Finding Your Path-The Senior's Guide

pathThe Senior’s Guidefindingyour

Medicaid: know the rules

The key Toyour FuTure:

Volume 3 • 2013 edition

veteran? the va can help

Medicare vs. Medicaidwhat’s the difference?

PrePlanning for long-term careA T T O R N E Y S A T L A W

+senior resource guide Local facilities, resources &

providers for space Coast seniors

321.984.3200Melbourne I Palm Bay I Suntree I PAFB

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FINDING YOUR PATH

T he decision on whether to move a family member or loved one to a long-term care facility or keep the loved one at

home is one of the most difficult decisions you can make. Perhaps the move is needed because the family member can no longer care for him or herself … or has a progressive disease like Alzheimer’s … or has had a stroke or heart attack.

No matter the reason, those involved are almost always under great stress. At times like these, it’s important that you pause, take a deep breath and understand that there are things you can do.

Good information is available and you can make the right choices for yourself and your loved one.

“Finding Your Path” is designed to provide you with helpful information and answers to some of the questions you will encounter. These are questions that Elder Law attorneys deal with on a daily basis. In this guide, we will discuss:

n Ways to pay for long-term care n Medicare vs. Medicaidn The rules of Medicaidn Veterans’ Benefits including Aid and Attendancen Advantages of planning aheadn Other important stepsOur clients have found this guide to be a valuable resource

and we hope you will find it useful too. This guide is brought to you by:

MEET STEPHEN J. LACEY

Stephen J. Lacey concentrates his practice in the areas of Medicaid planning, VA plan-ning, tax and estate planning, real estate, and business trans-action law. Mr. Lacey is experienced in the formulation of estate plans to achieve his clients’ testamentary goals and maximize their tax benefits and properly settling their estates. Mr. Lacey understands the needs of individuals, families and businesses, enabling him to be particularly sensitive to the multiple stresses that we all confront on a daily basis. He is committed to helping clients navigate the legal systems by providing honest answers where they are hard to find, and identifying lawful solutions to each client’s particular needs and goals. Mr. Lacey is available to meet with you individually or in a small family setting if desired. Please call (321) 984-2700 to schedule an appointment today.

The hiring of a lawyer is an imporTanT decision ThaT should noT be based solely upon adverTisemenTs.Thank you for viewing this consumer guide. The materials in this consumer guide have been provided for general informational purposes

only and are not legal advice. none of the information in this consumer guide is intended to constitute, nor does it provide, legal advice, and none of the information necessarily reflects the opinions of mcclelland Jones, llc. This information is not intended to create any relationship between mcclelland Jones, llc and the recipient. The information is not guaranteed to be correct, complete, or current.

This consumer guide is not meant to be a referral service and does not make any recommendations or suggestions as to how to use any services or any information regarding services, including addresses, phone numbers, emails, websites or any other method of contacting service providers contained in any of the pages herein.

The materials contained herein are general in nature and may not apply to particular factual or legal circumstances. under no circumstances shall this consumer guide or any other party involved in creation, production or delivery of this consumer guide be liable to you or any other person for any damages of any kind arising from your access to, or use of, this consumer guide. you should not act or rely on any information in this consumer guide without seeking the advice of an attorney. The determination of whether you need legal services and your choice of an attorney are very important matters that should not be based on this consumer guide or advertisements.

STEPHEN J. LACEY

One Harbor Place | 1901 South Harbor City Boulevard | Suite 500 Melbourne, FL 32901-4770 | Phone. 321.984.2700 | Fax. 321.723.4092 Email. [email protected] | Web. www.mcclellandjones.com

2 Stephen J. Lacey

Americans are living longer than ever before. At the turn of the 20th century, the average life expectancy was about 47 years. As we enter the 21st century, life expectancy has almost doubled. As a result, we face more challenges and transitions in our lives than those who came before us.

One of the most difficult transitions people face is the change from independent living (meaning aging in their own home or apartment) to living in a long-term care facility or “nursing home.”

There are many reasons why this transition is so difficult. One is the loss of home … a home where the person lived for many years and where they have a lifetime of memories. Another is the loss of independence. Still another is the loss of the level of privacy enjoyed at home, since most nursing home residents have roommates.

Most people who move to a nursing home do so during a time of great stress. Some have been hospitalized after a stroke, some have fallen and broken a hip, and others have progressive dementia, like Alzheimer’s disease, and can no longer be cared for in their own homes.

Whatever the reason, the spouse or relative who helps a person transition to a nursing home faces the immediate dilemma of how to find the right nursing home. The task is no small one, and a huge sigh of relief can be heard when the right home is found and the loved one is moved lovingly into a new environment.

But for many people, the most difficult task is just beginning. How do you cope with nursing home bills that may total $8,000 to $9,000 or more per month?

How to Pay for NursiNg Home CareOne of the things that concerns people most about

nursing home care is how to pay for that care. There are basically four ways that you can pay the cost of a nursing home stay:

1. Long-Term Care Insurance. If you are fortunate enough to have this type of coverage, it may go a long way toward paying most or all of the costs of the nursing home stay. Unfortunately, long-term care insurance has only started to become popular in the last few years and most people facing a nursing home stay do not have this coverage.

