="font-weight: 400;" aria-level="1">You don&rsquo;t need to select a Primary Care Doctor.</li>
<li style="font-weight: 400;" aria-level="1">If you have an emergency, doctors, providers, and hospitals have to treat you. </li>
</ul>
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</ul>
<h3 style="padding-left: 36pt;">4. Special Needs Plans (SNPs) plans&nbsp;</h3>
SNP plans offer additional help for medical costs associated with specific chronic health conditions. These plans may also have an over-the-counter benefit.
Facts on SNPs plans:
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<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">You must meet certain requirements in order to enroll in a Special Needs Plan: Have a Chronic Condition, Institutional SNP, or Dual Eligible SNP (D-SNP). Visit <a href="http://medicare.gov/">medicare.gov</a> for further information on how SNPs plans work.&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">If you have Medicaid and Medicare most costs of joining an SNP plan will be covered for you. Visit your local Medicaid office for further information.</li>
<li style="font-weight: 400;" aria-level="1">SNPs plans cover the same services as a Medicare Advantage plan.</li>
</ul>
</li>
</ul>
&nbsp;
<h3 style="padding-left: 36pt;">5. Medicare Savings Account (MSA) plans</h3>
MSA plans to combine a plan with a higher deductible with a medical savings account.&nbsp;
Facts on MSA plans:
<ul>
<li style="list-style-type: none;">
<ul>
<li>High-Deductible health coverage.</li>
<li>Medicare MSA plans do not cover Medicare Part D prescription drug coverage.</li>
<li>You can choose your healthcare providers and services.&nbsp;</li>
</ul>
</li>
</ul>
&nbsp;
<h2>How to enroll in a Medicare Advantage plan</h2>
The open enrollment period starts on October 15 and lasts till December 7th, this period provides you the opportunity to review your plan annually and change your current Medicare coverage.&nbsp;
During Open Enrollment Period, the below list shows you what changes can be made:
<ul>
<li style="font-weight: 400;" aria-level="1">Join a Medicare Part C plan</li>
<li style="font-weight: 400;" aria-level="1">Discontinue your Medicare Advantage plan and return to Original Medicare (Part A and Part B)</li>
<li style="font-weight: 400;" aria-level="1">Change from one Medicare Advantage plan to another</li>
<li style="font-weight: 400;" aria-level="1">Add or change your Prescription Drug Coverage (Part D), if you are enrolled in Original Medicare </li>
</ul>
If you are enrolled in a Medicare Advantage plan, you will have a one-time opportunity to make changes to your Medicare coverage. This includes switching to a different Medicare Advantage plan or returning to Original Medicare with the option of enrolling in a Prescription Drug Coverage plan.
Tips to consider when selecting a Medicare Advantage plan: 
<ul>
<li>Cost: How much will I pay for premiums, deductibles, coinsurance, and copayments?</li>
<li>Doctors and Hospitals: Do the healthcare providers I use accept the plan? Are my doctors in-network? What network does this plan have?</li>
<li>Benefits: Does this plan have all the benefits I need? Dental, Vision, and Hearing Aids. What benefits are most important to me?</li>
<li>Health History: How often do you need medical care? Are you fairly healthy or have a chronic condition that needs frequent doctor visits and treatment?&nbsp;</li>
</ul>
<h3>&nbsp;</h3>
<h2>Common Questions About Medicare Advantage plans</h2>
<h3 style="padding-left: 36pt;"> How does Medicare Advantage cover my prescription drugs?</h3>
To find out which prescription drugs are covered, visit the <a href="https://www.medicare.gov/">https://www.medicare.gov/</a> website&rdquo;, click &ldquo;Health &amp; Drug Plans&rdquo;, followed by &ldquo;Find Health &amp; Drug Plans&rdquo;.&nbsp; You will then be prompted to type in your zip code in the search.&nbsp;
From there, you&rsquo;ll get a list of the plans in your area which will show the monthly premium and yearly drug and premium cost specifically for your medication. 
<h3 style="padding-left: 36pt;">How much is the deductible and coinsurance on Medicare Advantage plans?</h3>
These amounts vary depending on the location, the service area, the plan selected, and the Private Insurance Company provider.&nbsp;
Each plan usually has a fixed deductible and/or coinsurance amount. Your cost share will typically be higher for visiting non-network providers. 
<h3 style="padding-left: 36pt;">How much are the monthly premiums for Medicare Advantage?</h3>
Every plan is different, however many plans offer a low or $0 monthly plan premium based on the plan you choose.
Note: You must continue to pay for the Part B monthly premium that you have.&nbsp;&nbsp;
&nbsp;
<h3 style="padding-left: 36pt;">How much is the deductible and coinsurance on Medicare Advantage plans?</h3>
These amounts vary depending on the location, the service area, the plan selected, and the Private Insurance Company provider.&nbsp;Each plan usually has a fixed deductible and/or coinsurance amount.&nbsp;
Your cost share will typically be higher for visiting non-network providers.
<h3 style="padding-left: 36pt;"> Do my Medicare Advantage plan cover doctors, facilities, and other providers I want?</h3>
Medicare Advantage plans have provider networks, so you&rsquo;ll need to find out whether the doctors, hospitals, and outpatient clinics you want to use are covered. Refer to the Provider &amp; Services page on <a href="https://www.medicare.gov/">https://www.medicare.gov/</a>, and find a care provider.&nbsp;
Another important factor is finding out how your Medicare Advantage plan will treat your use of an out-of-network provider:
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">
Health Maintenance Organizations (HMOs) pay nothing for out-of-network providers except for emergencies.&nbsp;
</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">
Preferred Provider Organizations (PPOs) cover out-of-network providers but charge higher copayments and have a higher out-of-pocket spending limit for out-of-network services.&nbsp; 
</li>
</ul>
</li>
</ul>
<h2>Final Reminders When Enrolling in a Medicare Advantage Plan</h2>
To enroll in a Medicare Advantage plan:
<ul>
<li style="font-weight: 400;" aria-level="1">
You must have Medicare Part B Coverage in order to enroll in a Medicare Advantage plan and keep paying your Medicare Part B premium to stay in your plan.
</li>
<li style="font-weight: 400;" aria-level="1">
Medicare Advantage out-of-pocket varies by plan. Once you pay the plan&rsquo;s limit, the Medicare Advantage plan pays 100% of your covered medical services for the rest of the calendar year.
</li>
<li style="font-weight: 400;" aria-level="1">
You can&rsquo;t buy and won&rsquo;t need a Medigap policy.
</li>
<li style="font-weight: 400;" aria-level="1">
You can join a Medicare Advantage plan even if you have pre-existing conditions.
</li>
<li style="font-weight: 400;" aria-level="1">
You can only be signed up for one Medicare Advantage plan. 
</li>
</ul>
To find a Medicare plan and to compare Health and Drug Plans that meet your needs, visit medicare.gov/plan-compare to shop and compare plans that meet your need, or call 1-800-MEDICARE for any specific questions about billing, claims, medical records, and more. Teletypewriter (TTY) users can call 1-877-486-2048.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Shelia Benson was born and raised in Las Vegas, Nevada. She comes from a family of insurance professionals and has 12 years of experience in the insurance industry as a licensed agent and is also certified in Medicare. It's her passion to be of service to consumers turning 65 or coming onto Medicare for the first time. During her free time, she loves to spend time with family and her dog, working out, hiking, trying out new restaurants, and going to concerts. Shelia's goal is to educate the Medicare eligible about how Medicare works.&quot;}" data-sheets-userformat="{&quot;2&quot;:15105,&quot;3&quot;:{&quot;1&quot;:0},&quot;11&quot;:4,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:2236962},&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">Shelia Benson was born and raised in Las Vegas, Nevada. She comes from a family of insurance professionals and has 12 years of experience in the insurance industry as a licensed agent and is also certified in Medicare. It's her passion to be of service to consumers turning 65 or coming onto Medicare for the first time. During her free time, she loves to spend time with family and her dog, working out, hiking, trying out new restaurants, and going to concerts. Shelia's goal is to educate the Medicare-eligible about how Medicare works.

