Estate planning is a critical process for ensuring that one’s wishes are honored after passing. However, it’s fraught with potential pitfalls that can undermine its effectiveness. Understanding these common challenges is key to creating a robust and effective estate plan.

• 1. Poor Drafting and Infrequent Updates: A major factor undermining the effectiveness of many estate plans is the poor drafting or inadequate updating of documents. This neglect often leads to a failure in reflecting personal life changes or adapting to new legal statutes, compromising the relevance of the estate plan.

• 2. Reliance on Generic Templates: The use of generic online templates or standard documents is another critical issue. These resources might not be equipped to address the unique complexities and legal subtleties of an individual’s situation. This inadequacy can result in complications and the potential disregard of a person’s final wishes.

• 3. Relying on Advice from Non-Experts: Taking advice from family members or friends can be problematic. They might not fully understand the specific circumstances or the nuances of different state laws, leading to the creation of documents that are irrelevant or incorrect for the person’s situation and state.

• 4. Importance of Tailored Legal Advice: Given these challenges, the need for personalized legal advice and regular updates to estate planning documents is vital. This ensures that the documents stay effective and in alignment with the current legal and personal context.

• 5. Inadequate Designation of Executors: Estate plans are often flawed due to the inappropriate selection of individuals to manage the estate or the failure to appoint alternates if the primary choice is unavailable. This can lead to difficulties in the execution of the estate plan.

• 6. Lack of Clarity in Documentation: Attempts to create estate documents that are either overly specific and rigid or too broad and undefined can be detrimental. Such documents may fail to provide clear and actionable directions for carrying out the deceased’s intentions.

• 7. Conflicting Information and Assumptions: A common mistake is the presence of conflicting information, such as pay-on-death beneficiaries or joint property ownerships, with assumptions that other documents will distribute these assets. Without specific language, these assumptions often do not hold true.

• 8. Consequences of Inconsistent Planning: Inconsistent estate planning can lead to a chaotic situation, hurt feelings among beneficiaries, and ultimately, the failure to fulfill the deceased’s wishes.

Conclusion: The Path to Effective Estate Planning

To avoid these pitfalls, it’s crucial to approach estate planning with thoroughness and precision. Regular consultation with legal experts, careful consideration in document drafting, and an awareness of the specific legal requirements of one’s state are essential. By doing so, individuals can ensure that their estate plan accurately reflects their wishes and is capable of being executed smoothly, thereby safeguarding their legacy and providing peace of mind.

The post Common Shortcomings in Estate Planning appeared first on CareAvailability.

When seniors are considering downsizing, having an appropriate estate plan in place is crucial. This involves several key documents which are essential to ensure that their wishes are honored and their assets are managed and distributed according to their preferences.

Here are the primary documents that should be considered.

Will

This is the fundamental document in estate planning. It outlines how the individual wants their assets to be distributed after their death. It can also specify guardians for any minor children.

Trust

Trusts can be used for various purposes, such as avoiding probate, increased privacy, reducing estate taxes, or providing for a disabled family member. There are different types of trusts, and each serves different needs.

Durable Power of Attorney

This document allows seniors to appoint someone to manage their financial affairs if they become unable to do so. This can include paying bills, managing investments, and handling other financial matters.

Healthcare Power of Attorney

Also known as a healthcare proxy, this document designates someone to make healthcare decisions on the senior’s behalf if they are incapacitated.

Living Will

This outlines the individual’s preferences for medical treatment in situations where they are unable to communicate their wishes, particularly concerning life- sustaining measures.

Beneficiary Designations

Often overlooked, these designations on financial accounts, insurance policies, and retirement accounts can override instructions in a will, so they need to be kept up to date.

Letter of Intent

While not a legal document, a letter of intent can provide guidance to family members about personal wishes and directions regarding the individual’s estate.

Digital Asset Inventory

As more aspects of our lives move online, it’s important to have a plan for digital assets, like social media accounts, online banking, and email accounts.

Each of these documents plays a critical role in estate planning, especially when seniors are downsizing. It’s advisable for them to consult with an estate planning attorney to ensure that their documents are properly drafted and reflect their current wishes and circumstances.

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Retirement is often seen as the ultimate reward for decades of hard work—a time to relax, travel, or pursue long-neglected hobbies. But what often gets overlooked is the significance of maintaining holistic wellness during this new chapter. How do you make the most of this freedom? The answer lies in your well-being, not just financially, but physically, mentally, and emotionally as well.

Picture this: You’ve got the financial resources for a comfortable life, but your health doesn’t allow you to enjoy it. Or perhaps your mind is weighed down with boredom or stress. To unlock a truly fulfilling retirement, it’s essential to integrate various elements of wellness.

In this article, we will guide you through five carefully chosen wellness strategies that can enrich your life after work. Each of these approaches serves a crucial role, targeting different yet interconnected aspects of your well-being. Whether you’re about to retire or have already entered this new phase, these strategies can offer you a roadmap to a healthier, happier life.

1.   Physical Exercise

Retirement often brings a decline in daily physical activity. Without a commute, office work, or other job-related tasks, the body enters a more sedentary phase. This idleness not only affects your physical health but also dampens your mental and emotional well-being. 

A Spectrum of Choices

The beauty of exercise lies in its diversity: from brisk walking and swimming to yoga and weightlifting, choices abound. Each form of exercise serves a different purpose. Cardiovascular workouts like jogging improve heart health. Strength training maintains muscle mass. Flexibility exercises like yoga aid joint health. The key is to find a blend that suits you.

