By Rick Banas of assisted living provider BMA Management, Ltd.
Here is some great advice for older adults from Ella York of the Illinois Attorney General’s Office.
Ella serves as Community Outreach Liaison in the Attorney General’s Carbondale office. She spoke recently at the Heritage Woods affordable assisted living community that BMA manages in Benton, Illinois, about what older adults can do to protect their hard earned dollars from fraud and scams.
Never Give Out Personal Information to Someone Who Has Called You
Do not give out personal information over the phone unless you have initiated the call and you know the person with whom you are speaking.
If someone calls you and starts asking you for personal information, the best thing you can do is hang up on them. This is true if you have caller ID because you cannot trust the number that shows up on caller ID. Scammers have learned how to fake the telephone number that will show up. This is true if the caller claims to be from your bank, saying that there is a problem with your account. This is true even if the caller claims to be from Medicare or the Federal Bureau of Investigation (FBI). Nobody from Medicare should be calling you and either asking you for or looking to verify personal information. The FBI certainly does not need to call you to get personal information.
Be Very Protective of Your Social Security Number
Do not carry your Social Security Card or your Medicare Card with you. Your Medicare number is your Social Security Number. If you want something to carry with you to show health care providers, make a photo copy of your Medicare card and black out the last four digits of your Medicare number. Doctors should accept it. If you are visiting a doctor or other health care provider for the first time, you may want to take your Medicare card with you. After the visit, be sure to take it out of your purse, wallet or pocket and return it to a safe place.
Regularly Check Your Credit Card and Medicare Statements and Your Credit Reports
Review your credit card statements, even if you have not used your credit card, to be certain that there are no unauthorized charges on your account. Likewise, be sure to check your Medicare statements to be certain there are no unauthorized charges, especially for medical procedures such as hip and knee replacements and for medical equipment such as wheelchair and scooters. If you see unauthorized charges, you need to immediately notify Medicare. Do not assume that because Medicare is paying that it is Medicare’s problem. If sometime down the road you need a wheelchair, scooter or a right hip replacement and your Medicare statements indicate that you recently received one, Medicare is not likely to easily authorize the request.
Obtaining and reviewing your Credit Report also helps verify if you have been a victim of Identity Theft.
You want to verify that the personal information in Section 1 of the Credit Report is accurate. You want to review Section 2, which lists every single line of credit under your name and whether each line of credit is in good standing. This is the only way to see if someone has opened a new Credit Card account in your name without your authorization. You also want to be sure to review Section 3, which lists any Public Records such as Court Judgments or Liens that have been placed against you. In the last section of your credit report, you’ll find a list of everyone who has asked to see your credit report.
If there is a mistake or something on your Credit Report that should not be there, call up the credit reporting agency and let them know. If you believe that you have been or might be a victim of Identity Theft, call the ID Theft Hotline in addition to the credit reporting agency. You can call 1-866-999-5630, TTY 1-877-844-5461, in Espanol 1-866-310-8398.
Free credit reports are available to you from the Equifax, Experian and TransUnion Consumer Reporting Agencies (CRA). You are entitled to one free report from each agency each year so you can stagger when you obtain the reports. For instance, you can obtain a report from a different CRA every four months.
To request your free credit report, Ella recommends going to www.annualcreditreport.com or calling 1-877-322-8228. Don’t confuse this website with the free credit report.com website, she said, because the www.freecreditreport.com website will charge you for the report.
Shortly after the ball dropped in Times Square to mark the start of 2013, the U.S. Senate passed the American Taxpayer Relief Act of 2012 (ATRA) by an overwhelming 89 to 8 vote. The compromise legislation, which was adopted at about 2 a.m. on Jan. 1, was designed to avert the fiscal cliff.
ATRA is generally classified as tax legislation, but has built into it numerous provisions affecting public benefits, elder care, Elder Law and our seniors and boomers in general.
What does this mean for seniors and boomers? Consider the following:
1. Tax rate changes – The bill permanently extended current tax rates for individuals earning less than $400,000 and couples earning less than $450,000. Wealthy taxpayers (those making more than $400,000) will revert back to a 39.6% (up from 35%) tax rate. Taxpayers in this wealthy category will also see an increase in their capital gains tax rate and dividend tax rate from 15% to 20%. Also, married couples that earn more than $300,000 and individuals that earn more than $250,000 will face a phaseout of the personal tax exemption.