Wondering how to choose the right Medicare Advantage plan for you or a loved one? Learn about the different types and how to enroll.

How To Choose A Medicare Advantage Plan | Ready Set Care

How To Choose A Medicare Advantage Plan

Different parts of Medicare cover specific services. Generally, most beneficiaries choose to receive Medicare Part A and Medicare Part B coverage through Original Medicare. Original Medicare is the traditional fee-for-service program offered directly by the federal government.&nbsp;
The government pays directly for health care services under Original Medicare. With this coverage, you can see any doctor and hospital that takes Medicare anywhere in the country.&nbsp;
Refer to your explanation of benefits/summary of benefits for the specific doctors and hospitals covered under your Medicare benefits.&nbsp; 
<h2>What does Original Medicare cover?</h2>
With Original Medicare:
<ul>
<li style="font-weight: 400;" aria-level="1">You can go directly to the doctor or hospital when you need care. You do not need prior authorization or permission from Medicare or your primary care doctor when seeking these services.</li>
<li style="font-weight: 400;" aria-level="1">You are responsible for paying a monthly premium for Part B. Some beneficiaries may also pay a premium for Part A.</li>
<li style="font-weight: 400;" aria-level="1">You will typically pay a coinsurance for each service received.&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">There are limits on the amounts doctors and hospitals can charge you for your care.</li>
<li style="font-weight: 400;" aria-level="1">Prescription drug coverage will most likely need to be purchased as a stand-alone Medicare private drug plan.&nbsp;</li>
</ul>
Note: You may be able to help reduce your health care and prescription drug plan costs if you meet certain eligibility requirements. 
<h2>What Programs Provide Assistance with Healthcare Costs?</h2>
&nbsp;
<h3 style="padding-left: 36pt;">Medicaid</h3>
If you have a low monthly income and a few assets, you may be eligible to receive Medicaid, on top of your Original Medicare benefits.&nbsp;
Medicaid can help pay for costs like copayments, and deductibles and cover healthcare not covered by Medicare, such as dental care and transportation to medical appointments.&nbsp; 
<h3 style="padding-left: 36pt;">Medicare Savings Programs</h3>
The Medicare Savings Program helps you pay off Medicare costs. If you have a low monthly income, you may qualify for this program.&nbsp;&nbsp;
Instead of Original Medicare, you can decide to get your Medicare benefits from a Medicare Advantage Plan, also called Medicare Part C or Medicare through private insurance companies. You will still have Medicare if you enroll in a Medicare Advantage Plan. You must still pay your monthly Part B premium (and Part A premium if you have one.) 
<h2>Which Programs Offer Assistance with Prescription Drug Costs?</h2>
<h3 style="padding-left: 36pt;">Medicare Part D Low-Income Subsidy (LIS)</h3>
This federal program helps individuals with low-income pay for the costs of Medicare prescription drug coverage. If you are enrolled in Medicaid, an MSP, or receive Supplemental Security Income (SSI), you should automatically get Extra Help.&nbsp;
Apply for this program via the Social Security Administration or contact your local Medicaid office.&nbsp;Understanding your Medicare coverage choices and knowing how to pick coverage is crucial.&nbsp;
How you choose your benefits and where you get them from can affect your out-of-pocket costs.&nbsp;
For instance, with Original Medicare, you are covered to go to nearly all doctors and hospitals in the country. On the other hand, Medicare Advantage plans typically have network restrictions, meaning there will likely be more restrictions and a more limited choice of doctors.&nbsp;
Medicare Advantage also provides additional benefits that Original Medicare does not cover, for instance, routine vision or dental care.
<h2>What are the different parts of Medicare?</h2>
<h3 style="padding-left: 36pt;">Medicare Part A</h3>
Medicare Part A (hospital coverage) covers things like inpatient hospital stays, nursing homes, home health care, hospice care, and some skilled nursing facilities.
Typically most people don&rsquo;t pay for Medicare Part A, however, some may pay a premium for these benefits. If you paid Medicare taxes for a certain amount of time while working you don&rsquo;t pay.
If you do not qualify for premium-free Medicare Part A, it can be purchased for a monthly premium. Keep in mind, this amount can change each year and is based on how long you or your spouse worked and paid Medicare taxes.
<h3 style="padding-left: 36pt;">Medicare Part B</h3>
Medicare Part B (medical coverage) covers doctor visits, outpatient services, X-rays, lab tests, medical equipment, mental health, and preventive services.
If you have health insurance through a current job or are on your spouse&rsquo;s active insurance plan, you can delay your Medicare Part B enrollment without penalty.&nbsp;
Once you or the spouse with employer coverage stops working, you have eight months to sign up for Medicare Part B. You also need to be enrolled in a Medicare Part B plan if you want to sign up for Medicare Advantage. 
<h3 style="padding-left: 36pt;">Medicare Part C</h3>
Medicare Part C (Medicare Advantage) is offered through private insurance companies.&nbsp;
When joining Medicare Advantage, you still have Medicare. The difference is this plan covers and pays for your services instead of your Original Medicare plan. The services provided on this plan must provide the same coverage as the Original Medicare. Medicare Advantage plans also offer extra benefits.
Plans offered through a private insurance company cover everything Original Medicare does and usually include more coverage for services you might need down the line.&nbsp;
Medicare Advantage plans can include extra benefits and parks, such as gym memberships or discounts.
&nbsp;
<h3 style="padding-left: 36pt;">Medicare Part D</h3>
Medicare Part D (prescription drug coverage) is only offered through private insurance companies. It is usually offered through a Medicare Advantage plan or you can purchase a separate Medicare Part D plan.&nbsp;
Medicare Part D provides a wide range of coverage for vaccines and outpatient prescription drugs. 
<h2>What does Medicare cover?</h2>
There are common services that Medicare does and doesn&rsquo;t cover. Visit <a href="http://medicare.gov/coverage">medicare.gov/coverage</a> for further detail.&nbsp;
Also, check your Medicare health plan&rsquo;s Summary of Benefits to learn what&rsquo;s covered.&nbsp;
<h3 style="padding-left: 36pt;">Acupuncture</h3>
Medicare has some coverage for acupuncture services however, it is limited to the treatment of chronic lower back pain.
Some Medicare Advantage plans have benefits that help pay for acupuncture services, such as chronic pain in other parts of the body, headaches, and nausea.&nbsp;
<h3 style="padding-left: 36pt;">Assisted Living</h3>
Medicare Part A may cover care in a skilled nursing facility if it&rsquo;s deemed medically necessary. This is usually a short-term visit for recovery from an illness or injury.
<h3 style="padding-left: 36pt;">Cataract Surgery&nbsp;</h3>
Medicare Part B covers outpatient surgery to correct cataracts.&nbsp;
<h3 style="padding-left: 36pt;">Chiropractic Care</h3>
Medicare Part B covers chiropractors&rsquo; manual alignments of the spine. However, Medicare doesn&rsquo;t cover other chiropractic tests or services like X-rays, massage therapy, or acupuncture.
<h3 style="padding-left: 36pt;">Eyeglasses or Contacts</h3>
Medicare generally doesn&rsquo;t cover these services, however, Medicare Part B does pay for eyeglasses or contact lenses if needed after cataract surgery.
<h3 style="padding-left: 36pt;">Home Health Care</h3>
Both Medicare Part A and Medicare Part B cover some home health services if you meet certain conditions. These services include: 
<ul>
<li style="list-style-type: none;">
<ul>
<li> Skilled Nursing Care or Home Health Aide Services that are part-time or occasional</li>
<li>Physical, Occupational, or Speech Therapy</li>
<li> Medical Social Services </li>
</ul>
</li>
</ul>
For more information on the different parts of Medicare, Covered Services, Covered Providers, and Covered Hospitals visit <a href="http://medicare.gov/">medicare.gov</a>.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Shelia Benson was born and raised in Las Vegas, Nevada. She comes from a family of insurance professionals and has 12 years of experience in the insurance industry as a licensed agent and is also certified in Medicare. It's her passion to be of service to consumers turning 65 or coming onto Medicare for the first time. During her free time, she loves to spend time with family and her dog, working out, hiking, trying out new restaurants, and going to concerts. Shelia's goal is to educate the Medicare eligible about how Medicare works.&quot;}" data-sheets-userformat="{&quot;2&quot;:15105,&quot;3&quot;:{&quot;1&quot;:0},&quot;11&quot;:4,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:2236962},&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">Shelia Benson was born and raised in Las Vegas, Nevada. She comes from a family of insurance professionals and has 12 years of experience in the insurance industry as a licensed agent and is also certified in Medicare. It's her passion to be of service to consumers turning 65 or coming onto Medicare for the first time. During her free time, she loves to spend time with her family and her dog, working out, hiking, trying out new restaurants, and going to concerts. Shelia's goal is to educate the Medicare-eligible about how Medicare works.

