Frankly Speaking Blog - North Carolina's First Elder Law Firm

New COLA Takes Effect December 2011

By A. Frank Johns JD, LLM, CELA

Social Security Income and Social Security Disability Insurance beneficiaries will realize a 3.6% increase in benefit payments starting with the December 2011 payments, which are payable in January 2012.  This is a result of a newly implemented cost-of-living adjustment, also known as COLA.  Legislation originally enacted in 1973 provides for cost of living adjustments which enable Social Security (an entitlement program that allows those who pay Social Security taxes during the years in which they work to draw benefits when they reach a certain age) and Supplemental Security Income (also known as SSI; a program designed to provide food, clothing and shelter to those who are aged, blind, or disabled and have little or no income) benefits to keep pace with inflation, (Social Security Online).

This marks the first time a COLA has been implemented since 2008.  Currently, the average monthly Social Security payment for a worker with disabilities is $1,072.  In January 2012, the payment will rise to $1,111.  The federal SSI payment standard will increase to $698 a month for an individual and $1,048 a month for a couple, (Social Security Online).  The SSI resource allowance will remain the same at $2,000 for an individual and $3,000 for a couple, but the amount of money that a person can earn without engaging in Substantial Gainful Activity, which can result in the loss of SSDI or SSI benefits, will increase to $1,010 a month for a person who is a not blind and $1,690 for a person who is blind, (Social Security Online).  A person who is earning more than a certain monthly amount (net of impairment-related work expenses) is ordinarily considered to be engaging in Substantial Gainful Activity (Social Security Online Substantial Gainful Activity).

For more information on how to calculate your COLA, visit http://www.ssa.gov/oact/cola/latest COLA.html.  If you would like to speak with an attorney about how the new COLA will affect you, please call us at (336) 275-9567.  We look forward to serving you!

Medicaid More Helpful to Seniors than Medicare?

By A. Frank Johns, JD, LLM, CELA

Does Medicare provide American citizens with worthwhile services?  The medical advances that might enable one to live into advanced old age are often not covered by Medicare. In fact, a question often asked by the elderly, their caretakers, and their children is, “What is covered by Medicare?”  For those considering residence in a nursing home in the near future, the question of whether Medicare is helpful is one that induces a helpless shrug of the shoulders, or a sigh of frustration; that, or sometimes rage.

The average cost of a nursing home in North Carolina ranges from $5,000 to $7,000 a month for private pay.  If the person seeking assistance happens to have special needs or requires a higher level of care, it is not uncommon for monthly healthcare costs to exceed $10,000. For even the most fore-thinking Americans, this cost of living increase easily drains a well funded retirement account in a matter of years.  Thousands of Americans need skilled nursing care and have life expectancies beyond the next few years while few have the money required to ensure their care.  Many find themselves in need of nursing care early in retirement due to stroke, dementia, or other chronic diseases, while still expected to live well into their 70’s or 80’s.   

Most people think that Medicare will cover their "medical costs." They have another “think” coming about Medicare.  Neither does Medicare pay for long-term care, nor does it cover all of the costs associated with providing eligible Medicare recipients with in-home aides to help with daily routines, like bathing, cooking, or transportation.  While Medicare does cover the cost of occasional doctors’ visits, medicines, surgeries, and a couple of hours of in-home care, it typically does not (to the shock of many) cover nursing home stays.  

America has another program that covers the cost of skilled-nursing care, whether it’s in a nursing home or administered in the privacy of the patients own home: Medicaid.  While most people think of Medicaid as a program for only the poor or impoverished, it is in fact a program that may help families in most economic situations to receive the services needed for the care for elderly or disabled loved ones.

If you are planning to help a loved one transition into a nursing home, or have a loved one in need of skilled-nursing care, please contact Booth Harrington and Johns of NC, PLLC at (336) 275-9567. As North Carolina’s first elder law firm, we are board certified and A rated in providing legal services that address asset preservation, eligibility for Medicaid and the Medicaid application process. We can help you plan for needed benefits. 

Quite Frankly

Booth Harrington & Johns of NC PLLC is pleased to present its newest blog - Quite Frankly. This blog is all about helping readers and their families make sense of the complicated issues related to special needs.

Unfortunately the legal world is complex. As a result, it is often difficult for those outside the legal world to fully understand it. The practice of special needs law is no exception.

For me and my team to serve as the best legal advisors and advocates we can be to our clients, we must continue to help individuals and their families understand the impact and solutions available in their individual situations. We strive to do that each day. We realize that our years of legal practice and hard-earned credentials are of limited value if we are unable to help clients make legal decisions that are right for them and their families. Those decisions require plain talk and clear answers.

If you or your family is affected with special needs issues, we invite you to come in and take a look. You can access it by clicking here.

P.S. Please feel free to share our Quite Frankly blog with others whom you think would want to know more about the critical issues facing those with special needs and their families. That can include another financial or legal professional, a health or human services provider, or someone who covers these topics in the news to name a few.

To learn more, visit us online at www.nc-law.com.

The Medicare “Improvement Standard”

Though not a true facet of the legal system, the Medicare “Improvement Standard,” that rule by which if a doctor does not anticipate possible improvement, one can be denied for Medicare coverage, is quite often strictly applied. The Center for Medicare Advocacy is currently beginning a new initiative to ban application of the “Improvement Standard.” In order to affect change, the initiative includes lobbying the Obama administration, litigation, and a broad education program.

As the Center states, “Although the Improvement Standard conflicts with the law, it has become deeply ingrained in the system and ardently followed by those who provide care and those who make coverage determinations throughout the health care continuum. Beneficiaries are told Medicare coverage is not available if their underlying condition will not improve, if they have 'plateaued,' are not likely to improve, or if they need 'maintenance care only'. As a result it keeps people with debilitating, chronic conditions from receiving the care they need. This practice persists although the Medicare Act does not require improvement as a precondition to coverage for illness or injury. Further, the federal regulations state that 'restoration is not to be the deciding factor' in making Medicare coverage determinations."

If you or someone you know has been handed an unfavorable Medicare coverage option, the law firm of Booth Harrington & Johns may be able to help. For information, please visit our website at www.nc-law.com or call toll free at 877-50-ELDER.

To read more in depth on the Center’s initiative, visit http://www.medicareadvocacy.org