The time may come when you decide it’s best to transition to a retirement home environment. But before you begin looking at individual homes, it’s a good idea to gain a basic understanding of the types of elder care facilities that are available. Each different type will offer specific amenities and services, and you will want to match your needs and desires with those offered by the appropriate type of facility.

Independent Living

These retirement homes give seniors the opportunity to live as independently as possible while still receiving some assistance from the facility staff. Independent living centers are often organized in a similar way to upscale college dormitories or village-like resorts, providing a wide range of social interactions and recreational options, as well as personal care assistants and even some medical assistance.

Assisted Living

For those who need a little more assistance than independent living centers can offer, assisted living centers may be the best choice. These facilities provide a higher level of personal and even medical care, while still providing seniors with reasonable independent living options.

Nursing Home

Of the three main types of retirement homes, nursing homes provide the most possible care. They have staffs that can provide 24-hour medical and personal assistance to those with the most serious medical conditions or personal limitations.

The Fourth Option

Of course, the fourth option is to remain at home and adapt your home environment to meet your needs. Although this is not always possible, it is something you should consider if your abilities allow for it.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

Since the U.S. Supreme Court ruled this past summer that the Patient Protection and Affordable Care Act (PPACA) could not require states to expand Medicaid, there have been dozens of stories about which states will or will not choose to accept the PPACA’s Medicaid expansion. But, according to the results of a survey by the Kaiser Commission on Medicaid and the Uninsured, along with the Georgetown University Center for Children and Families, regardless of which way a state is leaning over expansion, almost every state has taken advantage of federal funds, offered under the PPACA, to upgrade their dilapidated systems for Medicaid enrollment.

With about 15 to 20 states being almost certain to reject the Medicaid expansion, the acceptance of federal funds to modernize enrollment systems seems somewhat incongruous, but that incongruity is more than just a precautionary measure, should a state reject the expansion now and acquiesce at a later date, since all states will have the new health insurance exchanges. These exchanges are intended to create an easy enrollment experience, as well as allow for the enrollee to compare the benefits offered by various plans, and that is what is prompting the upgrades to these enrollment systems. Even if a state rejects the expansion now, the upgrades can be seamlessly integrated to the exchanges later.

At this point, online applications for Medicaid or the Children’s Health Insurance Program (CHIP) have become available in 37 states, and 45 states have linked verifications for those programs with the Social Security Administration.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

When the Supreme Court overturned the portion of the Patient Protection and Affordable Care Act that required states to expand Medicaid or risk losing federal dollars, it paved the way for states to choose whether they wanted to expand the program or not.  At the time, many Republican state governors expressed their opposition to the expansion, while Democratic governors generally supported it.

Now, in the wake of last year’s presidential election, more state governors have now begun voicing their acceptance of the proposed expansion of Medicaid services. So far, six Republican state governors have indicated that they are no longer opposed to expanding Medicaid in their states. Though states have until January 1, 2014 to make their final decision, states will have to develop their budgets before that deadline, and it appears now as if a majority of states will eventually expand Medicaid under the terms of the healthcare law.

The law directs that anyone who earns an income of up to 133% of the poverty line will be eligible to receive Medicaid health care coverage. That expansion is expected to bring at least 16 million additional people under the Medicaid umbrella, people who had previously gone without any kind of health care coverage because they were too poor to afford private insurance and also did not qualify for Medicaid.

Each state sets its own requirements for who qualifies for Medicaid, but under the terms of the healthcare law, qualification requirements would be nearly identical in any state that adopts the expansion.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

As state legislatures enter 2013, many face the question of whether or not to expand Medicaid under the terms of the Patient Protection and Affordable Care Act.  A study released by the Kaiser Family Foundation, a nonprofit organization that studies health care and healthcare policy, reports that states will not have to spend a lot of money to expand Medicaid coverage to include more people.