2. Pay with Your Own Funds. This is the method that many people are required to use at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home expenses averaging between $8,000 and $9,000 per month in our area, few people can afford a long-term stay.

3. Medicare. This is the national health insurance program primarily for people 65 years of age and older, certain younger disabled individuals, and those with kidney failure. Medicare provides short-term assistance with nursing home costs, but only if you meet strict qualification rules.

4. Medicaid. Medicaid is a federal and state-funded and state-administered medical benefit program which can pay for the cost of the nursing home stay if certain asset and income tests are met. Since the first two methods of private pay (i.e. using your own funds and long-term care insurance) are self-explanatory, our discussion will concentrate on Medicare and Medicaid.

wHat about mediCare?There is a great deal of confusion about Medicare

and Medicaid.Medicare is the federally funded and state-administered

health insurance program primarily designed for older individuals (those over age 65). There are some limited long-term care benefits that can be available under Medicare. In general, if you are enrolled in the traditional Medicare plan, and you have had a hospital stay of at least three days, and then you are admitted to a skilled nursing facility (often for rehabilitation), Medicare will pay the full cost of the nursing home stay for the first 20 days and may continue to pay part of the cost of the nursing home stay for the next 80 days.

Medicare Part A primarily covers the cost of a hospital stay, while Medicare Part B includes fees for doctors, labs, X-rays, therapy, etc. After day 20, your Medicare supplement policy may pay your deductible, which you would have otherwise had to pay. So in the best case scenario, the traditional Medicare or the Medicare Managed Care Plan may pay up to 100 days for each “spell of illness.” In order to qualify for these 100 days of coverage, however, the nursing home resident must be receiving daily “skilled care” and generally must continue to “improve.” (Note: If the Medicare and Managed Care beneficiary has not received a Medicare-covered level of care for 60 consecutive days, the beneficiary may again be eligible for the 100 days of skilled nursing coverage for the next spell of illness.)

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While it is never possible to predict at the outset how long Medicare will cover the rehabilitation, from our experience, it usually falls far short of the 100-day maximum. Even if Medicare does cover the 100-day period, what then? What happens after the 100 days of coverage have been exhausted?

At that point, in either case, you are back to one of the other alternatives…long-term care insurance, paying the bills with your own assets or qualifying for Medicaid.

wHat is mediCaid?Medicaid is a benefits program which is primarily

funded by the federal government and administered by each state. Sometimes the rules governing distribution of benefits vary from state to state. Recently, the State of Florida has re-named the Medicaid programs formally known as the Institutional Care Program (ICP), the ALF Medicaid Waiver Program and the Long-Term Diversion Program. All of these programs are now known as Statewide Medicaid Managed Care – Long Term Care or MMCLTC.

One primary benefit of Medicaid is that unlike Medicare (which only pays for limited-stay skilled nursing), the Medicaid program will pay for long-term care in a nursing home once you have qualified. Medicare does not pay for treatment for all diseases or conditions. One example is a person who has had to go to a nursing home for the treatment for Alzheimer’s or Parkinson’s disease. Even though the patient received medical care, such care will not be paid for by Medicare. In that instance, you will either have to pay privately (i.e. use long-term care insurance or your own funds), or you will have to qualify for Medicaid.

wHy seek adviCe for mediCaid?As life expectancies and long-term care costs continue

to rise, the challenge quickly becomes paying for these services. Many people cannot afford to pay $8,000 per month or more for the cost of an extended nursing home stay and those who can pay for a while may find their life savings wiped out in a matter of months, rather than years, leaving the “at home” spouse impoverished.

Fortunately, the Medicaid Program is there to help. In fact, in our lifetime, Medicaid has become the long-term care insurance of the middle class. But the eligibility to receive Medicaid benefits requires that you pass certain tests regarding the amount of income and assets that you have. The reason for Medicaid planning is simple. First, you need to provide enough assets for the security of your loved ones – they too may have a similar crisis. And second, the rules are extremely complicated and confusing. The result is that without planning and advice, many people spend more money than they should and their family security is jeopardized.

exemPt assets aNd CouNtable assets What Can Be Spent?

To qualify for Medicaid, applicants must pass some fairly strict tests with regard to the amount of assets they can keep. To understand how Medicaid works, we first need to review what are known as exempt (non-countable) and non-exempt (countable) assets. Exempt assets are those assets which Medicaid will not take into account (at least for the time being.) In general, the following are the primary exempt assets:• TheHome. The home must be the principal place of

residence. The nursing home resident may be required to show some “intent to return home” even if this never actually takes place.

• HouseholdandPersonalBelongings.These include items such as furniture, appliances, jewelry and clothing.

• OneAutomobile.This is a vehicle which is used to provide necessary transportation.

• BurialSpaces.Burial spaces for you and your spouse or any member of the individual’s immediate family.

• Irrevocable Burial Contracts. The total value of the contract must be irrevocably assigned to specific merchandise or services. Monies designated to “miscellaneous” could be counted as a transfer of assets.

• CashValueofLifeInsurance. If the face value of all life insurance policies is $2,500 or less, then the cash surrender value can be excluded from the countable assets.

