MEDICAID, MEDICARE, VA
AND SOCIAL SECURITY DISABILITY BENEFITS
By: Craig Riffel, Attorney and CPA
As the population ages, the public is having more and more questions about Medicaid, Medicare, veterans and Social Security disability benefits. They are confused about eligibility, qualifications, limitations, coverage, etc. The problem is compounded by the fact there is very little easy-to-read or easy-to-understand information readily available to the public. As a result, incorrect information about these benefits has been and continues to be disseminated by individuals, attorneys, accountants, financial advisors, social workers and many more. These myths spread like diseases and continue to infect and corrupt the decisions individuals make regarding these benefits.
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In order to make good decisions, individuals need good information. Basing decisions on incorrect information or myths can have disastrous consequences. To help inform the public and assist individuals, their advisors and other professionals about these benefits, I created Senior Resources & Benefits, L.L.C. (“SRB”). SRB’s sole mission is to educate and provide useful information about these benefits. SRB publishes its information in many written forms as well on its website.
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SRB’s educational materials and authorities dispense with many myths surrounding benefits. For example, in the Medicaid area, SRB explains on its website how Medicaid planning is completely legal and how a person: (1) does not have to do Medicaid planning either three or five years in advance, (2) with a typical trust will not qualified for Medicaid, (3) can have a substantial amount of assets (i.e. net worth from $50,000 to $3 million) and still qualify for Medicaid benefits, (4) can live at home and receive Medicaid, and (5) can reside in a private room at a nursing facility and still receive Medicaid, etc.
Medicare is a federal insurance program administered by the federal government to help pay medical expenses for persons over age 65 and some disabled persons under age 65. Medicaid is codified in Title XIX of the Social Security Act. Medicaid is a federal insurance program administered by the states designed to assist persons with long-term care expenses such as nursing home costs, in-home care costs, medical expenses and prescription medications.
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Medicare and Medicaid differ significantly. Medicare is entirely a federal program funded by the federal government while Medicaid is a joint federal-state program funded by federal and state money. Medicare is administered by the federal government and Medicaid is administered by the states. While Medicare is available to anyone 65 years of age and older or disabled and who has paid into Social Security, Medicaid is available to those individuals meeting very specific eligibility criteria.
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Medicare primarily pays for medical expenses and preventative care. It only pays up to 100 days of skilled nursing care received while the individual is receiving rehabilitation services. If the person is receiving only custodial care and not any rehabilitation services, Medicare does not pay for any skilled nursing care even if the person has all 100 days remaining. Additionally, the 100-day limit is reduced by the number of days the individual is in a hospital.
Medicaid pays for skilled nursing care in both a nursing facility and at-home regardless if the person is receiving rehabilitation services and without any limit. There is a new program in Oklahoma in which Medicaid will be paying for some care in assisted living facilities. Medicaid also pays for unreimbursed medical and prescription medication expenses.
The Veterans Administration offers a variety of benefits to veterans, their surviving spouses and dependents. One of the most popular is the Aid and Attendance pension. Basically, a veteran, surviving spouse and dependent would be entitled to the pension if: (1) the veteran did not receive a dishonorable discharge, (2) the veteran served at least 90 days of consecutive active duty, and (3) at least 1 day of the veteran’s active duty service was during a time of war. The specific dates of war are defined on SRB’s website. If the preceding three criteria are met, the amount of pension will vary from $1,056 to $1,949 per month depending upon the particular applicant and the applicant’s income. There are very few asset limitations with the Aid and Attendance benefit and no transfer of asset restrictions.
An individual may also qualify for Social Security disability benefits. To be disabled: (1) the person must not be able to perform the work in which he or she was previously engaged, (2) not be able to adjust to perform other work, and (3) the disability must be expected to last for at least 1 year or result in death. Additionally, a person must have accumulated 40 credits in most cases. Of these credits, 20 credits must be earned within the 10 years prior to the application. A credit is equal to one quarter of work resulting in a total of 4 credits being available each year. Younger workers can qualify with lower credit requirements based upon their ages.
For more information about Medicaid, Medicare, Veteran’s benefits, Social Security disability, estate planning or asset protection planning, or how to become a community partner, visit Senior Resources and Benefits, LLC (“SRB”). All legal services for SRB provided by the law firm of Mitchel, Gaston, Riffel & Riffel, P.L.L.C. with website . Any additional questions or inquiries can be directed to Jeremy Nichols at Senior Resources & Benefits, LLC at 3517 W. Owen K. Garriott, Suite Three, Enid, Oklahoma 73703, (580) 794-0042, or at his email. Senior Resources & Benefits, LLC has offices in Alva, Enid, Fairview, Oklahoma City, Ponca City, Tulsa or Woodward, Oklahoma. |
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