Health and Wellness

Brooklyn senior advocates look ahead to health coverage changes

August 14, 2013 Heather Chin
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With health insurance reform due to go into effect in New York and most other states on January 1, 2014, the Senior Umbrella Network of Brooklyn (SUN-B) dedicated its July meeting to educating local seniors, senior advocates and health care providers about some of the key changes.

Providing an update on Medicaid and the Uniform Adult Guardian Jurisdiction Act (UAGJA) was Ronald Fatoullah, Esq. of Ronald Fatoullah & Associates.

In April, the New York legislature unanimously passed UAGJA, which establishes a uniform set of rules regarding guardianship cases. Currently, if a patient lives in one state and travels to another for care, or if family members in different states fight over guardianship of a parent or other elderly relation, the case must go through all states involved, each with different rules.

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Now, with a uniform federal law regarding jurisdiction, the senior has a “home state” and any guardianship case can be transferred from one state to another as necessary, saving money in legal fees, said Fatoullah.

Fatoullah also explained income and resource allowances for Medicaid qualification, and about monthly regional nursing home rates—New York City’s is currently $11,350.

Speaking about Managed Long-Term Care (MLTC) was Judith Grimaldi, Esq. of Grimaldi and Yeung LLP. She explained that until recently, if you wanted home care, you just had to enroll.

Now, managed care will be mandatory and you must choose between partial managed care and a standard package of Medicare + Medicaid home care. Those affected include people with dual eligibility, who are over age 21, who want a personal home care day program, and who want over 120 days of service.

Enrollees must consider things like hours available and the list of network-approved nursing homes. Grimaldi noted that if January 1 brings a reduction in services, you should get written notice of a change to your care plan 10 or more days in advance. If you don’t, you can appeal.

The final panelist, Vincent Russo, Esq. spoke on the topic of pooled trusts, using his Theresa Foundation as an example.

Pooled trusts are charity-run trusts where you can transfer some of your assets or income and have those funds be exempt from counting toward Medicare services eligibility. The trust would manage your assets by paying your living expenses so that Medicare pays for only the cost of medical care. The trust would also protect your funds from seizure after death.

Pooled trusts, including The Theresa Foundation, use leftover funds to support programs—such as music, dance and art for children with special needs—sponsored by the charity.

For more information about SUN-B, visit www.sunb.org.


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