• BurialAccount.Up to $2,500 can be designated to burial.

• Personal Effects. $2,000 exclusion ($3,000 if both spouses are applying for Medicaid) Otherwise, the community spouse can maintain $115,920.All other assets are generally non-exempt, and are

countable. Basically, all money and property, and any item that can be valued and turned into cash is a countable asset unless it is one of those assets listed above as exempt.

This includes:• Cash, savings, checking and credit union accounts;

• Certificates of deposit;

• U.S. Savings Bonds;

• Individual Retirement Accounts (IRA), Keogh plans (401K, 403B);

• Nursing home accounts (patient fund accounts);

• Prepaid funeral contracts which can be cancelled or revoked;

• Some trusts (depending on the terms of the trust);

• Real estate (other than the residence);

• More than one car unless otherwise excluded;

• Boats or recreational vehicles;

4 Stephen J. Lacey

• Stocks, bonds or mutual funds; and• Land contracts or mortgages held on real estate sold.

While the Medicaid rules themselves are complicated and tricky, it is safe to say that a single person will meet the qualification requirements for Medicaid in Florida as long as he or she has only exempt assets and the countable assets total $2,000 or less.

iNCome testIn order to qualify for Medicaid, an applicant must

also meet the income test. In 2013, an individual applicant must have less than $2,130 per month in gross income. The spouse who is not in need of care can have unlimited income. All available income is counted, including interest, dividends, rents, salary, Social Security benefits, royalties, retirement payments, inheritances, alimony, etc. Additionally, deductions must be added back in to calculate the gross income for Medicaid purposes. Some of these include premiums for Medigap insurance, premiums for health insurance, Part B and Part D Medicare deductions from Social Security benefit payments, Social Security taxes, optional deductions, and garnished or seized payments.

If an applicant has one penny more than the “income cap” limit, qualification for Medicaid is not allowed unless a Qualified Income Trust is established.

some CommoN QuestioNsI’ve added my child’s names to my bank account.

Does that money still count?

Yes. The entire amount could be counted unless you can prove some or all of the money was contributed by the other person who is on the account. This rule applies to cash assets such as:• Savings and checking accounts;

• Credit union share and draft accounts;

• Certificates of deposit; and

• U.S. Savings Bonds.

Can I give my assets away?

Many people wonder, can I give my assets away? The answer is, maybe, but only if it is done just right. The law has severe penalties for people who simply give away their assets to create Medicaid eligibility. In Florida, for example, every $7,362 given away during the “look back” period* prior to a Medicaid application creates a one month period of ineligibility. So even though the federal gift tax laws allow you to give away up to $13,000 per year without gift tax consequences, a $13,000 gift could result in a period of ineligibility for Florida Medicaid of almost three months.*NOTE – Currently the “look back” period is five years from the date one applies for Medicaid.

Though some families do spend virtually all of their savings on nursing home care, Medicaid often does not require this. There are a number of strategies which can be used to protect family financial security and quality of life for the at-home spouse.

mediCaid PlaNNiNg for married CouPlesThe Spousal Impoverishment provisions of the

Medicare Catastrophic Act of 1988 apply only to couples. The intent of the law was to change the eligibility requirements for Medicaid where one spouse (institutionalized spouse) needs nursing home care while the other spouse (community spouse) remains in the community (i.e. at home.) The law, in effect, recognizes that it makes little sense to impoverish both spouses when only one needs to qualify for Medicaid assistance for nursing home care. Basically, the couple gathers all their countable assets together for review. Exempt assets, discussed above, are not counted.

The countable assets are reduced by the Community Spouse Resource Allowance (CSRA) which allows the “community spouse” to keep up to a maximum of approximately $115,920. The remaining countable assets must be “spent down” until $2,000 or less remains. The amount of the countable assets which the at-home spouse gets to keep is called the Community Spouse Resource Allowance (CSRA.) Each state also establishes a monthly income floor for the at-home spouse. This is called the Minimum Monthly Maintenance Needs Allowance. This permits the community spouse to keep a minimum monthly income ranging from about $1,939 to $2,898.

If the community spouse does not have at least $1,939 in income, then he or she is allowed to take the income of the nursing home spouse in an amount large enough to reach the Minimum Monthly Maintenance Needs Allowance (up to at least $1,939.) The nursing home spouse’s remaining income, less a $35 personal needs allowance, goes to the nursing home to help pay expenses. This avoids the necessity (hopefully) for the at-home spouse to dip into savings each month, which would result in gradual impoverishment.

To illustrate, assume the at-home spouse receives $800 (total income) per month in Social Security. Also assume that her needs are calculated to be the minimum of $1,939. With her Social Security, she is $1,139 short each month.

$1,939 at-home spouse’s monthly needs(as determined by formula)- $800 at-home spouse’s Social Security=$1,139shortfallIn this case, the community spouse will receive $1,139

(the shortfall amount) per month from the nursing home spouse’s Social Security, and the rest of the nursing home spouse’s income (less the personal needs allowance) will then go to pay for the cost of his or her care. This does not mean,

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however, that there are no planning alternatives which the couple can pursue. Consider the case studies below.