Do you know what the different parts of Medicare cover? Prepare for the enrollment process by learning what Medicare Part A, B, C, and D cover.

What are the Different Parts of Medicare? (Parts A, B, C, and D) | Ready Set Care

What are the Different Parts of Medicare? (Parts A, B, C, and D)

As parents age, their adult children often become more involved in their care. This may involve helping them pay bills, as well as doing house or yard work for them. At some point, many children find themselves taking on a caregiver role for their aging parents, whether part-time or full-time. This may occur as a result of a parent suffering from Alzheimer&rsquo;s or dementia or simply needing help on a regular basis with various activities of daily living.
For some adult children, this is a temporary duty until their parents move into a nursing home or retirement facility which offers some level of elder care services. For children whose parents want to remain in their homes, this is not an option. In such cases, either outside caregiving assistance must be arranged or one or more of the children must step into the role of primary caregiver themselves.
When an elderly parent requires full-time care, there are a number of decisions to be made about how best to provide that care. This may include deciding how to pay for any outside care needed in addition to the services the children are providing.&nbsp;
One of the most consequential decisions is in regards to whether you as a caregiver should say &ldquo;I quit my job&rdquo; in order to care for your parent full-time. While doing so can free up significant time to devote to caregiving responsibilities, it also can cause financial strain. Whether it is worth doing will depend to a large degree on whether the time freed up by leaving your job outweighs the financial hit it causes.
&nbsp;
<h2>Advantages &amp; Disadvantages of Caregiving While Working Full-Time</h2>
<h3 style="padding-left: 36pt;"> Advantages</h3>
The advantages of keeping your full-time job while still providing care for a parent include: 
<h4 style="padding-left: 72pt;"> Improved quality of care:&nbsp;</h4>
With more time you can provide better care to your parents and be more attentive to their caregiving needs. This includes overseeing their health care by scheduling and making sure they make it to regular visits to a doctor.
<h4 style="padding-left: 72pt;">Reduce the cost of third-party caregiving services:&nbsp;</h4>
Paying for nursing home care is not cheap, and by keeping your parent at home you save the money that this would cost. The same applies to hiring an in-home caregiver, which can also be expensive.&nbsp;
<h4 style="padding-left: 72pt;">Keep parents in their home&nbsp;</h4>
A primary goal of many elderly individuals is to remain within their homes. By becoming their caregiver, you can make this happen. 
Better relationship with a parent The extra time you spend with your parent or parents gives you a chance to deepen your relationship with them.&nbsp;
&nbsp;
Note: For potential caregiver compensation, some programs such as Medicaid may offer compensation to caregivers for people enrolled in the program.&nbsp; 
<h3 style="padding-left: 36pt;">Disadvantages</h3>
People who continue to work while providing a significant amount of care to a parent or parents often face a <a href="../../resources/articles/challenges-of-caring-for-a-parent">number of challenges</a> in doing so. These can include: 
<h4 style="padding-left: 72pt;">Difficulty at work</h4>
As a caregiver, it can be hard to perform at your best at the job and at home. To provide the best care possible to a parent, it may be necessary to cut back on your work hours. This can not only infringe on your ability to do your best at work but can also impede your career development. 
<h4 style="padding-left: 72pt;">Pressure from coworkers</h4>
If you are not able to fulfill all of your work duties as a result of being a caregiver, this can result in pressure and even discrimination from your co-workers and even bosses. Your caregiver role may cause you to miss work often which can cause resentment among other workers who feel they have to pick up the slack. 
<h4 style="padding-left: 72pt;">Financial strain If you have to cut back your hours at work, this can result in financial stress. Additionally, you may not be able to contribute as much to a 401k plan or Social Security and other retirement benefits programs.</h4>
<h4 style="padding-left: 72pt;">Physical and Emotional Stress Aside from the financial stress working as a caregiver and at a job can take, there is also the potential for physical and emotional stress. Because you may not be able to fully complete all your duties at work, this can result in stress. When this is added to the natural stress of dealing with a parent in declining health, it can take a physical and emotional toll on a person. </h4>
<h2>What are the Risks of Leaving Your Job to Take Care of a Parent?</h2>
<h4 style="padding-left: 36pt;"> Lost or Reduced Income</h4>
A major drawback to quitting your job to become a caregiver is the lost income. 
While there are programs that may compensate you as a caregiver in certain cases, these can take time to apply and qualify for, or may not apply at all in your case. As a result, it is important to thoroughly model the financial impact of leaving our job. 
Consider whether your parents have the income they can dedicate to their care, whether in the form of a regular stipend to you or free room and board, or other assistance, that can play a part in making quitting your job to care for them feasible.