The study shows that individual state Medicaid spending would increase by only about .3% if a state chose to adopt the full expansion as outlined in the healthcare law. This is primarily due to the law’s provision that the federal government will be responsible for paying the vast majority of the expenses that states incur when expanding the Medicaid program.

The Kaiser study said that the federal government would see a Medicaid expense increase of about 12% if all states chose to adopt the expansion. This is because the federal government would have to pay for 100% of the expansion costs, at least during the first several years. By 2020, the federal government would be responsible for 90% of the costs while the states would have to fund the remaining 10%. This 90/10 distribution would remain in effect for as long as the states maintained the expanded Medicaid program.

Additionally, a handful of states could end up with smaller Medicaid budgets if they adopt the expansion, including New York. This is because New York, along with states such as Massachusetts, Iowa, Maine, and a small number of others, have already expanded Medicaid to cover those who would be covered under the healthcare law. Once those states begin seeing federal dollars for the expansion, it would amount to extra federal dollars.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

In early December, Kathleen Sebelius, the secretary of the Department of Health and Human Services, sent a letter to state governors informing them that the federal government would not support or pay for a limited expansion of Medicaid coverage for needy individuals and families.

The Obama administration wants states to expand Medicaid under the terms of the Patient Protection and Affordable Care Act, the healthcare legislation passed during the first Obama term. However, the Supreme Court’s ruling on the law allowed states to choose whether they wished to expand Medicaid or not. Under the terms of the law, any state that chooses to expand Medicaid to include anyone earning a specific income amount or lower would have the costs of such an expansion covered entirely by the federal government for the first several years. After that states would have to pay a percentage of the cost, but no larger than 10% by 2020.

The letter details how the Obama administration would not pay for expansions that were less than those outlined in the healthcare law. If, for example, a state chose to implement the Medicaid expansions slowly over several years, the federal government would not provide matching funds until the state met the full expanded coverage guidelines.

A handful of states have already chosen not to participate in the Medicaid expansion at all, while others have already begun implementing the expansion prior to the 2014 deadline. Many, if not most, other states will decide whether to expand Medicaid in the coming year prior to developing their 2014 budgets.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

The past year has been one filled with heated discussions about the expenses associated with programs such as Medicaid. If you are unfamiliar with Medicaid, it is the massive government program through which millions of disabled or impoverished Americans receive their healthcare insurance coverage, if they are able to make it through the infamous restrictions placed upon who can qualify for its benefits. Regardless of how you feel about Medicaid, the results of an annual survey conducted by the Kaiser Family Foundation have disclosed some good news about the program.

According to the survey, the total amount of Medicaid spending increased an average of 2-percent across all 50 states in 2012. That is a 7.7-percent decrease from 2011’s spending increase of 9.7-percent. In fact, the analysts at Kaiser stated that this was “among the lowest rates of spending growth ever recorded,” and those same analysts expect that the growth in Medicaid spending will be even smaller in 2013. Perhaps it will match the 1.3-percent growth in spending that occurred in 2006?

Analysts have not said with any certainty what prompted the decrease, but it is estimated to be the result of an improving economy combined with increased efforts by states to reduce costs. One of the most productive cost reduction measures has been the lowering of rates paid to doctors and other healthcare providers. As for the enrollment rate, the number of new enrollees increased by just 3.2-percent, down from last year’s rate of 4.4-percent.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

One might think that the answer to this question would be heavily in favor of the private insurance, but, according to a study recently conducted by the Government Accountability Office (GAO), that may not be the case.

According to the GAO study, persons whose healthcare coverage is provided by Medicaid tend to enjoy nearly the same access to medical care as those persons covered by private insurance plans. In fact, the GAO found that children do have equal access to doctors regardless of their insurance source, but that differences do exist between working-age adults covered by Medicaid versus working-age adults covered by private insurance plans. The difference was that 7.8% of those adults covered by Medicaid reported difficulty in obtaining care, compared to 3.3% reported by those with private insurance.

There was, however, a significant disparity in dental care between the two groups. The reason for this disparity is likely due to the number of states that omit dental coverage from its Medicaid benefit package.