Consult Before You Leap

Before diving headlong into any fitness regimen, consult your healthcare provider, especially if you have existing medical conditions. Tailored advice can ensure your exercise plan aligns with your health needs, preventing avoidable injuries or complications.

Routine Matters

Consistency outweighs intensity. Instead of embarking on an exhaustive one-week gym spree, aim for regular, moderate exercise. Experts recommend at least 150 minutes of moderate-intensity aerobic exercise per week, along with muscle-strengthening activities on two or more days a week.

The Compound Benefits

Regular exercise does more than keep you physically fit; it enhances cognitive function, elevates mood, and even betters your sleep quality. So, you’re not just working on your body, but you’re also nurturing your mind and soul. It’s a cascade of benefits that shouldn’t be ignored.

2.   Mental Stimulation

Shifting our lens from the corporeal to the cerebral, the age-old adage rings truer than ever in retirement: “A sound mind in a sound body.” While your muscles require workouts to stay toned, your brain craves its own kind of exercise to maintain peak performance.

Feed Your Brain

What’s the cerebral equivalent of a gym? It can range from crossword puzzles and Sudoku to more elaborate undertakings like learning a new language or a musical instrument. These activities stimulate your brain, enhancing cognitive function and preventing mental rust.

Neuroplasticity: The Flexible Brain

Your brain has the capacity for neuroplasticity and can rewire and adapt. You can teach an old brain new tricks through cognitive training! Engaging in activities that challenge your cognitive faculties promotes this neural flexibility.

Digital Aides

In this digital era, numerous apps and online platforms specialize in cognitive exercises. Platforms like Lumosity or Duolingo can be convenient tools for daily mental workouts. But remember, moderation is key; excessive screen time can be counterproductive.

Social Stimulation

Thinking of things to do when you retire? Let’s not overlook the mental benefits of social engagement. Book clubs, discussion groups, or even strategic games like chess or bridge can serve dual purposes: they are intellectually stimulating and provide a social outlet.

Balance is Crucial

While it’s vital to keep the brain engaged, it’s equally important to allow moments for relaxation and reflection. A balanced mental diet that includes both stimulation and downtime enhances overall well-being.

3.   Financial Security and Healthcare

Retirement offers the freedom to explore new avenues, but it also comes with the challenge of managing your finances in a way that supports your newfound lifestyle. From long-term care to unexpected medical bills, the expenses can pile up. Financial security isn’t just about how much you have saved; it’s about how well you manage what you have.

Budget Wisely, Live Wisely

Creating a realistic budget is a non-negotiable first step. It should be expansive enough to include leisure activities that bring you joy, yet prudent enough to account for unforeseen expenses, especially healthcare costs.

Healthcare: A Priority Expense

Speaking of healthcare, this is often a significant budget item for retirees. From regular check-ups to unexpected illnesses, having a financial cushion for health-related expenses is crucial. It’s not merely about setting aside funds, but also understanding how to make the most of them. For instance, getting your Medicare coverage explained can help you make informed choices that align with your healthcare needs.

Beyond Savings: Investments

To bolster your financial health, consider low-risk investments that can provide a steady income stream. A balanced portfolio can work as a financial safety net, giving you the peace of mind to explore retirement to its fullest.

The Emergency Fund

An often overlooked yet crucial element is the emergency fund. It should cover at least six months’ worth of expenses. This reserve becomes even more critical in retirement, given the potential for unexpected health issues or other emergencies.

Insurance: The Safety Net

Apart from Medicare, additional health insurance can cover gaps that public health services may not address. It’s also wise to review your life and property insurance at this stage. Updating these can provide an added layer of financial security.

4.   Emotional Well-being

Photo by Kampus Production from Pexels

Retirement, for all its promise of leisure and liberty, can sometimes harbor an emotional minefield. The shift from a structured work life to a less defined daily routine can incite feelings of loneliness, boredom, or even depression.

Social Circles: The Emotional Net

One antidote to emotional pitfalls lies in sustaining a robust social life. Connections matter. Whether it’s a group of close-knit family members, long-standing friends, or new acquaintances made in a community group, these relationships can serve as emotional pillars.

Engage in What Brings Joy

There’s no rule that hobbies and passions should wane in retirement. Whether it’s painting, gardening, or simply reading, engaging in activities that bring joy can be an emotional balm. They not only fill your time but also provide a sense of accomplishment.

Let’s Talk: Emotional Health Services

The stigma surrounding mental health services has considerably lessened over the years, making it easier to seek professional guidance. Therapy or counseling isn’t just for crises; they’re beneficial platforms for anyone seeking emotional balance. Monthly or bi-monthly sessions can offer valuable insights into your emotional state.

Mindfulness and Meditation

These practices have crossed from Eastern philosophy into mainstream wellness for a reason: they work. Mindfulness exercises, even as simple as deep breathing, can help manage stress, anxiety, and even depressive symptoms.

5.   Purpose and Personal Growth

Retirement isn’t the end of the road; it’s a diverging path offering multiple routes to personal development and growth. The question isn’t what you’re retiring from, but what you’re retiring to. The concept of ‘purpose’ takes center stage here.

Finding Your ‘Why’

What energizes you? What gives your life meaning? The answers might not come immediately, but that’s alright. Consider this a period of exploration. Whether it’s gardening, mentoring, or writing that novel you’ve always talked about, the possibilities are virtually endless.

The Gift of Time: Use It Wisely

The newly acquired time can either be a gift or a challenge. Setting objectives, even small ones, can provide a roadmap. Goals give you something to work toward, making your days more structured and meaningful.