<h4 style="padding-left: 36pt;">Lost Social Security Benefits</h4>
While caring for a parent often involves long hours of work, because in most cases they are not directly compensated, these hours don&rsquo;t qualify you for Social Security benefits. Thus, you may lose out on a significant amount of such benefits depending on how long you serve as your parent&rsquo;s full-time caregiver.
<h4 style="padding-left: 36pt;">Reduced Retirement Savings</h4>
When you leave your job, not only do you lose what you would receive in salary or direct compensation but also your ability to contribute to an employer-sponsored retirement plan such as a 401k. 
In the worst case, you may find that you have to raid your existing retirement accounts to make ends meet.&nbsp;
<h4 style="padding-left: 36pt;">Job Skill Atrophy</h4>
The time spent caring for a parent or parents can take its toll on the skills you use at your place of employment. If and when you choose to return to the workplace, you may find that there are new requirements to do your job or that it takes some time to return your skills back to their previous level.&nbsp;
Lost Work Connections
When you are out of the workforce it naturally becomes hard to maintain and nurture your connections with others in the industry. 
While this may be more or less important depending on the type of work you do, in some cases it can be a significant impediment to getting work or maximizing a person&rsquo;s income.
<h4 style="padding-left: 36pt;">Mental and Emotional Fatigue</h4>
Serving as a family caregiver can be emotionally draining. One reason for this is that the job can be isolating as it often precludes you from doing much socializing with people other than your parents. 
Over time, this isolation can result in emotional burnout, making it difficult for a caregiver to give their full attention to the care they provide.&nbsp;
<h2>&nbsp;</h2>
<h2>What Support Is Available for Family Caregivers?</h2>
The decision as to whether to quit your job to become a full-time caregiver is complex. For some, it may be the right answer while for others it won&rsquo;t work.&nbsp;
For those who do take this step, there are a variety of programs and options they can look to for support. These may take the form of <a href="../../resources/articles/finding-family-caregiver-support-groups">family caregiver support groups</a> to help you deal with the <a href="../../resources/articles/how-to-cope-with-the-common-emotions-of-caregiving">emotional toll</a> of caregiving, financial aid, or other types of senior care assistance such as adult day care or respite care.
These include:
<h4 style="padding-left: 36pt;">Unemployment Insurance&nbsp;</h4>
A number of states have unemployment policies that may make unemployment insurance (UI) available to people who are forced to quit their jobs to care for an elderly relative. Each state has its own particular eligibility requirements.&nbsp;&nbsp;
<h4 style="padding-left: 36pt;">Parent&rsquo;s Benefits</h4>
If your parents receive benefits from an insurance policy or for monthly in-home care, they can pay you directly from these proceeds. This can include life insurance policies, long-term care insurance, and VA benefits. 
It&rsquo;s recommended to set up a personal care agreement to guide these types of arrangements to minimize any questions or issues arising after the fact.
<h4 style="padding-left: 36pt;">Medicaid</h4>
Most states allow Medicaid recipients to hire a family member as a paid caregiver through a Medicaid waiver program: <a href="https://www.medicaid.gov/medicaid/ltss/self-directed/index.html">Medicaid waiver self-directed long-term services and supports (LTSS) programs</a>. States offer a variety of self-directed caregiving options, including <a href="https://www.medicaid.gov/medicaid/hcbs/authorities/1915-j/index.html">self-directed personal assistant services</a>, which enable participants to choose and pay their providers. These Home &amp; Community Based Services (HCBS) fall under the waiver program. To determine if your mother qualifies for Medicaid, <a href="https://www.medicaid.gov/about-us/contact-us/index.html">you can look for your state&rsquo;s Medicaid office</a> at this link.
<h4 style="padding-left: 36pt;">State programs</h4>
In some states, programs that pay family caregivers may be available for those who don&rsquo;t qualify for Medicaid or when certain conditions are involved such as traumatic brain injury.&nbsp;
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="2">To see if your state offers this type of program, you can contact the state department of social services or human resources, or your local Medicaid office. </li>
<li style="font-weight: 400;" aria-level="2">State Health Insurance Assistance Program (SHIP) &ndash; <a href="https://www.shiphelp.org/">SHIP</a> operates on a national basis to provide counseling, resources, and assistance accessible to adults on Medicare, Medicaid, and Medicare supplemental insurance, also known as Medigap.</li>
</ul>
</li>
</ul>
<h4 style="padding-left: 36pt;">Centers for Medicare &amp; Medicaid Services</h4>
The <a href="https://www.cms.gov/">Centers for Medicare &amp; Medicaid Services</a> (CMS) provides several programs to eligible individuals, with different features from state to state. The CMS facilitates accessible and affordable options for care with Medicaid, Medicare, and Health Insurance Exchanges.

Are you considering quitting your job to care full-time for a parent? Consider the challenges you may face prior to quitting.

Should You Quit Your Job To Take Care Of A Parent? | Ready Set Care

Should You Quit Your Job To Take Care Of A Parent?

