Healthcare

How Veterans Can Qualify for a VA Pension Without Being Disabled

Many veterans may miss out on US Military benefits as they are always changing; it is important to understand how to navigate this life-changing aid option. Many wartime veterans receive a disability pension due to injury. But did you know that wartime veterans age 65 or more may qualify for a VA Pension without being disabled? The Veteran’s Administration qualifications for this type of VA Pension include:

  • Your military service discharge is deemed anything other than dishonorable conditions,
  • Your service was 90 or more active duty days with at minimum one day of service during a period of wartime.
  • You are age 65 years or older,
  • Your countable family income is below a threshold set every year by law.

2020 Family Income Limits (Effective December 1, 2019)

If you are a…Your yearly income must be less than…*
Veteran with no dependents$13,752*
Veteran with a spouse or a child$18,008**
Housebound veteran with no dependents$16,805
Housebound veteran with one dependent$21,063
Veteran who needs aid and attendance and has no dependents$22,939
Veteran who needs aid and attendance (A/A) and has one dependent$27,195
Two veterans married to each other$18,008
Add for each additional child to any category above$2,351
*Some income is not counted toward the yearly limit (for example, welfare benefits, some wages earned by dependent children, and Supplemental Security Income. It is also important to note that your medical-related expenses are considered when determining your yearly family income. *To be deducted, medical expenses must exceed $687 ** To be deducted, medical expenses must exceed $900

The financial information chart above, published by military.com, is commensurate with the numbers posted on the Veteran’s Administration website.  Be aware; there is a look-back period that will determine if you have transferred assets in the three years previous to filing your claim. There would be a penalty period rate of $2,266 if you did move assets for less than fair market value during this period.

The VA will pay a qualified veteran the difference between personal countable family income and the yearly income limit category into which they fall. Payments are made in 12 equal installments per month and rounded down to the nearest dollar. As an example, a single veteran with a $5,000 annual income qualifies for an annual limit of $13,752. Subtracting that veteran’s income from the income limit yields an annual pension rate of $8,752, which translates into a VA monthly pension check of $729.33 or $729.00 rounded down to the nearest dollar value.

The VA website recognizes the following wartime periods that determine if your service was during an eligible wartime period:

  • World War II (December 7, 1941, to December 31, 1946)
  • Korean conflict (June 27, 1950, to January 31, 1955)
  • Vietnam War era (February 28, 1961, to May 7, 1975, for Veterans who served in the Republic of Vietnam during that period. August 5, 1964, to May 7, 1975, for Veterans who served outside the Republic of Vietnam.)
  • Gulf War (August 2, 1990, through a future date to be set by law or presidential proclamation)

In addition to VA pension, wartime Veterans may also qualify for an additional allowance called Aid and Attendance. To qualify medically for VA Aid and Attendance, one of the following must be true:

  • Another person is required for you to perform daily activities such as bathing, dressing, and feeding, or
  • You spend a large portion, or all of your day in bed due to illness, or
  • Due to a loss of mental or physical abilities related to a disability you are a patient in a nursing home, or
  • Your eyesight is severely limited (wearing glasses or contacts your eyesight is 5/200 or less in both eyes or your concentric contraction visual field is 5 degrees or less)

There are similar benefits available to surviving spouses of wartime Veterans. If you are a wartime veteran or the surviving spouse of a wartime Veteran, we can help you determine whether you could qualify for pension benefits.

While eligible veterans or surviving spouses can apply for benefits on their own through the www.va.gov  website, it is advisable to seek the advice of counsel before applying. There may be planning options available to avoid a penalty period and speed up the qualification process. If you would like to explore whether you might qualify for VA pension benefits, please contact our Reno office by calling us at (775) 853-5700.

Healthcare

How Telehealth Services are Growing Coverage on Medicare

The Centers for Medicare & Medicaid Services (CMS) recently announced, in response to the COVID-19 outbreak, an increase of access to Medicare telehealth services. This means that Medicare beneficiaries can receive more benefits from their doctors without having to travel to a healthcare facility.