Never Stop Learning

Remember those cooking classes you never had time for or the history books that gathered dust on your shelves? Now’s the time to dive in. Lifelong learning isn’t just a phrase; it’s a lifestyle choice that adds layers of complexity to your life, making each day a treasure trove of potential discoveries.

Make Room for Change

Flexibility is your ally. Your interests and passions will likely evolve. And that’s okay! Adaptability allows you to change course when a particular path no longer serves you, ensuring your retirement remains dynamic and fulfilling.

Share Your Wisdom

You have a lifetime of experience; why not share it? Whether formally through teaching or informally through storytelling, imparting your wisdom can be incredibly gratifying. Plus, it’s a two-way street—you learn through the act of teaching.

Wrapping Up 

Retirement is more than just an extended vacation—it’s a new chapter that comes with its own challenges and rewards. The strategies discussed here aim to guide you through this life phase, focusing on holistic well-being. While the road ahead may have twists and turns, each day offers a fresh opportunity for happiness and growth. Your next steps are yours to decide, so make them count.

The post Top 5 Wellness strategies for a Happy Retirement appeared first on CareAvailability.

1. What is Medicare Advantage Plan?

The Centers for Medicare and Medicaid Services (CMS) oversees Medicare. The CMS contracts with private companies that create Medicare Advantage plans that are offered to eligible seniors. A Medicare recipient can then enroll in regular Medicare or a Medicare Advantage plan. The Medicare Advantage plan aims to keep you healthy, provide quality care, and improve wellness. An original Medicare plan would be considered a Fee For Service plan. 

2. What are some of the key differences in health benefits that are offered through Medicare Advantage plans?

Teeth, Eyes, and Ears! A Medicare Advantage plan can include additional benefits that regular Medicare does not provide. For example, many Medicare Advantage plans provide dental, vision, and hearing (audiology) benefits; otherwise, the senior beneficiary would have to pay out of pocket. Additionally, most Medicare Advantage plans offer drug coverage which can be very expensive if one pays out of pocket. Some additional benefits that some plans offer are over-the-counter benefits, meals, remote access, acupuncture, and transportation. Some of these benefits are also helpful to the home caregiver who is caregiving for a loved one. Each year the benefits change, for example, a couple of Medicare Advantage plans increased their levels of in-home support for 2023.

3. What are the costs of regular Medicare versus Medicare Advantage Plans?

Although costs vary, generally speaking, the premiums are lower or even $0 with the Medicare Advantage Plans. Copays can be lower as well. When looking at costs, it’s good to consider to include the savings from the additional benefits received from the Medicare Advantage Plans. Each firm can provide several different plans you can choose from which differ in cost. For example, UnitedHealthcare is one of the largest firms(companies) offering Medical Advantage plans, but within UnitedHealthcare, there are several plans to choose from. In 2023, there were a total of 9 firms offering a total of 43 plans. 

4.  What is the key difference between Medicare Advantage plans and traditional Medicare?

The most significant difference you’ll notice with the Medicare Advantage plan is the network of providers and doctors you can see. Each Medicare Advantage plan has a network of doctors and providers you can choose from, and the doctor or provider you currently see may not be a part of that network. 

For example, you’ve been seeing Dr. Jackson for several years and continued seeing Dr. Jackson after you turned 65; now you’re 70 and enrolled in a Medicare Advantage. Dr. Jackson is not in the network of the Medicare Advantage plan, and you have other Dr.s and providers to choose from. The Medicare Advantage plans you choose will give you a list of all the providers you can choose from. 

Note: Emergency visits and urgent care visits are typically covered nationwide. 

5. Are the Medicare Advantage plans a new thing? 

Medicare Advantage plans have been around for over fifteen years. Recently, its popularity has significantly grown due to the lower costs of premiums and the services it provides the Medicare Advantage plan members. Many Medicare Advantage plans include additional benefits that regular fee-for-service/traditional Medicare doesn’t offer. Medicare Advantage plans were created to drive innovation and plan design. 

In Jan 2023, the number of individuals enrolled in Medicare Advantage plans surpassed 30 million people, and the number of traditional Medicare was just under 30 million people. Therefore, more individuals are enrolled in Medicare Advantage plans than the regular fee-for-service. Additionally, Medicare Advantage plans understand the importance of staying healthy at home, and offer a variety of services that traditional Medicare doesn’t provide, some plans, for example, provide Part B rebates, telemonitoring, transportation, and bathroom safety. 

6.   Does the traditional Medicare or Medicare Advantage plan leave you exposed to additional out-of-pocket expenditures?

Generally speaking, the Medicare Advantage program can offer not only more security but also minimize the additional out-of-pocket risk associated with care requirements that can be expensive. Please read all benefits carefully of the Medicare Advantage plans, but the goal of the Medicare Advantage plan is to put a cap on medical expenses. Medicare Advantage plans continue to adapt and evolve to meet our current population’s needs and care requirements. In a traditional Medicare Fee For Service model, you may be exposed to risk of for a lot of expenses you did not account for. Therefore, out of pocket expenditures are typically higher in traditional Medicare Programs.

7.  I have specific needs or am a part of a particular population. Would a Medicare Advantage plan be right for me?

Medicare Advantage plans to continue evolving to meet specific populations’ needs, address particular diseases, and look at the population as a whole from a health equity standpoint. The nice thing about Medicare Advantage plans is you can choose which plan to enroll in. Various firms and companies have contracted with the CMS and developed Medicare Advantage plans, and one of them may be right for you or the person you care for. The CMS recognizes that Medicare Advantage plans are a critical par of advancing health equity. 