2. Estate Tax Changes – The estate tax is alive and well. The federal estate tax exemption for 2013 will be $5.25 million per person and be indexed for inflation in future years. Effective January 1, 2013, the top federal estate tax rate will increase from 35% to 40%. Portability of the unused exemption will remain in place for spouses. And the gift tax exemption will remain at $5 million. The Illinois estate tax exemption will increase to $4 million per person for 2013.
3. Payroll tax – Since 2011, the payroll tax rate, which funds Social Security, was kept at 4.2%. Starting January 1, 2013, the payroll tax rate will now revert back to 6.2% for those earning wages.
4. Good news for doctors (and all of us) – For another year, doctors will not suffer the previously scheduled 27% reimbursement cuts to Medicare patients’ fees.
5. Older Americans Act funding – There is additional increased funding for important aging programs. For fiscal year 2013, Area Agencies on Aging will receive an additional $7.5 million in additional funds. The Aging and Disability Resource Centers received an additional $5 million. The National Center for Benefits and Outreach Enrollment will also see an increase of $5 million in funding. Also, Medicare State Health Insurance Programs (SHIP) will receive an additional $7.5 million in additional funding for 2013.
6. Sequestration – The scheduled automatic spending cuts are delayed by a few months. Half of the cuts would come from defense spending and the other half would come from non-defense spending.
7. Class Act is repealed – This was to be an attempt at a national long-term care insurance program. It was scrapped in exchange for the establishment of the Commission on Long-Term Care.
8. Commission on Long-Term Care – This commission will develop a plan for the establishment, implementation and financing of a comprehensive system that ensures availability of long-term care services and support. The commission will look into the coordination of Medicare, Medicaid and private long-term care insurance. The commission will have 15 members, including the President. The various members will represent the interests of consumers, older adults, family caregivers, healthcare workers, private long-term care insurance, state insurance departments, and state Medicaid agencies.
Let’s hope they come up with an affordable long-term care model for our boomers and seniors. The (NAELA)Illinois Supportive Living program provides a wonderful example.
Remember, the most painful financial crisis affecting seniors and boomers today is the devastating cost of long-term care ($6,000 to $10,000 per month, per person in the Chicagoland area!).
9. Other items – The bill extended Medicare programs for older Americans including the payment for outpatient therapy services and specialized Medicare advantage plans for special needs individuals. The bill also extended the Qualifying Individual program (QI program).
10. Note – This is complicated stuff. But don’t let it stop you. Keep reading in the months ahead to understand more about the changes and how they might impact you. Also note that this bill still doesn’t solve the problems regarding sequester and the debt limit debate. That heavy lifting is still coming. Things will certainly heat up between now and May in trying to resolve those issues.
Takeaways – Stay tuned in. Start your “senior” estate planning now.
Anthony Ferraro is a member of the National Academy of Elder Law Attorneys, Inc. (NAELA)
What are your thoughts? Leave a comment and let us know.
“BMA Management is the leading provider of assisted living in Illinois and one of the 20 largest providers of assisted living in the United States.”
By Rick Banas of assisted living provider BMA Management, Ltd.
“When is a hospital patient not a hospital patient?, asked Rick Law during yesterday’s 24th Annual Kane County Legislative Forum on Aging and Disability Issues.
The #1 complaint is that Medicare patients are being held in the hospital under “observation status” rather than being admitted as an “inpatient” to the hospital.
Unless you ask, you probably won’t even know. Just because who have been placed in a hospital bed in a hospital room does not mean you are an “inpatient.” You can be sharing a room with an “inpatient” while you are on “observation” status. You can be in the hospital for more than 48 hours and be on “observation” status the whole time.
Why is this so important?
First, you’re Medicare Part A benefits apply if you are admitted to the hospital as an “inpatient.” Medicare has you covered. If you are in the hospital under “observation” status, you are considered an outpatient. Most of the burden for the cost of your stay in the hospital shifts from Medicare to you.
