In 2013, a settlement was reached in Jimmo v. Sebelius, Docket No. 11-cv-17 (D.Vt., January 18, 2011), a nationwide federal class-action lawsuit. Under the settlement, Medicare coverage rules changed significantly. Prior to the settlement, a decades-old practice, called the “improvement standard,” required beneficiaries to show medical or functional improvement before Medicare would pay for covered.. read more →

The Centers for Medicare and Medicaid Services, the Department of Veterans Affairs (VA), the Social Security Administration and other state and federal agencies have released the following important numbers for 2017. MEDICARE Medicare Part A deductible: $1316 for each benefit period. Medicare Part A co-payments for hospital stays: Day 1-60: $0 co-payment for each benefit.. read more →

On November 15, 2016, I presented at the Second Annual Caring for Caregivers Conference at the East Rutherford Community Center. The first section of my presentation focused on guardianship law in New Jersey, Public Benefit Basics, and the use of special needs trusts by parents of adult disabled children. The powerpoint slides from the first part.. read more →

Medicare’s annual open enrollment period runs from October 15 to December 7–the period when enrollees can shop for new coverage. Now is the time to review your options to determine if you should switch plans. During Medicare’s annual open enrollment period, you may (1) enroll in a Medicare Part D (prescription drug) plan; (2) change your Part.. read more →

Government Long-Term Care Benefits for NJ Residents 908-232-7400 The Law Office of Donald D. Vanarelli provides comprehensive Government Long-Term Care Benefits Legal Services throughout the State of New Jersey. See: https://vanarellilaw.com/medicaid-public-benefits-planning/ Elder Law topics covered in the video include Eligibility for Medicaid, Income and Resource Limits and Caps, Medicare Coverage, Home Health Aides, Home Health Care, Nursing Home.. read more →

The Alzheimer’s Association has issued its 2016 Alzheimer’s Disease Facts and Figures report. The report is “a statistical resource for U.S. data related to Alzheimer’s disease, the most common cause of dementia, as well as other dementias.” Aside from providing a definition of Alzheimer’s disease (“Alzheimer’s disease is a degenerative brain disease and the most common cause of.. read more →

Medicare beneficiaries may now discuss options for end-of-life care with their health care providers. Beneficiaries were always free to talk about advance care planning with their doctors or other qualified health professionals. Unfortunately, however, until recently practitioners could be reimbursed for such discussions only during a patient’s “Welcome to Medicare” visit. Under new regulations effective.. read more →

Medicare is the federal government’s principal health care insurance program for people 65 years of age and over. In addition, the program covers people of any age who are permanently disabled or who have end-stage renal disease (people with kidney ailments that require dialysis or a kidney transplant). The Medicare program insures 49 million Americans.. read more →

 Supplemental Security Income (SSI): Effective 1-1-15  SSI Federal Benefit Rate           SSI Resource Maximum For an Individual – $733.00                   2,000.00 For a Couple – $1,100.00                      3,000.00 New Jersey State Supplement: New Jersey supplements the federal benefit rate with additional money. The payment received by SSI recipients each month includes.. read more →

The Affordable Care Act (ACA) is an historic effort by the government to extend medical insurance coverage to all Americans, increase the quality of care, increase accountability, and reduce cost. It’s been said that the ACA changes the relationship between government, health care providers and all who receive health care in the U.S. However, at.. read more →

Several months ago, I presented a program on Veterans Benefits and Social Security Disability Benefits at the Elder Law College, a seminar on Elder Law and Special Needs Law presented each year by the New Jersey Institute of Continuing Legal Education. I wrote a blog post summarizing the seminar material  presented at the Elder Law.. read more →

On Saturday, April 27, 2013, I presented a session on the impact of elder law issues on divorce mediation at the 2013 Annual Divorce Mediation Seminar by the New Jersey Association of Professional Mediators. The topics covered in my session included Social Security, including retirement, disability and survivors benefits, Supplemental Security Income benefits, Medicare, Medicaid,.. read more →