One area that the GAO study did not explore was whether there was a difference in the quality of the healthcare received between the two groups. Even though the GAO omitted this from its study, there’s a body of separate research which suggests that persons covered by Medicaid have worse outcomes than those persons covered by private insurance; still, it’s better than no insurance at all.

The GAO did find a difficulty that’s unique to Medicaid recipients: a lack of transportation to be able to seek out medical care.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

Each year the Federal government pays out tens of billions of dollars from the Medicare and Medicaid coffers because of fraud. With the number of seniors only expected to increase as humans begin to live longer than ever before, and the baby boomers age into their retirement years, the frequency of, and amounts lost to fraud, is expected to increase as well.

So how can you protect yourself? The number of scams by which Medicare and Medicaid funds are obtained fraudulently is mind-boggling, but there are some steps you can take to lessen or prevent becoming a victim of such fraud.

The FBI recommends that you: never sign a blank insurance claim form, or give blanket authorization to a medical provider to bill for services rendered; ask how much a provider will charge and how much you’ll have to pay out-of-pocket; review your statements for any billing discrepancies, and don’t be afraid to ask questions if you find some; know whether your doctor has ordered any equipment for you; keep an accurate record of all your health care appointments, and store this record where it is easily accessible; and, don’t do business with a door-to-door salesperson who claims to be able to provide you with free medical equipment or services.

Additionally, you should be aware of telephone callers who pretend to represent providers of Medicare Part D, in order to obtain your personal data for use in committing identity fraud. People who actually represent Part D plans won’t call you to update information, ask for payment, or show up at your home uninvited.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

When the Patient Protection and Affordable Care Act was first passed, it contained a requirement that all states must expand their Medicaid programs to include anyone making up to 133% of the federal poverty guidelines. However, after the Supreme Court ruled on the law, states are now capable of opting out of this expansion. Recently, Mississippi became the first such state to do so, even though a recent report from a professional group of actuaries states that choosing not to expand Medicaid could be detrimental for those on private healthcare plans.

A report from the American Academy of Actuaries, entitled “Implications of Medicaid Expansion Decisions on Private Coverage,” details how states that opt-out of Medicaid expansion could cause the cost of private health care premiums to increase in their state. Because of the health differences between those on Medicaid in states without the expanded coverage and those in states that choose to expand, those on private plans may end up paying more.  Also, employers in states without the expanded Medicaid coverage may end up paying additional costs in penalties.

The American Academy of Actuaries is a nonpartisan group composed of more than 17,000 professional members. In addition to establishing professional standards and qualification criteria for actuaries around the nation, the Academy also provides information and analysis about actuarial topics to the public and policymakers.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.

In recent years, both state governments and the federal government have made a lot of money in settling Medicaid fraud cases. Because Medicaid is a jointly run state and federal health insurance program, Medicaid fraud cases often result in both state and federal governments receiving funds.  A recent report from the consumer group Public Citizen details exactly how much money is involved.

During the first six months of 2012, companies and individuals settling Medicaid fraud cases with the state and federal governments have paid about $6.6 billion in settlement fees. This money comes primarily from healthcare providers and pharmaceutical companies that participated in various types of fraud, such as overcharging Medicaid, unlawfully promoting drugs, and engaging in illegal price fixing.

Between late 2010 and mid-2012, the total amount of Medicaid fraud settlement payments equaled about $10.2 billion. Much of this money came from three of the larger pharmaceutical companies, including Johnson & Johnson, Glaxo Smith Kline, and Abbott.

Because of the windfall settlements, many states can now boast Medicaid fraud investigation departments that bring in far more than they spend. According to the report, some states are recouping between $12 and $84 for every single dollar the state spends on investigating and prosecuting Medicaid fraud cases. According to the report, 17 states have recovered enough to either completely pay for their investigative costs, or have made a profit on Medicaid fraud investigations.

The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.