The terms “telehealth” and “telemedicine” refer to the ability to exchange medical information from one site to another through electronic communication to improve a patient’s health.  With the rapid rise of COVID-19 cases, there is the urgency to expand the use of technology to help people who need routine care. Telehealth will keep vulnerable beneficiaries and those with mild symptoms in their home, but with access to the care they need by phone and video rather than requiring an office visit.

Prior to this change, Medicare would only pay for telehealth on a limited basis, and only for persons in a designated rural area. Now Medicare beneficiaries will be able to receive the following services through telehealth: common office visits, mental health counseling, and preventive health screenings. This will help keep more of the at-risk population (Medicare beneficiaries) able to visit with a doctor from home, rather than traveling to a doctor’s office or hospital which puts the beneficiary and others at risk. Telehealth visits will be treated the same as regular, in-person visits and will be paid by Medicare at the same rates.

These changes go into effect for services starting March 6, 2020, and will continue for the duration of the COVID-19 Public Health Emergency. For more information, view the fact sheet prepared by CMS.

Better access to telehealth is a big step in getting Medicare beneficiaries appropriate care in the least restrictive way If you have questions, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

Healthcare

Medicare, Medicaid, and Out Of Pocket Cost for Alzheimer’s Disease

According to the 2020 Alzheimer’s Association report entitled Alzheimer’s Disease Facts and Figures (alz.org),  many Americans who will be living with crippling dementia are contemplating the next steps for their health options. Health care and long-term care costs for individuals with Alzheimer’s Disease and Related Dementias (ADRD) are staggering as dementia is one of society’s costliest conditions.

The year 2020 sees total payments for all individuals with dementia diseases to reach an estimated 305 billion dollars. This substantial sum does not include the value of informal caregivers who are uncompensated for their efforts. Of this 305 billion dollars Medicare and Medicaid are projected to cover 67 percent of the total health care and long-term care costs of people living with dementia, which accounts for about 206 billion dollars of the total cost of care. Out of pocket expenditure projections are 22 percent of total payments or 66 billion dollars. Other payment sources such as private insurance, other managed care organizations, as well as uncompensated care account for 11 percent of total costs or 33 billion dollars.

The Centers for Medicare and Medicaid (CMS) cite that 27 percent of older Americans with Alzheimer’s or other dementias who have Medicare also have Medicaid coverage. As a comparison, the percentage of those Americans without dementia is 11 percent. The addition of Medicaid becomes a necessity for some as it covers nursing home and other long-term care services for those individuals with meager income and assets. The extensive use of CMS services, particularly Medicaid, by people with dementia translates into extremely high costs. Despite the high rate of expenditure by federal social and health services, Americans living with Alzheimer’s and other forms of dementia still incur high out-of-pocket expenses compared to beneficiaries without dementia. Much of these costs pay for Medicare, additional health insurance premiums, and associated deductibles.

Older Americans living with Alzheimer’s or other forms of dementia have twice the number of hospital stays per year than those without cognitive issues. Dementia patients with comorbidities such as coronary artery disease, COPD, stroke, or cancer, to name a few, have higher health care costs than those without coexisting serious medical conditions. In addition to more hospital stays, older Alzheimer’s sufferers require more home health care visits and skilled nursing facility stays per year than other older people without dementia.

Cost projections for Medicare, Medicaid, and out of pocket costs for Americans living with Alzheimer’s disease or other forms of dementia continue to increase. The average life span of an American with Alzheimer’s is 6 -8 years, and as the disease progresses, so do the requirements of care and support. This care and support include medical treatment, prescription medications, medical equipment, safety services, home safety modifications, personal care, adult daycare, and ultimately residence in a skilled nursing facility. Disease-modifying therapies and treatments remain elusive, and there is no cure for Alzheimer’s and other dementia diseases. ADRD imposes a tremendous financial burden on patients and their families, payers, health care delivery systems, and society.