(I recently presented a program on Veterans Benefits and Social Security Disability Benefits at the Elder Law College, a seminar on Elder Law and Special Needs Law presented each year by the New Jersey Institute of Continuing Legal Education. A summary of the seminar material is presented below.) VA BENEFITS Veterans and their families should.. read more →

The Centers for Medicare and Medicaid Services has announced new Medicare premiums, deductibles, and co-insurances as follows: Part B premium: $104.90/month (was $99.90) Part B deductible: $147 (was $140) Part A deductible: $1,184 (was $1,156) Co-payment for hospital stay days 61-90: $296/day (was $289) Co-payment for hospital stay days 91 and beyond: $592/day (was $578).. read more →

The settlement of Jimmo v. Sebelius, Docket No. 11-cv-17 (D.Vt., January 18, 2011), a nationwide class-action lawsuit, has resulted in a significant change in Medicare coverage rules. Under the settlement, Medicare will scrap a decades-old practice that required beneficiaries to show medical or functional improvement before Medicare would pay for skilled nursing and therapy services… read more →

In a landmark ruling released on Thursday, June 28, 2012, the United States Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (“Affordable Care Act”), President Obama’s health care overhaul passed in 2010.  National Federation of Independent Business v. Sebelius, 567 U.S.___ (2012). Congress enacted the Affordable Care Act in order to.. read more →

Below are figures for 2012 that are frequently used in the estate and elder law practice or are of interest to clients. Medicaid Spousal Impoverishment Figures for 2012 The new minimum community spouse resource allowance (CSRA) is $22,728, and the new maximum CSRA is $113,640. The new maximum monthly maintenance needs allowance is $2,841. The minimum monthly maintenance.. read more →

This situation has occurred many times over the years: a client gives me a copy of a letter from the Social Security Administration (SSA) which contains a Social Security Number (SSN) followed by the letters “A”,  “B”,  “E” or other letters, and then asks me to explain what type of benefit is indicated by the.. read more →

Medicare is the federal government’s health care insurance program for people age 65 and over, and for people under age 65 who have certain disabilities. The Medicare program consists of four basic parts: Medicare Part A: Hospital, skilled nursing, home health care and hospice coverage Medicare Part B: Coverage for medical care, durable medical equipment,.. read more →

In Rodbart v. County of Union, 2009 N.J. Super. Unpub. LEXIS 3084 (December 21, 2009), Union County was sued by three retirees who expected the County to pay their Medicare Part B premiums for life if they accepted early retirement. Two of the retirees were former Union County assistant prosecutors and the other served as.. read more →

The September 21, 2009 edition of amednews.com, the internet version of American Medical News, published by the American Medical Association, reported that the number of uninsured Americans increased by about 600,000 in 2008, despite government health programs such as Medicare and Medicaid enrolling about 1 million more people than they did the year before. Although.. read more →

Seniors who have been overcharged by Medicare’s prescription drug program shouldn’t look to the government for help.  The government-run health-care program for older adults appears to have washed its hands of any responsibility for mistakes that have cost subscribers and taxpayers several billion dollars.  That was the message contained in Medicare’s response this week to.. read more →

As many Social Security Disability Insurance (SSDI) recipients already know all too well, there is currently a two-year waiting period from the day their applications are approved until they can begin receiving Medicare benefits. This policy forces people with disabilities to either find another form of health insurance (sometimes through Medicaid, if they qualify), or.. read more →

A new Programs Operations Manual System (POMS), used by Social Security Administration employees to administer the Social Security and Supplemental Security Income (SSI) programs, has recently been issued by the Center for Medicare and Medicaid Services (CMS) for trusts under the heading “SI 01120.200 Trusts – General, Including Trusts Established Prior to 1/1/00, Trusts Established.. read more →

Below is compilation of Medicaid, Medicare, Social Security and other figures for 2009 that are of interest to the elderly, the disabled and their families. Source: ElderLawAnswers.com Medicaid Spousal Impoverishment Figures for 2009 – effective January 1, 2009 In 2009, the spouse of a Medicaid recipient living in a nursing home (called the “community spouse”).. read more →