There is understandably much confusion over the difference between home health care and home care and how Medicaid and Medicare pay for these home care services. As someone who needs personal care services and skilled nursing care, it can be challenging to get the medical and personal care services you need. 
<h2>What is Medicaid?</h2>
<a href="../../resources/articles/medicaid-long-term-care-questions-answers">Medicaid</a> is a joint state and federal program that provides programs and services to low-income individuals. Each state determines income and asset limits for participation and develops a state plan for how they want to use Medicaid money. Medicaid pays for skilled nursing services, in-home care, adult day care, respite care, aide services, and home health care. Medicaid recipients still have to meet eligibility requirements, and qualifying for many of the available programs can be arduous.
Some Medicaid programs are consumer-directed and others are part of waiver programs that waive specific Medicaid requirements, and others are called HCBS Waiver programs which expand where individuals can receive services. Community-based services aim to keep patients out of institutional settings and provide various services, including case management, nursing, therapies, and personal care. It costs far less to bring assistance to a Medicaid recipient at home rather than to have them in a nursing home.&nbsp;
One of the challenges with Medicaid is that Medicaid coverage, although adequate, often doesn&rsquo;t pay home care companies at a profitable rate. What this means for the consumer is that there may not be many companies or limited access to programs where you live. 
<h2>What is Medicare?</h2>
Medicare is not income based. It is the federal insurance program for people 65 and older and younger disabled individuals. Some people qualify for both Medicare and Medicaid. They are low-income, over 65 or younger, and disabled. 
<h2>What is Home Care?</h2>
Home care is caregiver services that you either pay for or, if you qualify for Medicaid, you can apply for Medicaid home care caregivers. Wait lists could be long, and due to national staffing shortages, you could have difficulty meeting your care needs on the schedule you require.
Due to differing state regulations, most home care personnel cannot provide medical services or medical care. But they can assist with activities of daily living. Medicaid covers home care, but you or your loved one must meet the eligibility requirements for participation.&nbsp;
Medicare does not pay for home care caregivers except with enrollment in home health care. Even in those cases, caregivers are restricted to specific functions.&nbsp; 
<h2>What is Home Health?</h2>
Home health care is an insurance-covered, time-limited medical service for people who meet the criteria. To qualify for home health you have to have a doctor&rsquo;s order, be home-bound, and have a skilled need. Most people, whether on Medicaid or Medicare, choose home health care when needed due to the intensive services they provide. Home health care offers:
<ul>
<li style="font-weight: 400;" aria-level="1">Physical therapy&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Home health aides&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Other therapy services&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Nursing&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Occupational therapy&nbsp;&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Some <a href="../../resources/articles/medicare-covers-dme">medical equipment</a> to help you recover from an accident or illness</li>
<li style="font-weight: 400;" aria-level="1">Social services</li>
</ul>
However, home health services are not round-the-clock and are not intended to provide long-term care. 
A nurse develops a care plan after receiving a doctor&rsquo;s order for home health. The other challenge with home health care is that aides are only permitted to help with activities of daily living. They can&rsquo;t cook, offer transportation, shop, or provide companionship. All home health programs are time-limited under both Medicare and Medicaid except under specific circumstances.
Suppose you or a family member need more assistance, or your level of care requirements are around the clock. In that case, neither Medicare nor Medicaid care may be able to provide what you need. You may have to consider <a href="../../resources/articles/what-are-the-different-senior-living-options">assisted living</a> or a nursing home. 
<h2>What are the Benefits of Medicaid and Home Health Care?</h2>
If you can, it is almost always beneficial to get a doctor&rsquo;s order for home health care for these reasons:
<ul>
<li style="font-weight: 400;" aria-level="1">Home health can help you recover function and become more independent</li>
<li style="font-weight: 400;" aria-level="1">You can receive services in the comfort of your home</li>
<li style="font-weight: 400;" aria-level="1">A nurse can help you with medications and monitor your progress</li>
<li style="font-weight: 400;" aria-level="1">A social worker can assist you with accessing additional resources </li>
</ul>
<h2>What are the Challenges of Medicaid and Home Health Care?</h2>
Although Medicaid does pay for home health care, there are some challenges to be aware of:
<ul>
<li style="font-weight: 400;" aria-level="1">You may not have many home health agencies to choose from since most in your area contract with Medicare only.</li>
<li style="font-weight: 400;" aria-level="1">You may have additional personal care needs that you can&rsquo;t afford to pay for, but you don&rsquo;t qualify for or have to wait for any Medicaid program to help.</li>
<li style="font-weight: 400;" aria-level="1">Your home health care services may discharge you because you have met your goals but still need assistance. Or, you cannot meet goals and therefore are discharged from service. </li>
</ul>
<h2>Home Health Care and Medicaid</h2>
Both Medicaid and home health care are valuable resources for you and your family if you have a chronic illness or are recovering from an accident. It can be tricky to maximize the benefit of both. But with enough education about criteria and availability limits, you can leverage these programs to improve your health.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;A Certified Care Manager, Aging Life Care Professional, and Certified Master Guardian Emeritus.\nShe is also the founder of Lambert Care Management, providing care management and consultation services to older and disabled adults. She has 20+ years of experience in geriatrics, with expertise in mental health, home health, and guardianship, as well as all aspects of care planning, including assessment, projected costs of care, client advocacy and education, caregiver coaching, and advance directives. She is also co-author with Leslie Eckford of Choose Your Place: Rethinking Home as You Age (2020), Aging with Care: Your Guide to Hiring and Managing Caregivers at Home (Rowman and Littlefield 2018).&quot;}" data-sheets-userformat="{&quot;2&quot;:13059,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:3,&quot;3&quot;:2},&quot;11&quot;:4,&quot;12&quot;:0,&quot;15&quot;:&quot;Arial&quot;,&quot;16&quot;:11}">A Certified Care Manager, Aging Life Care Professional, and Certified Master Guardian Emeritus. She is also the founder of Lambert Care Management, providing care management and consultation services to older and disabled adults. She has 20+ years of experience in geriatrics, with expertise in mental health, home health, and guardianship, as well as all aspects of care planning, including assessment, projected costs of care, client advocacy and education, caregiver coaching, and advance directives. She is also co-author with Leslie Eckford of Choose Your Place: Rethinking Home as You Age (2020), Aging with Care: Your Guide to Hiring and Managing Caregivers at Home (Rowman and Littlefield 2018).

There are distinct differences between home care and home health care. Learn about the differences and how home health can help if you are on Medicaid