Secondly, one of the requirements for Medicare benefits in a post-acute skilled nursing care center is that you have been in a hospital as an “inpatient” for at least three midnights. Being held in the hospital under “observation status” or being treated in the emergency room means that you will not qualify for any Medicare benefits to help cover the cost of skilled nursing care.
Under the Affordable Care Act, hospitals have an incentive to hold you under “observation” rather than admit you as an “inpatient.” As of October 2012, Medicare is penalizing hospitals if they have too many “inpatients” being readmitted within 30 days. Those held under “observation” status do not count in the calculations.
Rick pointed out that your doctor most likely is not the best person to ask if you are in the hospital as an “inpatient” because your doctor can be accused on Medicare fraud if he or she says that you are an “admitted patient and then later is overruled by a Medicare auditor.”
You or your advocate should question the hospital about your status, especially if you are in the hospital for more than 48 hours.
However, even if you are able to confirm that you have been admitted as an “inpatient” with the hospital, there still is no certainty. A “Recovery Audit Contractor” designated by the Centers for Medicare and Medicaid can review your case and decide to change the status of your stay in the hospital from “inpatient” to “observation” 4 or 5 months after you have been in the hospital.
Just wanted you to know what Rick Law had to say.
What are your thoughts? Leave a comment and let us know.
“BMA Management is the leading provider of assisted living in Illinois and one of the 20 largest providers of assisted living in the United States.”
By Rick Banas of assisted living provider BMA Management, Ltd.
When you look through the materials distributed by the Centers for Medicare & Medicaid Services (CMS) on “2012 Choosing a Medigap Policy,” you should take notice of a statement printed in bold, said John McCallag in a presentation on Medicare Supplements that he conducted at our Heritage Woods assisted living community in Huntley, Illinois.
The statement reads “There can be big differences in the premiums that different companies charge for exactly the same coverage.”
Medigap is the common name used to describe a Medicare supplemental insurance policy.
John is a Certified Senior Care Advisor based in McHenry, Illinois.
The main ways you get Medicare coverage is either through what is termed the Original Medicare Plan or through a Medicare Advantage Plan.
With Original Medicare Plan, Medicare Part A is your hospital insurance. It helps cover inpatient care in hospitals and provides certain benefits for skilled nursing, hospice and home health care services. Medicare Part B is your medical insurance. It helps cover doctor’s services, hospital outpatient care, and certain preventive health and home health services.
Medicare Part D provides your prescription drug coverage.
If you get your coverage through Original Medicare Care, you can add supplemental coverage through a Medigap Insurance Policy if you so choose. A Medigap policy helps you pay for some of the health care costs that Original Medicare does not cover such as copayments and deductibles. If you have a Medigap policy, Original Medicare will pay its share and then your Medigap policy will pay its share.
A Medicare Advantage Plan works like an HMO or PPO and combines Part A, Part B and usually Part D. If you decide to get your Medicare coverage through a Medicare Advantage Plan, you do not need a Medigap or Medicare Supplemental insurance policy.
Here are some key points that John stressed during his presentation about Medigap policies:
When you buy a particular Medigap plan, what is covered through the plan is identical whether you buy the plan through Blue Cross, AARP, Aetna, Mutual of Omaha or any of the other carriers that offer the plan in your area. Click here for Medigap Policies in your area.
The monthly cost can vary widely for a Medigap plan with identical coverage. To illustrate the point, John distributed a monthly premium cost comparison analysis for a standard Medicare Plan F supplemental insurance coverage for a female non-smoker living in a 600 zip code. Depending on the age of the individual, the premium difference for the same policy with the same coverage among ten insurance companies ranged from more than $30 to nearly $150 a month (from more than $360 to nearly $1,800 a year).
What you pay has nothing to do with the claim services or whether or not your carrier will pay for a procedure.
It is Medicare that determines if a particular procedure is covered, not your Medigap insurance carrier. If Medicare approves it, your Medigap insurance carrier is obligated by law to pay.
The determination as to whether or not Medicare approves a particular procedure is all done by Medicare and by computer.
John suggested that you should review your Medicare supplemental insurance (Medigap) once a year.
He also suggested that it might be worthwhile taking a look at a high-deductible Plan F Medigap insurance policy. The difference in the monthly cost may be more than enough to cover the potential cost of having to pay a deductible amount before your Medigap plan will provide coverage.
