Useful Info During COVID (v. 5)

August 15, 2020

Hello Friends!

I hope you have been enjoying / avoiding / surviving this heat, depending on your predisposition to such weather.  We live in a proper New England house with not enough storage and no A/C (just window units), so I have definitely been missing the luxurious central air conditioning in my office lately!  But we have been getting to the beach a bit, especially in the evening (the best time of day).  I hope you have too.  Don’t you just love living on the South Shore?

Let’s start at the top:

#1 If you have a loved one in a nursing home, then you know there are a lot of changes going on lately when it comes to procedures and protocols.   Here are a few places where you can go to keep up: Consumer Voice, MANR, Center for Medicare Advocacy, and mass.gov.  If you have an issue with a nursing home and you don’t feel like you are making headway, call your Ombudsman.  These are volunteers who genuinely love the role and usually want to help develop a solution that is win-win.

#2 Great news on qualifying for MassHealth home care!  As you may know, MassHealth has some programs that will pay to send home health aides into you home.  To qualify, you must (1) medically need a certain level of care, (2) be below an asset limit, and (3) be below an income limit of $2349/month.

Ironically, this last piece, the income requirement, has put home care out of reach for many over the years, needlessly forcing people into the nursing home, which MassHealth will pay for with no income cutoff.  For far too long, if an elder meets the other requirements for home care, but is $1 over the income limit, she must spend down, every single month, on medical care, every dollar over $542.  That means that she could use the excess over $542 to pay for health insurance, private aides, and the like, but then she is somehow supposed to pay for groceries, heat, home repairs, sundries, and all the rest on just $542 per month!  Impossible to do.  Most elders in that situation have no choice but to move to a nursing home (which can cost the state much more than a home care package!!).

But – great news.  On a temporary basis, during the state of emergency, MassHealth is CHANGING the rules for anyone over-income for home care.  Instead of spending down to $542, an elder can simply spend down to the actual home care income limit of $2349.  It will be very interesting to see the data as the months go by, to see how many more seniors were able to stay at home with this simple change.  But what about after the state of emergency, you may ask?  Well, there is a health care bill currently in conference at the state legislature.  Please call your state representative and your state senator, and ask them both to talk to their caucus representatives about making this change permanent.

#3 Last week I had my first telehealth appointment!  What a pleasure to not have to drive, navigate through a building, and then sit in a waiting room forever.  An added bonus was getting a glimpse into the doctor’s life and personality, as he was sitting in his studio at home, surrounded by musical instruments.  That added a new dimension to the relationship.  Congress is talking about making telehealth a more prominent part of our medical landscape post-pandemic – yes, please.

#4 This is your periodic reminder to keep your health care proxy and emergency contact information with you at all times!  If you are out and about, that could mean keeping copies in the glove compartment of your car or making up a card to keep in your wallet.  We enroll all of our clients in DocuBank, and they send you a wallet card that connects emergency responders to your key health information.  I keep my DocuBank card in my wallet, and if I am going off adventuring without my bag, I put the card in my pocket.  Like when I go rowing with the fabulous crew out of the Hull Lifesaving Museum.

#5 Along the same lines… your health care agent can do a better job for you if you have shared your care wishes.  There are some great tools out there to help you think through your priorities and wishes for yourself, and then share them with your health care agent.  One free option online is the Conversation Project.  We give our clients the Your Way Workbook.  If we gave you one and you have not completed it – go pull out your black folder with all of your estate planning documents, find the Your Way workbook in there, and fill it out!

As always, reach out with any questions related to elder law, veterans benefits, long-term care, estate planning, and special needs planning.  Get outside, and wash those hands!

– Alexis