Articles Posted in Medicaid & Medicare

Mature Couple Calculating Coin In The PiggybankIf you haven’t heard of the Medicare Savings Program, today may be your lucky day. You could save thousands of dollars a year on medical costs courtesy of the State of Connecticut and Medicaid.

The Medicare Savings Program covers

  • out-of-pocket expenses for premiums,
  • deductibles
  • co-pays
  • and subsidizes your prescriptions drug costs if you are an eligible Medicare beneficiary.

Do you meet the criteria?  Continue reading

StethoscopeMoneyA federal court ruled that hospitals may retain a patient in their building under “observation status” rather than formally admitting them, and that such “observation status” does not count as a hospital stay for nursing home Medicare qualification purposes.

Medicare (not to be confused with Medicaid or Title 19) provides a limited nursing home benefit. If a nursing home resident spends three nights in a hospital and then is discharged to a nursing home for some type of rehabilitation services, the nursing home resident is entitled to Medicare benefits at the nursing home for up to 100 days. Medicare will pay the entire bill for the first 20 days and, for the next 80 days, Medicare will continue to pay a portion of the bill and the nursing home resident must pay a portion. In 2021, the nursing home resident must pay $185.50/day and Medicare pays the balance (many nursing home residents have a Medicare supplemental insurance policy to cover the $185.50/day). The Medicare benefit can save a nursing home resident tens of thousands of dollars.

So what does “observation status” have to do with all of this?

Under Medicare regulations for hospitals, if a hospital admits a patient and Continue reading


Choice Wooden Letterpress ThemeUntil recently, there was a Catch 22 when it came to getting care in the community. If you are 65 years of age or older, the Connecticut Home Care Program for Elders is available. But for younger people with complex care needs, the options in Connecticut have been limited.

The PCA (Personal Care Assistance) Medicaid Waiver is available, for example, but primarily serves individuals with limited needs and certain conditions, and the program has a cap on the number of slots available. Furthermore, other waiver programs are also limited. Continue reading

Medicaid making a hole through a dollar bill.Few crises are more stressful than those related to health and long-term care. Figuring out how to sustainably support necessary home care, medical services, nursing home costs, and other critical expenses can easily become overwhelming.

And, the situation is exponentially worse if you’ve waited until you’re in crisis to address the important questions of how to pay for critical services, protect your assets, and ensure your comfort, security, and quality of life.

In fact, waiting until it’s too late is the biggest mistake older adults make when it comes to planning for ongoing home care or long-term care in a nursing home or other facility.

Brendan-mug-shot-e1595015692932-281x300By Brendan Daly

As an elder law attorney, I’ve been advocating for my senior clients for twenty years, but I recently discovered that my 78-year-old dad still has a few things to teach me.

It was a lesson I maybe should have seen coming.

home-sign-300x200“Promise me you won’t ever put me in a nursing home.” Our parents would make us sign in blood if they could.

Fear of losing their independence and way of life is a tremendous concern among Connecticut seniors. And, in today’s COVID-19 environment – knowing how the virus can easily spread throughout a nursing home and to its vulnerable population – staying at home is a preferable option for many.

But if you’re like so many Connecticut residents, you may not know that there is Medicaid coverage for receiving care at home – that Medicaid benefits are not just for nursing home residents. This is great news!

Hand with marker writing the word BewareThere are few planning tasks more daunting than applying for Medicaid. The process is intimidating and can quickly become overwhelming, not merely because it’s complicated but also because it opens up a Pandora’s Box of legally nuanced questions and concerns.

This is not a task anyone can afford to botch, and it’s something that you have to get right on the first try.

Because of the challenges, most people seek help navigating the Medicaid labyrinth. While there are many reputable Connecticut elder law attorneys who assist with Medicaid applications and asset protection planning, there is also a dangerous new breed of “senior planning” providers that is preying on elderly nursing home residents, often reducing them to financial ruin. 

Money on the table, next to a cardboard sign with Prepaid Expenses writtenAssets count when it comes to qualifying for Medicaid, but some assets related to your funeral expenses are excluded, and prepaying them is an acceptable way to spend down your assets to qualify for Medicaid, or Title XIX.

Specifically, here’s what the State of Connecticut allows:

Irrevocable Funeral Trust or Contract

You can prepay up to $10,000 for an irrevocable funeral trust, also called an irrevocable funeral contract. This covers basic service charges, funeral services, preparation of remains, vehicles, etc. Keep in mind that this type of contract cannot be canceled or cashed in. It can only be transferred to another licensed funeral home. Continue reading

medicaid claimBy Lara Schneider-Bomzer

The Connecticut Supreme Court decision, Pikula v. Department of Social Services, established clear guidelines for determining if a trust should be considered a “supplemental needs trust” or a “general support trust.”

In general, assets held in a supplemental needs trust are considered unavailable in determining Medicaid eligibility for the trust beneficiary. Continue reading

Grunge Stempel rot PREPAIDYou have probably heard the phrase “spend down” – something you could do to reduce your assets which would help to qualify you for Medicaid.

A prepaid funeral contract is one of those items that are considered exempt. In other words, its value won’t be counted when the Department of Social Services is reviewing your total assets.

The standard amount allowed by the the state of Connecticut for a prepaid irrevocable funeral service contract is $10,000.

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