Case studyMedicaidPlanningforMarriedCouplesRalph and Alice were high school sweethearts who lived

in Indialantic, Florida their entire adult lives. Two weeks ago, Ralph and Alice celebrated their 51st anniversary. Yesterday Ralph, who has Alzheimer’s disease, wandered away from home. The police found him hours later, sitting on a street curb, talking incoherently and they took him to a hospital. Now the family doctor has told Alice that she needs to place Ralph in a nursing home. Ralph and Alice grew up during the Great Depression. They always tried to save something each month. Their assets totaling $120,000, not including their house, are as follows:• Savings account - $35,000• CDs - $65,000• Money Market account - $17,000• Checking account - $3,000• Residence (with mortgage) - $80,000Ralph gets a Social Security check for $800 each month;

Alice’s check is $300. Her eyes fill with tears as she says, “At $8,000 to the nursing home every month, our entire life savings will be gone in two years!” Also, she is afraid she will not be able to pay her monthly bills because a neighbor told her that the nursing home will be entitled to all of Ralph’s Social Security check.

There is good news for Alice. It’s possible that with proper planning, she will get to keep most, if not all, of their assets and income and still qualify for the state Medicaid program to assist with Ralph’s nursing home costs. The process may take a little while, but the end result will be worth it.

This is possible because the law does not intend to impoverish one spouse because the other needs care in a nursing home. Sometimes there are other options. Many home care providers can help clients such as Ralph stay at home longer and may have their services paid by Medicaid. Additionally, some families may qualify for Medicaid or VA Assistance to help pay the cost of assisted-living care where they accept individuals with some dementia. Situations such as these are instances where an elder law attorney can provide tremendous benefits for all seniors who find themselves in the shoes of Ralph and Alice.

Of course, proper Medicaid planning differs according to the relevant facts and circumstances of each situation, as well as the current law. For example, some children never gain independence – they remain dependent on their parents. What can be done in such a case?

Case studyATrustforaDisabledChildMargaret and Sam have always taken care of their

daughter, Elizabeth. She is 45, has never worked, and

has always lived at home. Elizabeth is developmentally disabled and receives SSI (Supplemental Security Income). Margaret and Sam have continually worried about who would take care of Elizabeth after they die. A few years ago, Sam was diagnosed with dementia. His health has deteriorated to the point that Margaret can no longer take care of him. Now she has placed Sam in a nursing home and is paying $8,000 per month out of their life savings. Margaret is very worried that no money will be left for the care of Elizabeth.

Margaret is satisfied with the nursing home where Sam lives. The facility has a Medicaid bed available that Sam could have if he were eligible. Medicaid would pay his nursing home bill. However, according to the information she got from the case worker, Sam is $48,000 away from Medicaid eligibility. Margaret wishes that there was a way to save the $48,000 for Elizabeth after she and Sam are gone. There is indeed a way.

Margaret can consult an elder law attorney to set up a “special needs trust” with the $48,000 to provide for Elizabeth’s future needs. As soon as she does, Sam will be eligible for Medicaid. Elizabeth will not lose her government benefits and her security is assured. Of course, all trusts must be reviewed for compliance with Medicaid rules. Also, failure to report assets is fraud, and when discovered, will cause loss of eligibility and repayment of benefits. Still, some people question making gifts before entering a nursing home.

I heard I can give away $13,000 per year. Can I?As discussed earlier, many people have heard of a tax

provision that allows them to give away $13,000 per year without paying any gift taxes. What they do not know is that this refers to a gift tax exemption. It is not an absolute right with no consequences. Having heard of the exemption, they wonder, “Can I give my assets away?” The answer is, maybe, but only if it is done within the strict guidelines of the law. So, even though the federal gift tax law allows you to give away up to $13,000 per year without incurring a gift tax, those gifts could result in a period of ineligibility for Medicaid long-term care purposes. Still, some parents want to make gifts to their children before their life savings is all gone. Next, consider the following case study:

Case studyFinancialGiftstoChildren

After her 73-year-old husband, Harold, suffers a paralyzing stroke, Mildred and her daughter, Joan, need advice. Dark circles have formed under Mildred’s eyes. Her hair is disheveled. Joan holds her hand. “The doctor says Harold needs long-term care in a nursing home,” Mildred says. “I have some money in savings, but not enough. I don’t want to lose my house and all our hard earned money. I don’t know what to do.”

6 Stephen J. Lacey

Joan has heard about Medicaid benefits for nursing homes, but does not want her mother left destitute in order for Harold to qualify for them. Joan wants to ensure that her father’s medical needs are met, but she also wants to preserve Mildred’s assets. “Can’t Mom just give her money to me as a gift?” she asks. “Can’t she give away $13,000 a year? I could keep the money for her so she doesn’t lose it when Dad applies for Medicaid.”

Joan has confused federal gift tax law with the issue of transfers and Medicaid eligibility. A “gift” to a child in this case is actually a transfer for “less than fair market value,” and Medicaid has very specific rules about such transfers.

