ELDER LAW ATTACK OUTLINE
COBRA Timelines and Costs (First ask if COBRA even applies)
After the qualifying event (termination of employment)
Company has 14 days to notify client of what s/he needs to do to elect COBRA.
Company has 30 days to notify health care company of qualifying event
Client has 60 days after the qualifying event OR the date of notice to elect COBRA (if s/he doesn’t, may have Credible Coverage issues for Part D and Medigap)
Coverage Duration
Default: Coverage must last 18 months after qualifying event
Coverage can last 36 months if you qualify for Medicare (e.g., turn 65) before your 1st 18 months elapse
Premium = 102% of what your employer paid.
SSI ELIGIBILITY ≈ MEDICAID ELIGIBILITY
Maximum assets = $2000/single, $3000/Couple
Countable resources = cash or assets you can easily liquefy (bank accounts, stocks, etc…)
What is not a countable resource? (Important for Medicaid)
The house you live in and the land it’s on
Household goods and personal effects.
Wedding and engagement rings.
$11,072 can be prepaid on an irrevocable funeral contract
Burial spaces for immediate family up to $1500
Certain limited life insurance policies (usually “burial policies”)
ONE vehicle (two if you have a farm or business)
Medicaid Limits
Deficit reduction act of 2005 limited the exclusion with regard to the house. In Michigan, homestead is excluded ONLY if the equity value in the house is under $500,000.
Annuities (but it’s complicated, and nowhere near as common)
Trust funds (be careful)
SSI Countable Income = Earned income + Unearned Income – Exclusions
Earned income = wages, commissions, tips
Unearned income = Social Security benefits, private pensions, unemployment benefits,
t are listed on the countable net assets page up to a total of $101,880.
Snapshot date = the date on which one spouse was admitted to the hospital and/or nursing home and stayed for 30 days.
Issue: How much income does this individual get to retain and how much do they have to give to the nursing home?
State’s amount (719) plus and “excess shelter allowance”, totaling up to $2541. In 2007, you could divert up to $2541.
Take this amount, and subtract the community spouse’s actual income.
Community Spouse Income Allowance (CSIA) = the maximum amount allowed to be deducted from the NH spouse’s income to the community spouse.
Now you calculate the NH spouse’s PPA:
Take the PPR amount