8. What if I sign up for a Medicare Advantage plan and I don’t like it? Can I switch back to regular Medicare?  

Yes. You can switch between Medicare Fee For Service and Medicare Advantage plan typically during the Medicare Annual Enrollment Period and the Medicare Special Enrollment Period. Therefore, your “risk” of trying out a Medicare Advantage plan is ultimately one year. There are some plans where you can switch plans more often, and please ask the author for further detail. 

9.  I am a home caregiver taking care of a loved one. What benefits can a Medicare Advantage plan offer me to help care for my loved one?

With the innovation and the plan design of many of these Medicare Advantage plans, I’d encourage you to do your research and find a plan that is designed not only for the person you’re caring for but also for you as a caregiver. Some Medicare Advantage plans realize how vital home caregiving is and how resource-depleting home caregiving can be. The goal of the Medicare Advantage plan is to keep the individual healthy, and often, helping with home caregiving does just that. Therefore, look at the benefits that some of the plans offer such as transportation, bathroom safety, over the counter help, remote access and meals. 

10. I’m considering moving into an assisted living community. Is there a Medicare Advantage plan this is right for me?

Several senior living operators are realizing the importance of clinical outcomes and ensuring you live well and are healthy for a long time. Additionally, some senior living operators are partnering and collaborating with Medicare Advantage plans to keep the resident healthier for longer. When searching for a senior housing provider, ask what type of clinical outcomes they focus on,  what providers and therapy they offer, and what clinical programs do they have in place to reduce the risk of complications or incidences that can be costly. Ultimately, staying healthy means providing upstream prevention programs to minimize into downstream complications. 

Final Thought: Ultimately, the goal of a Medicare Advantage plan is to provide Great Access to Quality Care at an Affordable Cost. 

The post Top 10 Medicare Advantage Plan Questions for Senior Care, Cost, and Housing- Explained appeared first on CareAvailability.

How do I enroll in Medicare?

You can call the Social Security Administration at 1-800-772-1213 to enroll in Medicare or to ask questions about whether you are eligible. You can also visit their website at www.socialsecurity.gov.

The Medicare.gov website also has a tool to help you determine if you are eligible for Medicare and when you can enroll. It is called the Medicare Eligibility Tool.

If you already receive benefits from Social Security:

If you already get benefits from Social Security or the Railroad Retirement Board, you are automatically entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the first day of the month you turn age 65. You will not need to do anything to enroll. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If your 65th birthday is February 20, 2010, your Medicare effective date would be February 1, 2010. (Note: if your birthday is on the 1st day of any month, Medicare Part A and Part B will be effective the 1st day of the prior month. For example, if your 65th birthday is February 1, 2010, your Medicare effective date would be January 1, 2010.)

If you are not getting Social Security benefits:

If you are not getting Social Security benefits, you can apply for retirement benefits online. If you would like to file for Medicare only, you can apply by calling 1-800-772-1213.

If you are under age 65 and disabled:

If you are under age 65 and disabled, and have been entitled to disability benefits under Social Security or the Railroad Retirement Board for 24 months, you will be automatically entitled to Medicare Part A and Part B beginning the 25th month of disability benefit entitlement. You will not need to do anything to enroll in Medicare. Your Medicare card will be mailed to you about 3 months before your Medicare entitlement date. (Note: If you are under age 65 and have Lou Gehrig’s disease (ALS), you get your Medicare benefits the first month you get disability benefits from Social Security or the Railroad Retirement Board.) For more information about enrollment, call the Social Security Administration at 1-800-772-1213 or visit the Social Security website. See also Social Security’s Medicare FAQs.

For more information, see Medicare.gov

Medicare Benefits are broken into Medicare part A,B, C and D that help cover specific services

Medicare Part A (Hospital Insurance) – 

Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people don’t pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.

Medicare Part B (Medical Insurance) – 

Part B helps cover doctors’ services and outpatient care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Most people pay a monthly premium for Part B.

Medicare Part D (Prescription Drug Coverage) – 

Medicare Part D is also known as Medicare Prescription Drug plan. Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage. Most people pay a monthly premium for Part D.

Medicare Advantage Plan-

Medicare Advantage Plan is offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. In most cases, Medicare Advantage Plans also offer Medicare prescription drug coverage. A Medicare Advantage Plan can be an HMO, PPO, or a Private Fee for- Service Plan. May sometimes be referred to as Medicare Part C.

Medicare Certified-

Medicare Certified facilities can offer services to individuals receiving Medicare benefits in exchange for reimbursement from Medicare.

Medicare Advantage Plan – Medicare Part C

Medicare Advantage Plan is offered by a private company that contracts with Medicare to provide you with all of your Medicare Part A and Part B benefits. In most cases, Medicare Advantage Plans also offer Medicare prescription drug coverage. A Medicare Advantage Plan can be an HMO, PPO, or a Private Fee for Service Plan. 

**Formerly known as Medicare Part C or “Medicare+Choice– These are Medicare-approved private insurance plans, including HMOs, PPOs, private fee-for-service plans, and medical saving accounts. These plans may or may not include prescription drug coverage. The M+C program in Part C of Medicare was renamed the Medicare Advantage (MA) Program under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which was enacted in December 2003. The MMA updated and improved the choice of plans for beneficiaries under Part C, and changed the way benefits are established and payments are made. Under the MMA, beneficiaries may choose from additional plan options, including regional PPO (RPPO) plans and special needs plans (SNPs). 

Medigap (Medicare Supplement Health Insurance)

Medicare Supplemental Insurance is private insurance (often called Medigap) that pays Medicare’s deductibles and co-insurances and may cover services not covered by Medicare.