How to Qualify for Home Health Care on Medicaid | Ready Set Care

How to Qualify for Home Health Care on Medicaid

It&rsquo;s that time of year again! The Medicare Open Enrollment period is here and runs through December 7th. Enrolling in Medicare can be quite a challenge and a new process for some. Understanding the <a href="../../resources/articles/medicare-parts-a-b-c-d">different parts of Medicare</a> can be confusing. In this article, we&rsquo;ll review a list of ten common questions related to Medicare coverage so that you can feel prepared to enroll when the time comes 
<h2>Commonly Asked Medicare Coverage Questions </h2>
<h3 style="padding-left: 36pt;">1. How do I know which Medicare benefits are right for me?</h3>
Some questions to ask yourself are &ldquo;How many times will I be going to the Doctor in a year?&rdquo;, &ldquo;What prescription drugs will I need?&rdquo;, &ldquo;Do I want to keep my same Providers?&rdquo;. These questions are helpful when it comes to selecting the right Medicare plan for you. If you see a particular specialist or need intensive medical care you may want to enroll in the richest plan to ensure you are receiving the benefits you need. You will also want to make sure that your provider is covered in-network before choosing a plan to ensure you will not have any expensive co-pays. Additionally, take into consideration the costs of your prescription drugs. 
<h3 style="padding-left: 36pt;">2. How much does Medicare cost?</h3>
You will likely pay a monthly premium for Medicare Part B, as well as other Medicare premiums, deductibles, copays, and coinsurance. The amount you pay for medical coverage will be determined by the plan that you choose to enroll in.
For more information on the premium amounts please refer to <a href="http://www.medicare.gov/">www.medicare.gov</a>.
&nbsp;
<h3 style="padding-left: 36pt;">3. What happens if I am still working past age 65?</h3>
If you work past age 65, you may be able to delay enrolling in Medicare or you have the option of enrolling during your Initial Enrollment Period in Parts A, B, and D if you want to avoid late penalties. This will depend on your employer and if your employer coverage is creditable. Refer to your employer's Human Resources department to find out what you need to do about Medicare when still working. Some people choose to still enroll in just Part A while still employed. Part A coverage is premium free, as long as you or your spouse worked and paid Medicare taxes for at least 10 years.
&nbsp;
<h3 style="padding-left: 36pt;">4. What does Medicare Part A cover?</h3>
Medicare Part A or &ldquo;hospital insurance&rdquo; covers inpatient care in a hospital, skilled nursing facility, nursing home care, hospice care, and home health care. Medicare Part A premiums are usually free, as long as you paid Medicare taxes for at least 10 years. These plans are considered &ldquo;Original Medicare&rdquo; alongside your Medicare Part B plan.
&nbsp;
<h3 style="padding-left: 36pt;">5. What does Medicare Part B cover?</h3>
Medicare Part B covers services or supplies needed to diagnose or treat your medical condition as well as necessary medical equipment. It also provides preventive services such as diabetes screenings, depression screenings, flu shots, and your yearly wellness check-up. Think of Medicare Part B as your traditional health insurance plan that covers medical services and routine exams.&nbsp;
&nbsp;
<h3 style="padding-left: 36pt;">6. What is Medicare Part C?</h3>
Medicare Part C or &ldquo;Medicare Advantage&rdquo; is another Medicare health plan coverage you can enroll in. Medicare Advantage plans are offered through private insurance companies.&nbsp;
Each Medicare Advantage Plan has a different charge for out-of-pocket costs and has different rules for how you can receive services. This includes whether or not you need a referral to see a specialist or if you have to go to only health care providers and facilities or use suppliers that belong to the plan for non-emergency or non-urgent care services.&nbsp;
Note: Medicare Advantage rules can change each year, refer to your plan benefit guide for specifics.
&nbsp;
<h3 style="padding-left: 36pt;">7. Do I need to sign up for a Medicare Part D Prescription Drug plan?</h3>
Enrolling in a Medicare Part D plan is voluntary, however, if you take specific medications you may want to enroll in coverage. Keep in mind, Prescription Drug coverage is not included in Medicare supplement insurance. It&rsquo;s important to evaluate your choices before enrolling in coverage, sometimes the &ldquo;best&rdquo; and most expensive plan offers little or no extra value.
&nbsp;Prescription Drug Plans can be purchased through private insurance companies. If you are unable to pay Medicare Part D premiums but take specific prescription drugs you may be able to qualify for extra help. Contact your local Social Security Administration office for further detail.
&nbsp;
<h3 style="padding-left: 36pt;">8. When will my benefits be effective?</h3>
If you are enrolling during your Initial Enrollment Period, your enrollment period lasts for seven months, starting three months before your turn age 65, and ending three months after you turn age 65.
Unsure of when your Medicare plan will go into effect? Refer to the list below:&nbsp;
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">Enrolling the month before you turn 65:
<ul>
<li style="font-weight: 400;" aria-level="3">&nbsp;Your coverage will begin the month you turn 65 years old.</li>
</ul>
</li>
<li style="font-weight: 400;" aria-level="1">The month you turn 65:
<ul>
<li style="font-weight: 400;" aria-level="3">&nbsp;Your coverage will begin the following month.</li>
</ul>
</li>
<li style="font-weight: 400;" aria-level="1">1 month after you turn 65 In 2022:&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="3">2 months after you sign up</li>
<li style="font-weight: 400;" aria-level="3">Starting January 1, 2023: the next month</li>
</ul>
</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">2 or 3 months after you turn 65:&nbsp;
<ul>
<li style="font-weight: 400;" aria-level="3">In 2022: 3 months after you sign up</li>
<li style="font-weight: 400;" aria-level="3">Starting January 1, 2023: the next month </li>
</ul>
</li>
</ul>
</li>
</ul>
<h3 style="padding-left: 36pt;">9. What happens if I move out of the area, will I lose my Medicare benefits?</h3>
No, this would be considered a &ldquo;Special Enrollment Period&rdquo; where you can make changes to your Medicare Advantage or Medicare Prescription drug plan.&nbsp;
There are certain events that would qualify you to make changes, such as moving out of the area, you lose current coverage, or having the opportunity to get other coverage.
&nbsp;
<h3 style="padding-left: 36pt;">10. Are there programs available to help pay for Medicare premiums?</h3>
There are several programs for people that are considered low-income. If you have a low income you may be able to get assistance through the following programs:
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">Medicaid: If you have a low monthly income and assets, you may be eligible for coverage through Medicaid to pay for your Medicare costs, such as copays, deductibles, and health care services not covered by Medicare, such as dental and transportation to doctor's appointments.</li>
<li style="font-weight: 400;" aria-level="1">Medicare Savings Programs (MSPs): If you do not qualify for Medicaid but still struggle to pay for health care, you may qualify for an MSP plan which is a government-run program that helps cover your Medicare Costs. There are three types of Medicare Savings Programs that help pay the monthly Medicare Part B premium.</li>
<li style="font-weight: 400;" aria-level="1">Extra Help or Part D Low-Income Subsidy (LIS): This is a federal program that helps pay for some costs of Medicare Part D prescription drug costs.</li>
<li style="font-weight: 400;" aria-level="1">State Health Insurance Assistance Program: These plans are offered in some states to help eligible individuals pay for prescriptions.&nbsp;</li>
</ul>
</li>
</ul>
Note: These plans have income guidelines and may also require you to enroll in a Medicare Part D plan and apply for Extra Help. 
Many Medicare beneficiaries make the simple mistake of enrolling in the wrong medical plan due to not being knowledgeable about the various Medicare parts and Medicare rules. It is very important to do research on Medicare plans prior to signing up or making any changes.
Any enrollments or changes made will take effect on January 1, 2023, and you will have to wait til the following year to make any changes to your medical insurance.&nbsp;
Additionally, you may want to make sure you are enrolling in the correct plans that are in compliance with Medicare guidelines to prevent any late enrollment penalties. If you have any particular questions regarding Medicare eligibility and Medicare enrollment visit the Medicare website for additional answers to questions you may have.
Visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) TTY users can call 1-877-486-2048.

Do you have questions about Medicare?  Read about ten of the most common Medicare questions to help you this AEP season.