At the time Harold applies for Medicaid, the state will currently “look back” five years to see if any transfers for less than fair market value have been made. The state will not let you just give away your money or your property in order to qualify for Medicaid. Any gifts or transfers for less than fair market value that are revealed in the “lookback” period* will cause an eligibility period for Harold for Medicaid purposes, if the transfers are above the allowable amount. For example, each $13,000 gift made during the “look back” period prior to a Medicaid application creates nearly a three-month period of ineligibility in Florida.

*NOTE – Currently the “lookback” period is five years from date of application for Medicaid benefits.

So what can Harold and Mildred do? They can institute a plan, save a good portion of their estate and still qualify for Medicaid. The plan may involve transfers of money for value received, such as a care contract, and it may involve gifts. However, as stated above, the gifts must not violate the federal law or the Medicaid rules. Generally, if done properly, you can often save as much as one half of your assets or more with proper planning.

But remember, when it’s given away, it’s given away. Studies have shown that “windfall” money received as a gift, prize or lawsuit settlement is often gone within three years. In other words, even when the children promise that the money will be available when needed, their own “emergencies” may make them spend the money.You must consult a knowledgeable attorney on how to establish a plan that complies with the law and achieves your goals.

will i lose my Home?Many people who apply for Medicaid assistance benefits

to pay for nursing home care ask this question. For many, the home represents much or most of their life savings. Often, it is the only asset that a person has to pass on to his or her children.

Under the Medicaid regulations, the home is an exempt and unavailable resource. This means that it is not taken into account when calculating eligibility for Medicaid. But in 1993, Congress passed a little-debated law that affects hundreds of thousands of families with a spouse or elderly parent in a nursing home. That law requires states

to try to recover the monies that Medicaid paid for nursing home residents. Estate recovery does not take place until the recipient of the benefits dies. Then, federal law requires that states attempt to recover any benefits which paid for nursing home care. This amount currently comes from the recipient’s probate estate. Generally, the probate estate consists of assets that the decedent owned in his or her name alone without a beneficiary designation.

Some states have also adopted an expanded estate recovery that goes even further and recovers from non-probate assets, including assets owned jointly or payable to a beneficiary and even assets that were properly transferred during the nursing home recipient’s lifetime.

About two-thirds of the nation’s nursing home residents have their costs paid in part by Medicaid. Obviously, the Estate Recovery law affects many families. The asset most frequently caught in the Estate Recovery web is the home of the Medicaid recipient.

A nursing home resident can own a home and receive Medicaid benefits without having to sell the home. But upon death, if the home is part of the probate estate, the state may seek to force the sale of the home in order to reimburse the state for the payments that were made. The Medicaid regulations do provide for a way to avoid recovery against the home in certain circumstances. Since Medicaid rules are constantly changing, you will need assistance from an experienced attorney who is very knowledgeable of these rules.

va beNefitsAnother governmental benefit that can be utilized is

the Aid and Attendance benefit offered by the Veterans Administration (VA). This program can provide assistance to your loved one to help with the payment of nursing home, assisted living facility or even in-home care if the veteran is in need of regular aid and attendance from someone else and the need is supported by medical reports and findings by the applicant’s physician. In order to qualify, the applicant must meet the following conditions:

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• The applicant or the applicant’s spouse must have served at least 90 days in the military, one of which was during a war time period.

The war time periods are as follows:° World War II – December 7, 1941 to December 31, 1946° Korean War – June 27, 1950 to January 31, 1955° Vietnam – August 5, 1964 to May 7, 1975

• The benefit for the veteran can be as high as $1,732 per month if the veteran does not have a dependent. If the veteran does have a dependent, then the benefit can be as much as $2,054 per month.

• Medical expenses must exceed income. The income test requires that all income less unreimbursed medical expenses must be less than the pension amount.

• There is not a hard-line asset test for Aid and Attendance like there is for Medicaid. Generally speaking, a couple must have less than $80,000 in assets while a single person must have less than $50,000 in assets. Again, this is a general guideline; but depending upon the age and medical expenses of the applicant, the VA may require less than the above guidelines.

• Medical expenses are out of pocket expenses that are not later paid for by any form of insurance. The award is based upon prospective costs; thus it is based upon future costs that are recurring and predictable.

• The surviving spouse may be able to receive the benefit also if the spouse was married to the veteran at the time of veteran’s death and did not remarry. The amount of the benefit could be as much as $1,113 per month.WORD OF CAUTION: While it is true that there

is not a look back period like there is for the Medicaid benefit, in our experience, when veterans take it upon themselves to qualify for VA by gifting assets to family members, they often create many legal and personal issues for the veteran. Some of these include loss of control of the monies by the veteran, gifts which circumvent their estate plan, and opening up those gifts to the creditors and predators of the person who received the gift. Most importantly, if the veteran later requires nursing home care, such gifts could disqualify the veteran from receiving Medicaid benefits.

Case studyNow let’s look at Captain Jim and Diana. Captain Jim

served in the Navy from December 15, 1941 through December 31, 1945. He has dementia and is residing at an assisted-living facility. He requires the assistance of a third party to take care of his activities of daily living. Diana lives in their home and visits Captain Jim on a regular basis. Their assets are a house worth approximately $150,000, stocks valued at roughly $250,000 and savings of $152,000. Their combined income is $3,071. Captain Jim executed a financial and health care power of attorney with Diana as his agent.