A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company.

If you’re a person with Medicare or help a person with Medicare, visit Medicare.gov to find more information about Medicare. 

What Is Medicaid?

Medicaid is an general assistance program. Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.

Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required.

Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Each state Medicaid agency has full responsibility for all aspects of the administration and operation of the Medicaid program in their state, including determining eligibility for and enrollment into their program.

To see if you qualify for your state’s Medicaid (or Children’s Health Insurance) program, see: https://www.healthcare.gov/medicaid-chip/eligibility/

Visit https://www.medicaid.gov/about-us/beneficiary-resources/index.html#statemenu to find state-specific information on:

• How to apply for Medicaid
• How to see if you are eligible for Medicaid
• How to contact your state
• How to check on your Medicaid
• How to get a new Medicaid card

Medicaid Eligibility Requirements

Medicaid eligibility criteria vary from state to state. Many states have expanded their Medicaid programs to cover more low-income adults. If you are unsure if you might qualify for Medicaid, you should apply.

You might be eligible depending on your household income, family size, age, disability, and other factors. You must be a United States (U.S.) citizen, a U.S. national, or have a satisfactory immigration status to be eligible for full benefits.

Visit HealthCare.gov to take a quick screening to help you determine your eligibility for Medicaid or other health insurance options. Please contact your state for all state-related Medicaid questions.

When to contact your State Medicaid Agency

In order to assist you in getting a timely response, please contact your State Medicaid Agency (click your state link above) for any questions on the following:

• Medicaid Eligibility
• Coverage and Services
• Liens and Third Party Liability (other insurance)
• Provider Enrollment
• Medicaid Claims
• Lost Medicaid Card/ Replacement
• Finding a Medicaid/CHIP Provider
• Status of a Medicaid/CHIP Application

If you need assistance in any of the areas noted, you will need to contact the agency for Medicaid/CHIP in your state of residence or the state you have questions about in order to receive assistance. Please contact your state for all state-related Medicaid questions.

Medicaid Contact Information by State and Territory

Alabama ★ Alabama Medicaid Alabama State Contacts Eligibility Enrollment General Questions: 334-242-5000

Alaska ★ Alaska Medicaid Alaska State Contacts Eligibility Enrollment Medicaid coverage questions, fair hearings, Care Management Program, general questions: 800-780-9972

American Samoa Eligibility Enrollment Home Page Department of Public Health: 684- 633-7676 / 684-633-4606

Arizona ★ Arizona Health Care Cost Containment System (AHCCCS) Arizona State Contacts Eligibility Enrollment In-State Toll Free: 800-654-8713 (Outside Maricopa County) Out-of-State Toll Free: 800-523-0231

Arkansas ★ Arkansas Medicaid Arkansas State Contacts Eligibility Enrollment Coverage, Bills, Denial letters, Other services: 800-482-5431 Lost/non-receipt of Medicaid cards, Eligibility: Toll-Free: 800-482-8988, Local: 501-682-8233

California ★ Department of Health Care Services California State Contacts Eligibility Enrollment Call the Medi-Cal Helpline: 800-541-5555, or 916-636-1980

Colorado ★ Health First Colorado Colorado State Contacts Eligibility Enrollment Health First Colorado Member Contact Center: 800-221-3943

Connecticut ★ Connecticut Medicaid Connecticut State Contacts  Eligibility Enrollment Automated Client Information Line: 855-626-6632

Delaware ★ Delaware Medicaid & Medical Assistance Delaware State Contacts  Eligibility Enrollment Customer Relations: 866-843-7212 Provider Relations: 800-999-3371 Health Benefits Manager: 800-996-9969

District of Columbia ★ DC Medicaid District of Columbia State Contacts  Eligibility Enrollment Customer Service: 202-727-5355

Florida ★ Florida Agency for Health Care Administration Florida State Contacts  Eligibility Enrollment Toll-free: 888-419-3456 Florida Relay Service (TDD number): 800-955-8771

Georgia ★ Georgia Medicaid Georgia State Contacts  Eligibility Enrollment Primary: 866-211-0950

Guam Eligibility Enrollment Home Page Department of Public Health and Social Services / Division of Public Welfare 735-7519, 735-3540, 735-7256 or 735-7375 (Central Office – Mangilao) 635-7429 or 635-7488 (Northern Office – Dededo) 828-7542 or 828-8524 (Southern Office – Inarajan)

Hawaii ★ Hawaii Med-QUEST Division Hawaii State Contacts  Eligibility Enrollment  808-692-8099

Idaho ★ Idaho Department of Health & Welfare Idaho State Contacts  Eligibility Enrollment  877-456-1233

Illinois ★ Illinois Department of Healthcare and Family Services Illinois State Contacts  Eligibility Enrollment  800-843-6154 (TTY) 800-447-6404

Indiana ★ Indiana Family and Social Services Administration Indiana State Contacts  Eligibility Enrollment  800-457-8283

Iowa ★ Iowa Department of Human Services Iowa State Contacts  Eligibility Enrollment  800-338-8366 (Toll Free)  515-256-4606 (Des Moines Area)

Kansas ★ Kansas Department for Children and Families Kansas State Contacts  Eligibility Enrollment  833-765-2003

Kentucky ★ Kentucky Cabinet for Health and Family Services Kentucky State Contacts Eligibility Enrollment Kynect: 855-306-8959

Louisiana ★ Healthy Louisiana Louisiana State Contacts  Eligibility Enrollment  855-229-6848 (TTY) 855-526-3346