10 Common Medicare Questions About Coverage Answered | Ready Set Care

10 Common Medicare Questions About Coverage Answered

Those turning 65 are eligible for Medicare Coverage, this is called your Initial Enrollment Period. This period lasts seven months, starting 3 months before your 65th birthday, and 3 months after the month you turn 65.&nbsp;
Your coverage start date depends on the month you signed up, and coverage always starts on the first of the month.
If you do not enroll in Medicare Part A or Hospital Insurance when you turn 65 there is a 10 percent penalty that will be applied to the premium, if you pay a monthly premium for your Medicare Part A.&nbsp;
Most people qualify for premium-free Part A coverage however those that did not pay Medicare taxes will have to pay a monthly premium for coverage.&nbsp;
For each year you go without coverage, starting the first month you become eligible for Medicare, you will be charged a 10% penalty fee.
In this article, we&rsquo;ll provide a list of questions and answers that will help guide you through Medicare B and Medicare Part D penalty charges. With these tips, you&rsquo;ll have a better understanding of what to expect with Medicare enrollment. 
<h2>Medicare Part B:</h2>
If you do not sign up for Medicare on time you will have to pay a 10% surcharge on Medicare Part B premiums. The longer you go without paying your Medicare Part B coverage the penalty will continue to increase. To prevent having to pay a penalty it is important you sign up for Medicare when you&rsquo;re first eligible. 
<h3 style="padding-left: 36pt;">1. What will happen when I leave my employer after turning 65 years old?</h3>
You will have the opportunity to enroll during the Special Enrollment Period and you get 8 months during SEP to enroll when you leave your job after age 65. By signing up during SEP you will not have to pay Medicare Part B premium surcharges. You will also be eligible to sign up for Medicare Part&nbsp; B if you were once covered under your spouse&rsquo;s employer-provided group health insurance coverage. 
<h3 style="padding-left: 36pt;">2. How can I avoid the Medicare Part B penalty?</h3>
Enroll in Medicare Part B coverage during your Initial Enrollment Period (IEP) or if it applies to you during your Special Enrollment Period (SEP).&nbsp;
As a reminder: The longer you wait to sign up for Part B coverage, the more the penalty continues to increase.&nbsp; 
<h3 style="padding-left: 36pt;">3. How do I pay the Medicare Part B penalty?</h3>
Any late enrollment penalties that you receive will be added to your monthly Part B premium for as long as you remain in the program.&nbsp;
For example, if you signed up five years after your deadline, you&rsquo;d always pay 50 percent more for your Part B coverage than if you&rsquo;d sign up on time.&nbsp; 
<h3 style="padding-left: 36pt;">4. When does the Medicare Part B penalty not apply?</h3>
If you miss your initial enrollment deadline but sign up during the next General Enrollment Period, the penalty will not apply if less than a 12-month period.&nbsp;
Coverage goes into effect on July 1st when you enroll during the General Enrollment Period.&nbsp;
For example, if your Initial Enrollment Period ends on November 30th and you do not enroll until the General Enrollment Period, you will have an eight-month period before your coverage becomes effective on July 1st. Part B penalties will not apply.&nbsp; 
<h3 style="padding-left: 36pt;">5. If I am still working do I have to sign up for Medicare Part B?</h3>
No, as long as you have creditable healthcare through your employer you will not have to enroll in Medicare Part B, nor face a penalty. 
<h3 style="padding-left: 36pt;">6. I&rsquo;m on Medicaid and didn&rsquo;t sign up for Medicare Part B, will I be penalized?</h3>
If you are on Medicaid, no need to worry about paying penalties because your state will cover those costs.&nbsp;
If you delayed your Medicare Part B enrollment because of other creditable coverage, you can avoid the penalty by signing up during the Special Enrollment Period.&nbsp;
Enrolling during the Special Enrollment Period means you are not liable for late penalties.
&nbsp;
<h3 style="padding-left: 36pt;">7. Can I get the penalty waived?</h3>
If you received bad advice from the federal government regarding your Medicare plan and find yourself without Part B coverage.&nbsp;
Social Security may be able to waive your Part B penalty and enroll you into Part B or do both things. This works if you would have otherwise had to wait to enroll in the General Enrollment Period.
You may also be able to have your Part B enrollment effective date retroactive.&nbsp;
It&rsquo;s important to specify to Social Security what you want to do when you make your request.&nbsp;
&nbsp;
<h3 style="padding-left: 36pt;">8. Can I appeal a Medicare penalty?</h3>
It&rsquo;s important to document as much information as possible about when someone from the government told you not to take Part B.
Include the date and time of your conversation or phone call, and the person you spoke with. Once you gather all of your information you can submit your equitable relief request to your local Social Security office.&nbsp;
Contact Social Security at 1-800-772-1213 or check&nbsp;<a href="http://www.ssa.gov/">www.ssa.gov</a> to find the mailing address of your local Social Security office.
&nbsp;
<h3 style="padding-left: 36pt;">9. What happens if I don't pay enough Medicare payroll taxes?</h3>
If you don&rsquo;t sign up for Part B coverage because you thought you hadn&rsquo;t paid enough Medicare payroll taxes to &ldquo;qualify&rdquo;, be aware that earning 40 credits through paying those taxes only ensures that, after age 65 you don&rsquo;t pay monthly premiums for Medicare Part A (hospital coverage).
The number of years you&rsquo;d have had to pay Medicare taxes is 10 years. 
<h2>Medicare Part D: </h2>
<h3 style="padding-left: 36pt;">10. Will I have to pay a Medicare Part D penalty if I don&rsquo;t enroll in insurance coverage?</h3>
Generally, you will not have to pay a Medicare Part D penalty if you have creditable drug coverage (coverage that&rsquo;s similar in value to Medicare Part D) or if you qualify for Extra Help.&nbsp;
If you don&rsquo;t join a Medicare drug plan when you first sign up for Medicare, you will pay an extra 1% for each month (12% a year), or go 63 days or more without creditable drug coverage.
Keep in mind you may pay a higher premium for Medicare Part D depending on your income. After signing up for a Medicare drug plan, the plan will tell you if you have to pay a penalty and what your premium will be each month. 
<h3 style="padding-left: 36pt;">11. How is the Medicare Part D penalty calculated?</h3>
There are two factors determined in the calculation of the Medicare Part D penalty:&nbsp;
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">The number of months you went without proper medication coverage before enrolling in Part D.</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">The amount of Medicare&rsquo;s current &ldquo;national base beneficiary premium.</li>
</ul>
</li>
</ul>
Medicare calculates this amount using a complex formula derived from the average amount insurance companies expect to spend on their plans in a given year.&nbsp;
The Centers for Medicare &amp; Medicaid Services (CMS) then uses that information to calculate the late enrollment penalty.
&nbsp;
<h3 style="padding-left: 36pt;">12. What if I already have a Medicare Part D Prescription Drug coverage plan?</h3>
If your current Medicare Part D plan is considered &ldquo;creditable&rdquo; stick with it. Your plan is considered &ldquo;creditable coverage&rdquo; if it pays out as much as Medicare plans do.&nbsp;
Creditable coverage can be through a current or former employer, retiree coverage, or labor union group health plan.&nbsp;
The following entities also offer creditable coverage:&nbsp;
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">Federal Employee Health Benefits (FEHB) Program</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">Veterans Benefits</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">TRICARE (Military Health Benefits)</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">Civilian Health and Medical Program of the U.S. Department of Veterans Affairs (CHAMPVA)</li>
</ul>
</li>
</ul>
<ul>
<li style="list-style-type: none;">
<ul>
<li aria-level="1">Indian Health Service </li>
</ul>
</li>
</ul>
<h3 style="padding-left: 36pt;">13. What happens when my employer-based creditable coverage comes to an end, do I have to pay a penalty?</h3>
If your employer plan comes to an end or you drop your Medicare Part D plan after the initial enrollment window closes, you can avoid the late enrollment penalty.&nbsp;
When your employer coverage ends, you enter a 63-day special enrollment period and during that time you can sign up for a Medicare Part D plan and avoid a late enrollment penalty. 
<h2>What to Keep in Mind about Medicare Enrollment</h2>
Enrolling in Medicare and being faced with a penalty can be a daunting experience. It is important to enroll during your Initial Enrollment Period once you become eligible on your 65th birthday and make necessary changes if need be.&nbsp;
To avoid Medicare penalties, Open Enrollment starts on October 15th and through December 7th. This time period is the perfect time to make changes to your current Original Medicare plan, enroll in Medigap, enroll in a Medicare Advantage plan, or enroll in various parts of Medicare.&nbsp;
For further information, and eligibility, process your Medicare enrollment visit <a href="http://medicare.gov/">medicare.gov</a> or by phone at 1-800-MEDICARE (1-800-633-4227), TTY users can call 1-877-486-2048.