Diana heard rumors that Captain Jim, who was not injured while on active duty, might be able to either get free care or some cash benefit from the VA and wants to know if that is true.

Because Captain Jim served in the Navy during wartime for at least 90 days, Aid and Attendance benefits through the VA are a possibility.

In this case, there is a total of $402,000 in counted resources. Therefore, in order to meet the asset test, the couple must enter into a spend down plan in order to bring the resources below the levels required by the VA. Examples include spending money on care; purchasing exempt assets; transferring assets to a trust, children or grandchildren; or making house improvements.

IT IS EXTREMELY IMPORTANT THAT WHATEVER SPEND DOWN PLAN CAPTAIN JIM AND DIANA FOLLOW, THEY MUST BE MINDFUL OF THE MEDICAID LAWS AS WELL SO THAT IF MEDICAID BECOMES NECESSARY, THE COUPLE IS NOT DISQUALIFIED FOR SUCH BENEFITS AS A RESULT OF THIS SPEND DOWN PLAN.

The expenses for the assisted living facility exceed the couple’s income. Therefore, if Captain Jim and Diana are able to lower their assets below the asset test for the VA, Captain Jim should be eligible for the highest level of pension ($2,054 in 2013). It may take up to 12 months to start receiving the payment, but it is retroactive back to the month following the month of application.

However, if Captain Jim must transition to a nursing home, and he becomes eligible for Medicaid and is single, he will only receive $90 a month as his benefit.

statewide mediCaid maNaged Care – loNg-term Care

(Previously Community Care – Medicaid)Generally, the qualifying rules are the same as they

are for the previously described nursing home Medicaid benefit. The difference is basically where the services are provided. This program was designed to forestall or delay the admission of individuals to nursing homes. The state recognizes that it is much more costly to pay for patients in a nursing home rather than at an assisted-living facility or at home.

The Statewide Medicaid Managed Care – Long-Term Care is a program that provides home and community-based services to individuals who meet nursing home levels of care but who could really get by in the community. It is also a program whereby assisted living facilities can participate and be reimbursed by the State of Florida which, based on a formula, will reimburse a portion of the care expenses to the ALF based on the individual’s level of care. The applicant then pays all other room and board costs as may be charged by the ALF over and above the costs the state will pay.

Stephen J. Lacey

The advantage of this program is that care can be provided in the home, assisted living facilities or adult day care. It is common to see about $1,000/month off the ALF bill. Home care services are customized and varied but can include the limited provision of home health aides, care managers, meals, cleaning, assistance with bathing, and nurse visits.

However, there are a few problems with this program. One is that not all assisted-living facilities have signed up to participate. Another is that it is dependent upon adequate state funding that at times creates waiting lists.

Another part of the Statewide Medicaid Managed Care – Long-Term Care Program provides care for individuals who are currently in a nursing home and qualify medically to go home or to an assisted living facility. Again, adequate state funding is a determining factor.

Pre-PlaNNiNg vs. Crisis PlaNNiNg“If you don’t design your own life plan, chances are

you’ll fall into someone else’s plan. And guess what they have planned for you? Not much.”

We see two types of cases in our office: pre-planning and crisis planning. Crisis plans involve individuals and/or families that come to our office because their loved one needs long-term care either now or in the very near future. With those types of cases, the strategies discussed above are utilized with very good results. The only problem being that oftentimes, the strategies are limited. In pre-planning cases, on the other hand, if done properly and early enough, the clients’ choices for addressing their long-term care needs are expanded and oftentimes we are able to protect 100 percent of the assets.There are a few different ways to achieve this:

1. Long-term care insurance.2.Givingtheassetsawaytochildrenorlovedones.We highly discourage this type of planning, as most of

the time, when the assets are needed again by the client, the assets are no longer available due to the fact that they have been spent by the child or loved one, or the monies have been caught up in the child or loved one’s personal problems such as divorce or creditor issues.3.Irrevocabletrusts.If properly drafted, there are certain types of trusts

available where the client is able to control their assets and retain a right to their income. Therefore, the client maintains their independence as long as possible.

Case studyMr. and Mrs. Walker are 76 years old. Unfortunately,

Mr. Walker had a stroke and is currently in a rehabilitation facility. Mr. Walker is due to be released and has a good prognosis. Mrs. Walker is scared that he may need a nursing home in the future and she is worried about how she would be able to pay for it without impoverishing herself. Mr. Walker is concerned about losing control of his assets. Mr. and Mrs. Walker have a combined income of $2,400 per month. Their joint assets total $553,500 which includes their house.

An irrevocable trust is discussed where Mr. and Mrs.Walker are able to maintain control of the assets and receive all income from the trust. While the transfers into the trust are considered uncompensated transfers for Medicaid purposes, Mr. and Mrs. Walker still wanted to go forth with the planning. They knew if they were able to stay out of a nursing home for five years after they completed the planning, ALL of their assets would be

protected thereafter and they would be instantly eligible for Medicaid.