By Rick Banas of assisted living provider BMA Management, Ltd.
Mahja Sulemanjel and Jorie Gustafson of HCR ManorCare conducted a free informational program on Medicare last week at the Heritage Woods affordable assisted living community that BMA manages in South Elgin, Illinois.
Here is some important information to keep in mind:
Medicare was created in 1965. The primary purpose of the program is to provide health coverage for individuals 65 years of age and older.
There are four parts to Medicare, with Part C being added in 1997 and Part D in 2003.
Medicare Part A helps cover the cost of inpatient care in the hospital. It also helps cover the cost of skilled nursing care, hospice services and home health care.
There is no charge for Medicare Part A if you are eligible.
A person, or the spouse of a person, who has worked in Medicare-covered employment for at least 10 years (40 quarters), and is a citizen or permanent resident of the United States and at least 65 years of age is eligible. Among those who also are eligible are those who meet Social Security or Railroad Retirement disability requirements and those with end-stage renal disease.
Since Medicare helps cover inpatient care, be careful not to assume that just because you are in a hospital overnight or just because you are taken to a hospital room does not necessarily mean that you are an inpatient. Make sure that you are clear about whether the hospital has admitted you as an inpatient versus holding you for observation.
Also, be careful not to assume that Medicare benefits apply just because you have been admitted into a nursing home. Medicare does not cover custodial care or long-term care in a nursing home. Medicare coverage only may apply if you require daily skilled nursing or daily rehabilitation services and have been an inpatient in an acute care hospital for at least three consecutive midnights within 30 days of being admitted to a skilled nursing facility. Being in the hospital for observation does not count. You also must be admitted to a Medicare-certified bed. Up to 100 days may be covered, with co-payments applying after the first 20 days.
Medicare Part B helps cover medically-necessary health services such as the cost of doctors, outpatient services, durable medical equipment, and home health care. Some preventive services also are covered.
Medicare Part C are health plans offered by private companies. These plans provide all of your Medicare Part A and Medicare Part B coverage. Many also offer extra coverage such as vision, hearing and dental services and health and wellness programs. Most also include Medicare Part D coverage.
Different types of Medicare Advantage plans are available such as Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and fee-for-service plans.
You usually pay a monthly premium in addition to your Medicare Part B premium for a Medicare Advantage plan.
Each Medicare Advantage Plan can charge different out-of-pocket costs.
Through Medicare Part D, Medicare offers prescription drug coverage to everyone on Medicare to help them with the cost of prescription medications.
To get the coverage, you must join a plan run by an insurance company or a private company approved by Medicare.
A variety of plans are available, with each plan varying in terms of drugs covered, monthly costs and potential out-of-pocket expenses.
Keep in mind that if you do not enroll in a Medicare Part D Plan when you first become eligible and you do not have other creditable drug coverage, you likely will have to pay a late enrollment fee penalty.
For More Information
The Centers for Medicare & Medicaid (CMS) is the branch of the U.S. Department of Health and Human Services (HHS) that is responsible for administering the Medicare program.
You can access a CMS Medicare & You Handbook by clickinghere.
Additional information also is available at medicare.gov
What are your thoughts? Leave a comment and let us know.
“BMA Management is the leading provider of affordable assisted living in Illinois and one of the 20 largest providers of assisted living in the United States.”
Guest Blog by 
1. Tax rate changes – The bill permanently extended current tax rates for individuals earning less than $400,000 and couples earning less than $450,000. Wealthy taxpayers (those making more than $400,000) will revert back to a 39.6% (up from 35%) tax rate. Taxpayers in this wealthy category will also see an increase in their capital gains tax rate and dividend tax rate from 15% to 20%. Also, married couples that earn more than $300,000 and individuals that earn more than $250,000 will face a phaseout of the personal tax exemption.
“When is a hospital patient not a hospital patient?, asked 
When you look through the materials distributed by the Centers for Medicare & Medicaid Services (CMS) on “
By Rick Banas of assisted living provider BMA Management, Ltd.
Through Medicare Part D, Medicare offers prescription drug coverage to everyone on Medicare to help them with the cost of prescription medications.