Maine ★ Maine Department of Health and Human Services Maine State Contacts  Eligibility Enrollment MaineCare: 800-977-6740

Maryland ★ Maryland Department of Health Maryland State Contacts  Eligibility Enrollment  855-642-8572 TTY: 855-642-8573

Massachusetts ★ Massachusetts Health & Social Services Massachusetts State Contacts  Eligibility Enrollment MassHealth: 877-623-6765 TTY: 877-623-7773

Michigan ★ Michigan Department of Health & Human Services Michigan State Contacts  Eligibility Enrollment Michigan ENROLLS: 800-975-7630 (TTY) 888-263-5897

Minnesota ★ Minnesota Department of Human Services Minnesota State Contacts  Eligibility Enrollment  800-366-5411

Mississippi ★ Mississippi Division of Medicaid Mississippi State Contacts  Eligibility Enrollment  800-421-2408

Missouri ★ Missouri Department of Social Services Missouri State Contacts  Eligibility Enrollment  573-751-3425

Montana ★ Montana Department of Public Health and Human Services Montana State Contacts  Eligibility Enrollment Member Help Line: 800-362-8312

Nebraska ★ Nebraska Department of Health and Human Services Nebraska State Contacts Eligibility Enrollment  855-632-7633

Nevada ★ Nevada Department of Health and Human Services Nevada State Contacts  Eligibility Enrollment  877-638-3472

New Hampshire ★ New Hampshire Department of Health and Human Services New Hampshire State Contacts  Eligibility Enrollment  888-901-4999

New Jersey ★ New Jersey Department of Human Services New Jersey State Contacts  Eligibility Enrollment  800-356-1561

New Mexico ★ New Mexico Human Services Department New Mexico State Contacts  Eligibility Enrollment  888-997-2583

New York ★ New York State Department of Health New York State Contacts  Eligibility Enrollment New York Medicaid Choice: 800–505–5678

North Carolina ★ North Carolina Medicaid North Carolina State Contacts  Eligibility Enrollment  888-245-0179

North Dakota ★ North Dakota Department of Human Services North Dakota State Contacts  Eligibility Enrollment  800-318-2596

Northern Mariana Islands Eligibility Enrollment Home Page  670-664-4880

Ohio ★ Ohio Department of Medicaid Ohio State Contacts  Eligibility Enrollment  800-324-8680

Oklahoma ★ Oklahoma Health Care Authority Oklahoma State Contacts  Eligibility Enrollment  888-365-3742

Oregon ★ OregonHealthCare.gov Oregon State Contacts  Eligibility Enrollment  800-699-9075

Pennsylvania ★ Pennsylvania Department of Human Services Pennsylvania State Contacts  Eligibility Enrollment  844-626-6813  TTY: 844-349-8916

Puerto Rico Eligibility Enrollment Home Page  787-765-2929

Rhode Island ★ Rhode Island Executive Office of Health and Human Services Rhode Island State Contacts  Eligibility Enrollment  HealthSource RI: 855-840-4774

South Carolina ★ South Carolina Health Connections Medicaid South Carolina State Contacts  Eligibility Enrollment  888-289-0709

South Dakota ★ South Dakota Department of Health South Dakota State Contacts  Eligibility Enrollment  800-597-1603

S. Virgin Islands Eligibility Enrollment Home Page  340-774-0930

Tennessee ★ Tennessee Department of Health Tennessee State Contacts  Eligibility Enrollment  855-259-0701

Texas ★ Texas Health and Human Services Texas State Contacts  Eligibility Enrollment  800-335-8957

Utah ★ Utah Department of Health Medicaid Utah State Contacts  Eligibility Enrollment  801-538-6155

US Virgin Islands ★ Virgin Islands Department of Human Services USVI State Contacts  Eligibility Enrollment  340-774-0930

Vermont ★ Department of Vermont Health Access Vermont State Contacts  Eligibility Enrollment  800-250-8427

Virginia ★ Virginia Department of Medical Assistance Services Virginia State Contacts  Eligibility Enrollment  855-242-8282

Washington ★ Washington State Health Care Authority Washington State Contacts  Eligibility Enrollment  800-200-1004

West Virginia ★ West Virginia Department of Health and Human Resources West Virginia State Contacts  Eligibility Enrollment  877-716-1212

Wisconsin ★ Wisconsin Department of Health Services Wisconsin State Contacts  Eligibility Enrollment  800-362-3002

Wyoming ★ Wyoming Department of Health Wyoming State Contacts  Eligibility Enrollment  855-294-2127

The post The Difference Between Medicare and Medicaid appeared first on CareAvailability.

What is a Medicare Advantage Plan?

Medicare Advantage plans (also known as Medicare Part C) are offered by private health insurance providers that have been approved by Medicare. These companies receive government funding to cover your Medicare benefits and keep you healthy.

With traditional Medicare, the federal government pays your providers directly.

What do Medicare Advantage Plans Cover?

If you join a Medicare Advantage plan, that plan will provide all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. But that’s not all.

Medicare Advantage plans cover many things that traditional Medicare doesn’t cover. These extras can include vision, hearing and dental benefits, as well as wellness programs. Many Medicare Advantage plans give seniors access to affordable prescription drug plans, often at no additional cost.

And all Medicare Advantage plans limit the amount you must spend out of pocket for deductibles, copayments, and coinsurance each year for covered Medicare services.

Who is eligible to purchase a Medicare Advantage plan?

You must already be covered by Medicare Parts A and B to join a Medicare Advantage plan. You also must live in the Medicare Advantage plan’s service area.