It was also explained that if one of them were to go into the nursing home prior to the expiration of the five-year look back period, a determination could be made at that time whether it would be more cost effective to pay for the nursing home out of pocket until the five-year look back period has expired, or utilize all the other “crisis planning” strategies described above in order to qualify for Medicaid.

Mr. and Mrs. Walker were overjoyed to hear that they

8

9

could start planning now, and if a nursing home stay was required in the future, they felt much better that they had a plan in place to ensure they did not lose all of their hard-earned assets. Mrs. Walker then asked if such planning may be helpful for her brother who lost his wife to cancer three years ago. I assured her that many of the same options could be available to him also.

are tHere otHer stePs i sHould take?Once the decision is made that a loved one requires

long-term care, clients often begin to wonder if there are additional steps they should take.

There are steps which should be taken. Some of the recommendations should be taken by everyone, while others may or may not be necessary, depending upon your particular situation.Power of Attorney. This is a document that gives

someone the legal authority to make decisions for you if you cannot make decisions for yourself. There are significant differences between a power of attorney created for an elder client as compared to run-of-the-mill forms. In these, it is important to include the authority to create a qualified income trust, the authority to sign an assignment of support or execute a written consent to bar a Medicaid recipient from claiming a marital election share. The Power of Attorney document covers a whole host of situations, from the agent handling real estate, to dealing with bank accounts, to paying taxes, to almost anything you can think of from a financial standpoint. It is crucial that you have the appropriate financial power of attorney in place.

NOTE: THE SELECTION OF THE PERSON HOLDING THE POWER OF ATTORNEY SHOULD BE CHOSEN VERY CAREFULLY AS THAT PERSON BASICALLY HAS CARTE BLANCHE AUTHORITY TO CREATE LOSS AND LIABILITY TO THE PRINCIPAL.Health Care Surrogate. This document is used to

designate someone to make your health care decisions if you cannot make the decisions for yourself. People often have questions such as, “My husband and I have been married for 40 years, can he just make decisions for me?” Unfortunately, the law presumes that, no matter how long you have been married, or no matter how close you are to your loved one, if you have not given them authority to act for you under a proper health care surrogate, then you must have meant not to give them permission to act for you.

Having powers of attorney and health care surrogate documents in place is crucial when someone needs long-term care since their health may deteriorate to the point where your loved one can no longer communicate his or her wishes. If that is the case, then perhaps at the most

critical time, without the proper documents in place, you will not be able to make legal, financial, and even life and death decisions for your loved one.

And if your loved one loses the ability to give you authority under a power of attorney or health care surrogate, (i.e. if he or she can no longer understand and sign the documents) and then decisions need to be made, you will have to go to court and begin a costly legal process to be named their guardian or conservator.

From my experience as an elder law attorney who has helped lots of families, the reason why people often do not have powers of attorney in place is not because they did not want someone to manage things for them; oftentimes it is simply that they did not know they needed these documents. It comes as a shock when I tell clients that since this was never put in writing, they have no legal authority to make decisions for their spouse or parents.

HIPAA (Health Insurance Portability and Accountability Act) has imposed restrictions on physicians, hospitals and other health care providers regarding the release of clinical information about a patient. That poses problems for health care surrogates in getting necessary information on which to form a course of action. Therefore, it is extremely important that a client has an up-to-date health care surrogate so that health care providers will be able to give all detailed information to the health care surrogate.LivingWill. As Florida residents, it is hard to forget Terry

Schiavo. The living will is a document announcing the maker’s intent and wish that no heroic measures be taken to keep the maker alive should a terminal or other stated condition befall the maker. In order for this to occur, two physicians must separately examine the patient and certify the terminal condition. Be careful of forms given by hospitals, nursing homes and other organizations as these are generally too vague and enforcement might be a problem.

After executing a power of attorney, health care surrogate and living will, you and your family may need to consider other legal planning.Revisingwillsandtrusts: Whenever a “major life event”

occurs, attorneys recommend that you review your wills and trusts. Your current legal documents may no longer be appropriate. You may want to make changes that reflect the new circumstances. Having a life-threatening illness is a “major life event” worthy of review. The plans that were put into place when everyone was healthy may no longer be appropriate.

For instance, many clients set up what we call “sweetheart wills” in which each spouse leaves everything to the other, and then at the death of the second spouse, everything is left to the children. That may be exactly the wrong way to set things up now, given

10 Stephen J. Lacey

one spouse’s illness. It may be that things can be arranged in a better fashion so that if the “healthy spouse” passes away first, the assets can be put into a trust to benefit the spouse who is requiring long term-care … or perhaps the assets should be passed down to the children to protect these assets from Medicaid. This is where specific legal planning with an experienced attorney is critical.Changingpropertytitles:The way

in which your real estate is titled can be critically important. In some cases, if things are not handled properly now, then dealing with the property in the future could require going to court. Reviewing property titles is also an important part of planning.Strategies for financial gifts:

Consulting a knowledgeable attorney is especially important before you transfer any property or make any gifts. The attorney can help you review your financial situation to determine whether a gifting program or other financial strategy is appropriate. Making gifts can protect your family and help save your estate, but acting improperly can have severe legal consequences and can even make you ineligible for governmental benefits. Thus, it is crucial that you have sound advice.

legal assistaNCeAging seniors and their family members face many

unique legal issues. As you can tell from our discussion of the Medicaid program, the legal, financial and care planning issues facing the prospective nursing home resident and family can be particularly complex. If you or a family member needs nursing home care, it is clear that you need expert legal help. Where can you turn for that help? It is difficult for the consumer to be able to identify attorneys who have the training, skills and experience required to provide expert guidance during this most difficult time.