In the absence of a cure, the Alzheimer’s Association predicts the total direct medical cost expenditures in the US for ADRD will exceed 1 trillion dollars in 2050 because of increases in elderly population projections. Health policy planners and decision-makers must gain a comprehensive understanding of the economic gravity that Alzheimer’s and other dementia diseases present to the US population. The direct and indirect total medical and social costs and accompanying solution-driven mandates must be identified to CMS, private insurance groups, facilities with dementia units, and family systems that function as non-compensated caregivers.

We help families plan for the possibility of needing long term care, and how to pay for it. If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Law, Elder Living, Healthcare

Lawmakers Discuss the Future of Healthcare

In June, Washington, D.C. political publication, The Hill hosted a Future of Healthcare Summit to address critical issues in healthcare, from the Medicare for All proposals made by Democratic presidential hopefuls to the opioid crisis. Speakers included policymakers, health officials, and industry leaders, on both sides of the aisle.

Sen. Joe Manchin (D-W.Va.), for example, took a critical stance on the idea of Medicare for All at the summit. His statements are summarized here. His concerns are practical; “We can’t even pay for Medicare for some,” he said, referring to an earlier report that Medicare will exceed its hospital insurance fund by 2026. Manchin, accordingly, prefers to fix the Affordable Care Act rather than create an entirely new system.

Another issue discussed at the summit was that of data security. As health care becomes increasingly digitized, the risk to people’s privacy rises, as evidenced by recent data breaches. Lawmakers are responding to these breaches, Sen. Mark Warner (D-Va.) by reaching out to health care groups for input on strategies to improve cybersecurity, and Sens. Amy Klobuchar (D-Minn.) and Lisa Murkowski (R-Alaska) by introducing the Protecting Personal Health Data Act. Read more about this here.

High-cost drugs are another upcoming issue in the health care world, discussed in this The Hill article. Innovative cures may merit a high price, but some companies are asking such massive sums for potentially life-saving solutions that they are inaccessible to the people who need them. Accordingly, lawmakers are trying to come up with solutions to make these drugs more affordable, such as Sen. Chuck Grassley (R-Iowa), who has considered allowing Medicaid to pay for drugs over time.

In the same vein, Rep. Tom Reed (R-NY.) called for the cost of insulin to be lowered in an op-ed in The Hill, available here; he notes that insulin prices have doubled in the last seven years, and tripled in the decade prior, that out-of-pocket insulin costs can exceed $300 a vial, and that patients are often racking up debt or skipping doses with serious health consequences. Reed is pushing for transparency from insulin manufacturers and has introduced the SPIKE Act, which would require justification for price hikes. Likewise, Rep. Buddy Carter (R-Ga.) has expressed his concern in a recent op-ed about the prices for drugs which treat cancer and is also pushing for transparency to lower costs.

Meanwhile, Reps. David Trone (D-Md.) and Donald Norcross (D-N.J.) wrote into The Hill, responding to issues of addiction raised at the conference. Trone drew attention back to the opioid crisis and its ongoing effects and described the steps being taken to combat it. Norcross called for enforcement of the 2008 requirement that insurance cover mental health and substance-use disorders to the same extent physical ailments are covered, and for continued funding and new strategies to deal with substance abuse.

Finally, Sen. Tammy Baldwin (D-Wis.) criticized the Trump administration as “sabotaging our health system” by destabilizing the health care market and creating difficulties in accessing it. She cites specific efforts the administration has made to reduce access, including supporting attempts to overturn the Affordable Care Act. Baldwin has responded by supporting the ENROLL Act to restore funding for the Navigator, which had previously been reduced by the Trump administration and by introducing the No Junk Plans Act to reel back the administration’s expansion of junk insurance plans.

From data security to drug prices, The Hill’s Future of Healthcare Summit covered a lot of ground. These issues in health care and the responses proposed to solve them continue to develop.

The Schulze Law Group can help you or a loved one create a thorough medical plan for the later years in your life. If you live in the Reno, Nevada area, and you have any questions, please give us a call at (775) 853-5700, or click here to message us through our website.