The Medicare Annual Election Period (AEP) which lasts from mid-October until early December, is when you can initially sign up, switch, or leave your Medicare Advantage plan.  You can also switch Medicare Advantage plans or from Medicare Advantage to traditional Medicare from January 1 until March 31 if you change your mind.

Are all Medicare Advantage plans the same?

There are different options to meet different health and financial needs. Just as with individual or employer-sponsored insurance, several types of Medicare Advantage policies are available. The most common types of Medicare Advantage plans are:

• Health Maintenance Organizations (HMOs)
• Preferred Provider Organizations (PPOs)

You also may see Medicare Advantage plans called Private Fee-for-Service (PFFS) and Medical Savings Account (MSA) plans.

If you are eligible for Medicaid, have a chronic condition, or live in a nursing home, you may also be able to sign up for another type of Medicare Advantage tailored to your specific needs called a Special Needs Plan (SNP).

While many Medicare Advantage plans are available at no additional cost, some charge premiums or have costs for optional services. Which providers are in the plan’s network also varies. That means it’s important to comparison-shop carefully, just as you do for other important expenditures. 

You’ll want to understand specific costs and benefits before you join. The online tool Medicare Plan Finder at Medicare.gov can help you can find and compare policies in your area.

The post Get the Scoop on Medicare Advantage appeared first on CareAvailability.

Plan Ahead

Healthcare crisis management is one of the biggest reasons people seek out an elder law attorney.  But, the best time to find an elder law attorney is before a crisis. Advance planning avoids many problems, and helps achieve peace of mind for yourself and your loved ones.

The post Talking About Aging, Planning Ahead & Finances appeared first on CareAvailability.

Nursing Homes in Oregon: A Comprehensive Guide

Looking for and selecting a nursing home in Oregon that checks off all the right boxes can be very intimidating for even the most experienced family members. You’ve probably got loads of questions from the costs to the services provided and everything in between.

Every state has different requirements, costs, and coverages, that’s why CareAvailability.com created our full guide to finding and understanding skilled nursing facilities near you in Oregon.

What Is a Nursing Home?

A skilled nursing facility, also known as a nursing home, is classified by Oregon as a residential care facility serving seniors, people with disabilities, and temporary residents who are getting care during a rehabilitation period.

It’s important to know which of those categories you or your loved one fall under since they are treated differently by health insurances including Medicare & Medicaid.

The term ‘nursing home’ is often misused for any type of facility that provides care outside of the person’s home, however, there are many care options in Oregon for people to be cared for in less restrictive settings and at more affordable prices.

Nursing homes often offer long-term care (LTC for stays over 100 days) for people unable to reside elsewhere due to high medical needs, however, it is often not paid by health insurance and requires private funds or a LTC policy.

What Services Do Nursing Homes Provide?

Skilled nursing facilities are one of Oregon’s highest levels of care outside of a hospital with capabilities to handle most injuries and illnesses that do not require emergency services but need to be cared for in a medical setting.

While most people utilize these facilities to recover from a serious injury or illness after a qualified medical stay at a hospital, some individuals find themselves needing the level of medical expertise for long-term care due to a chronic illness.

If you journeyed across Oregon to tour all of the state’s nursing homes, you’d find that no two facilities are the same. Some are set up to remind their residents of a home-like environment while others resemble more of a hospital’s layout. However, almost every option will be able to provide similar medical services.

• 24/7 supervision from trained staff. (LPNs, Certified Medical Assistants, Certified Nursing Assistants and Registered Nurses)
• Medical services provided on-site. (Wound care, IV care, needle care, etc.)
• Additional therapy offered from outside companies. (Speech therapy, physical or occupational therapy)
• Assistance with Activities of Daily Living such as personal hygiene, dressing, bathing, transferring and mobility. *Special note: If your loved-one has cognitive needs like dementia or Alzheimer's, you’ll want to look at Memory Care.
• Other activities of daily living include laundry, cooking, housekeeping, etc.
• Access to a life enrichment program for residents.
• Full nutritional program guided by your doctor or dietitian.

How Much Do Nursing Homes Cost In Oregon?

The cost of skilled nursing home care in Oregon can vary greatly depending on the type of care you receive as well as the location, however the average cost of nursing home care in Oregon averages $270 per night.

Health insurances, including Medicare, will often cover a significant part of the cost of nursing home care if the individual qualifies for rehabilitation after an incident or illness, however there are normally time limits associated with the benefit, such as Medicare’s 100-day rule.

It’s also important to note that if your loved-one or yourself need long-term care at a skilled nursing home, it will not be covered by health insurance but requires the individual to have a separate long-term care insurance policy to help cover the costs.

Does Oregon Medicaid pay for nursing homes?

If a person qualifies for Medicaid long-term care in Oregon, with Senior & Disability Services (APD) they are eligible to stay in a skilled nursing home covered by the State’s benefit.

• It's very important to note that long-term care benefits in Oregon are not normally a completely free benefit and require a thorough assessment from a Medicaid case manager using the State's current financial calculations to see how much of your own income you'll need to contribute towards that care.

Also, it’s important to understand that Oregon Medicaid for long-term care is different from Medicaid for the general population. 

Why is nursing home care so expensive?

The costs associated with skilled nursing can induce panic with the sticker shock effect, but it’s often not discussed as to why it costs $6000+ dollars per month.

The truth is that care, no matter the setting, but especially in nursing homes, requires robust staffing 24/7. The costs of hiring and keeping exceptional caregivers and medically trained staff such as nurses, is very costly. Add in the price of running a medical facility all day and night, pricey medical supplies and needed administrative staff, and you’ve got quite the overhead.