Need information regarding Medicare penalties? Learn about Medicare Part B and Medicare Part D Enrollment Penalties today to be better prepared.

Medicare Part B & Part D Enrollment Penalties to be Aware of | Ready Set Care

Medicare Part B & Part D Enrollment Penalties to be Aware of

Many seniors on Medicare experience some degree of food insecurity, finding it difficult at times to afford as much food as they need. This type of food deficit calls for more than just an <a href="../../resources/articles/emergency-plans">emergency plan</a>.&nbsp;
With both health care and food costs rising, older adults who rely on Social Security or other pension plans for income may find themselves short of the funds they need for food.&nbsp;
Seniors who find themselves in this position may want to look into food assistance options offered by the government and other private entities.
<h2>What are 8 Food Assistance Options for Seniors?</h2>
Food assistance programs or <a href="../../resources/articles/most-overlooked-senior-benefits">senior benefits are often overlooked</a>. These free food programs have different qualifying criteria.&nbsp;
Some are available to all seniors on Medicare or Medicaid, or to low-income seniors or those with disabilities. Caregivers with a loved one who is at risk of food insecurity may want to look into these programs on behalf of their charges.
These programs include: 
<h3 style="padding-left: 36pt;">1. The Medicare Food Allowance benefit</h3>
This program can be used in addition to other available programs. It is typically associated with Medicare Advantage (Medicare Part C) plans. The grocery benefit grants beneficiaries a quarterly allowance for qualifying food items.&nbsp;
Eligibility is based on enrollment. In addition, you need to live in the service area for one of these health plans to qualify.
Many Medicare Advantage plans offer the new healthy food card benefit. Among the items, you can buy with this card at grocery stores and other participating venues are:
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">Fresh, canned, and frozen fruit</li>
<li style="font-weight: 400;" aria-level="1">Fresh, canned, and frozen vegetables</li>
<li style="font-weight: 400;" aria-level="1">Salad kits</li>
<li style="font-weight: 400;" aria-level="1">Dairy Products</li>
<li style="font-weight: 400;" aria-level="1">Beans</li>
<li style="font-weight: 400;" aria-level="1">Healthy Grains</li>
<li style="font-weight: 400;" aria-level="1">Meats</li>
<li style="font-weight: 400;" aria-level="1">Baking needs like flour, seasonings, sugar</li>
<li style="font-weight: 400;" aria-level="1">Nutrition shakes and snack bars</li>
<li style="font-weight: 400;" aria-level="1">Water and vitamin water</li>
</ul>
</li>
</ul>
 Contact the Medicare plan you are enrolled in to see which specific items are covered.&nbsp;
The food card does not cover all items. Some of the items not covered include:
<ul>
<li style="list-style-type: none;">
<ul>
<li style="font-weight: 400;" aria-level="1">Pet food</li>
<li style="font-weight: 400;" aria-level="1">Baby formula</li>
<li style="font-weight: 400;" aria-level="1">Non-food items</li>
<li style="font-weight: 400;" aria-level="1">Chips</li>
<li style="font-weight: 400;" aria-level="1">Fresh baked goods</li>
<li style="font-weight: 400;" aria-level="1">Desserts</li>
<li style="font-weight: 400;" aria-level="1">Candy</li>
<li style="font-weight: 400;" aria-level="1">Soda</li>
<li style="font-weight: 400;" aria-level="1">Alcohol</li>
<li style="font-weight: 400;" aria-level="1">Tobacco</li>
<li style="font-weight: 400;" aria-level="1">Coffee&nbsp;</li>
<li style="font-weight: 400;" aria-level="1">Soda</li>
</ul>
</li>
</ul>
Many Medicare Advantage plans feature nutrition benefits such as a healthy food card for nutritious meals or home meal delivery for homebound seniors.&nbsp;
Eating healthy can help seniors avoid diseases such as <a href="../../resources/articles/what-is-diabetes">diabetes</a>. Some plans require that you have a qualifying health condition or specific medical care needed to access these benefits, and may require copays.&nbsp;
Plan members provided with a healthy food card have their benefits loaded onto the card. They can then use the card to make purchases when they checkout.&nbsp;
To use the care, those eligible must shop at a participating store and buy eligible foods. The card covers the cost of approved foods up to the specified limit.
Original Medicare (Part A and Part B) does not cover meal delivery services or grocery benefit cards. These benefits are only available to those with Medicare Advantage plans that offer them.
&nbsp;
<h3 style="padding-left: 36pt;">2. Senior Farmers&rsquo; Market Nutrition Program (SFMNP)</h3>
This program offers eligible seniors free vouchers that they can use at participating farmers&rsquo; markets, roadside stands, and community-supported agriculture programs. The SFMNP is federally funded and provides grants to states and territories.&nbsp; 
<h3 style="padding-left: 36pt;">3. Commodity Supplemental Food Program (CSFP)</h3>
This program makes available boxes of nutritious food to qualifying seniors who meet certain income criteria qualifications. The packages provided by CSFP include foods and drinks such as juice, cereal, milk, rice, pasta, dry beans, peanut butter, poultry, fish, and canned fruits and vegetables. Note that this program is not available in every state. 
<h3 style="padding-left: 36pt;">4. The Emergency Food Assistance Program (TEFAP)</h3>
TEFAP is a federal program that makes nutritious food available to low-income individuals for free.&nbsp;
The food is first purchased by the U.S. Department of Agriculture and then sent to the states. Eligibility qualifications are different from state to state.&nbsp; 
<h3 style="padding-left: 36pt;">5. Meals on Wheels</h3>
The Meals on Wheels Association of America features a program that offers free meals for seniors who are on Medicare by providing them with free grocery delivery.&nbsp;
The meals provided by the program are selected to meet the dietary guidelines set by the USDA. 
<h3 style="padding-left: 36pt;">6. Area Administration on Aging</h3>
The <a href="https://www.acl.gov/about-acl/administration-aging">Administration on Aging (AAA)</a>resource can help point seniors in the direction of discounted meal sites, such as senior centers and other programs such as Meals on Wheels.&nbsp;
You can use the <a href="https://eldercare.acl.gov/Public/Index.aspx">Eldercare.gov</a> locator link to see if there is a program near you. 
<h3 style="padding-left: 36pt;">7. Food Banks, Pantries, and Soup Kitchens</h3>
A number of these establishments serve needy seniors. Many of them are operated by churches and various community organizations. 
<h3 style="padding-left: 36pt;">8. Supplemental Nutrition Assistance Program (SNAP)</h3>
Once known as food stamps, the <a href="http://www.fns.usda.gov/snap">SNAP program</a> offers benefits to low-income households, including seniors, via electronic cards that can be used to purchase food.&nbsp;

8 Food Assistance Options for Seniors on Medicare | Ready Set Care

8 Food Assistance Options for Seniors on Medicare

While Medicare is managed by the federal government and primarily based on age, Medicaid is managed by states and is mainly based on a person’s income. Refer to our Medicare and Medicaid content for more information.

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