Although the cost can seem overwhelming, it’s smart to look into financial planning for end stage retirement and expected care needs.

How do I find a good nursing home?

Finding a good nursing home facility requires due diligence from the person responsible for finding the best fit facility for their loved one.

1 Start your search online to get all your options and view live availability using our convenient care availability search. 

2 Print off or share the results of your search to map out what places are optimal for your loved-one. Is the facility close enough to encourage family members to visit frequently?

3 Do some smart online research by looking at what others have said about the community. However, don’t just take every review as representative of the facility since the nature of caring for someone can be stressful and people often lash out online for things no one can control.

4 Then, do some good old fashioned in-person tours with all your options. We advise you to resist the temptation to select the first one you visit or give into sales pressure from the facility.

What should I look for when choosing a nursing home?

To find a good nursing home, or any care for that matter, you’ll need to put in a little extra effort during your visit. Here are some tips on things to look out for:

• Look to assure that the facility is clean and well maintained. You can tell a lot of the operations by what is clean and maintained. Are there a lot of lights burnt out? Are knobs loose or damaged?
• Does the facility have the right atmosphere for your needs?
• Ask about the nutritional program, visit while others are eating to get an idea of what is being served.
• Also, ask about the activities program. Activities are critical for our quality of life and play an important role in care.
• Spend a lot of time asking about pricing and add-ons, don’t skimp here.
• Lastly, and this is very important, get to know the leadership in the building. It’s a fact that caregiving positions see higher than average churn, so if you want to get a good feel for how a place runs, talk to the executive director, the head nurse, lead activities director and even the chef. If you feel good around these people, it’s a good sign you can trust them with care.

What questions should I ask when choosing a nursing home?

If you’re touring a nursing facility there are several people that you may be talking to, but no matter who it is, make sure that you have the opportunity to visit with multiple people in the building with different job titles.

Here is a short list of common questions to ask when choosing a nursing home:

• What is your average & minimum staffing ratios? - Everybody wants to believe that the facility they choose will have ample staffing ratios, way above minimum standards, but that’s just not reality.
• How often will your loved-one be attended to by a skilled nurse or medical aid? What medical services do you offer and what services can be brought in from outside agencies?
• What are the community's policies regarding fall prevention and bed sore prevention? If your loved-one has early signs of dementia, be sure to ask about how the nursing home handles individuals with dementia behaviors.
• Are there any extra charges we could expect to see outside of the pricing information already given?
• What happens when we run out of the person’s money? (Adult children do not need to cover the cost of care, Oregon has benefits for this.)
• Can you tell me about what life enrichment programs you offer to your residents? How are medications administered?
• How is laundry handled? (Tip: laundry is done communally, so be prepared to mark your laundry clearly and boldly.)
• Bonus tip: Ask for the Uniform Disclosure Statement required by care facilities in Oregon.

Should my loved one go into a nursing home?

This is a great question to ask and deserves an informed approach to answer it. The simple answer to this question is to make sure you are talking with the right person to help you make this decision.

If you’re in a situation where a loved-one or yourself are in the hospital, be sure to seek the advice of your doctor and the discharge planners involved. Be sure to ask if there are any other options available and what the expected time frame for the nursing home stay you might expect.

If skilled nursing is recommended as a permanent long-term care solution, we would encourage you to further talk with hospital professions, local advisors, and your local Aging and Disability Resource Connection specialist. Just because someone recommends a nursing home, doesn’t mean that you might not find a better solution in an alternative setting with modifications.

What other types of care are there?

There are many types of care that are available in Oregon that aren’t skilled nursing homes. Nursing homes happen to be the highest level of care outside of a hospital’s acute care setting, so, if possible, care should be done in the least restrictive setting that can provide all your care needs.

Types of Care For Seniors In Oregon: (besides Nursing Homes)

In-Home Care – Care provided in the individual’s home dwelling from another. There are many options for hiring, including hiring someone you know or trust, hiring a professional, or hiring an in-home care agency.

Adult Foster Care – Care provided in a home style environment with a maximum capacity of 5 people. This is a great option for people looking for a more intimate style of care but also comes with less services than facilities.

Assisted Living Facility – Perhaps the most well-known, assisted living facilities provide care to individuals in a community setting, providing mostly every care need an individual has but can be limited in what can be done medically.

Memory Care Facility – A specialized residential care facility that provides care for individuals diagnosed with a form of dementia.

Adult Day Services – Growing in popularity in Oregon, adult day services offer respite care daily for set hours. This is a great option for people looking to stay in their home but still require daytime coverage for care needs. They are great for social interaction as well.

Who regulates nursing homes in Oregon?

The nursing homes in Oregon are regulated by two different state agencies with different roles.  The Department of Human Services, under their Senior & Disability Services (APD), which oversees benefits pertaining to nursing homes and the Oregon Health Licensing Agency / Nursing Home Administrators Board (OHLA/NHAB), which regulates licensing and nursing requirements.

Who can you contact for nursing facility complaints or concerns in Oregon?

If you have questions, complaints, or concerns of your nursing home, contact the Oregon Long-Term Care Ombudsman’s office. Visit their website here: https://www.oltco.org/oltco/index.html

Looking to find a nursing home in Oregon?

Finding a nursing home in Oregon can be a difficult process, especially for those unfamiliar with Oregon’s long-term care system. However, we make it easier for families and providers to use our real-time care availability search. Search now to get current information on all your available options, easily reach out for facility tours and more so that you can find the best nursing home fit for your needs.

The post A Full Guide To Nursing Homes In Oregon appeared first on CareAvailability.