Generally, nursing home planning and Medicaid planning are aspects of the services provided by elder law attorneys. Consumers must be cautious in choosing an attorney and carefully investigate the attorney’s credentials.

Help your loved one get the nursing home care they deserve while legally protecting your family’s assets.

A Note on GuardianshipGuardianship is a legal process whereby the court,

based primarily on the opinions of various medical and social professionals, determines whether or not someone has the capacity to continue to handle their personal and financial affairs. Along with all the other unique legal issues that often face seniors, capacity issues are often at the top of the list. If you have taken the necessary steps such as executing a durable power of attorney and designating a health care surrogate to make decisions for you in case of incapacity, you may never run into a situation that requires a guardian be appointed for you. However, in cases where there may be financial exploitation or when a loved one refuses care, a guardianship may be the only solution to being able to make the financial and healthcare decisions that are in the best interest of a loved one. As you might expect, guardianships are quite costly as you must go through the court system and be represented by counsel. This is just one more reason to seek the advice of an attorney for preplanning. Although guardianships can be quite contentious, seeking an attorney that is well-versed in this area of the law is also important. l

Live Every MomentAt VITAS, hospice is about life and making the most of the time that you have left. We deliver quality end-of-life care so residents of Brevard can live every moment.

• VITAS has been caring for patients since 1978.

• VITAS offers 24-hour Intensive Comfort Care® when needed at home.

• Clinical staff is always just a call away, 24-hours a day.

• When patients need care beyond what can be provided at home, the VITAS Inpatient Hospice Unit at the Courtenay Village provides a home away from home.

• VITAS has special services for veterans. Additionally, we offer massage therapy, pet therapy, music therapy and other services to enhance you or your loved one’s care.

For Information: 1.800.723.3233For Admissions and Referrals: 321.751.6671 • VITAS.com/Floridatwitter.com/VITASHospice

12 Stephen J. Lacey

NursiNg HomesAnchor Care & Rehabilitation Center1515 Port Malabar Blvd. NEPalm Bay, FL 32905321-723-1235www.signaturehealthcarellc.com

Atlantic Shores Nursing Home & Rehab Center4251 Stack Blvd.Melbourne, FL 32901321-953-2219www.atlanticshoresrehab.com

AvanteatMelbourne1420 S. Oak StreetMelbourne, FL 32901 321-723-3215www.avantecenters.com

Carnegie Gardens Nursing Center1415 S. Hickory StreetMelbourne, FL 32901321-723-1321www.gulfcoasthealthcare.com

ConsulateHealthCareofMelbourne3033 Sarno RoadMelbourne, FL 32934321-255-9200www.consulatehealthcare.com

CourtenaySpringsVillage1100 S. Courtenay ParkwayMerritt Island, FL 32952321-452-1233www.courtenayspringsvillage.org

HealthCenterofMerrittIsland500 Crockett Blvd.Merritt Island, FL 32953321-454-4035www.healthcentermerrittisland.com

Huntington Place Care & Rehabilitation Center1775 Huntington LaneRockledge, FL 32955321-632-7341www.genesishcc.com

IndianRiverCenter7201 Greenboro DriveWest Melbourne, FL 32904321-727-0990www.opismr.com

Island Health and Rehabilitation Center125 Alma Blvd.Merritt Island, FL 32953321-453-0202www.islandhealthandrehab.com

LifeCareCenterofMelbourne606 E. Sheridan RoadMelbourne, FL 32901321-727-0984www.lcca.com

LifeCareCenterofPalmBay175 Villa Nueva AvenuePalm Bay, FL 32907321-952-1818www.lcca.com

Melbourne Terrace Rehabilitation Center251 Florida AvenueMelbourne, FL 32901321-725-3990www.melbourneterracerehab.com

Palms Rehabilitation & Healthcare Center5405 Babcock Street NEPalm Bay, FL 32905321-722-0660www.thepalmsrehab.com

Rockledge Health & Rehabilitation Center587 Barton Blvd.Rockledge, FL 32955321-632-6300www.greystonehcm.com

Royal Oaks Nursing and Rehab Center2225 Knox McRae DriveTitusville, FL 32780321-267-0060www.royaloaksnursingandrehab.com

TitusvilleRehabilitation& Nursing Center1705 Jess Parrish Court Titusville, FL 32796321-269-5720www.titusvillehealthandrehab.com

VistaManor1550 Jess Parrish CourtTitusville, FL 32796321-269-2200www.vistamanorhealthcare.com

West Melbourne Health & Rehabilitation Center2125 W. New Haven AvenueWest Melbourne, FL 32904321-725-7360www.westmelbournehealthandrehab.com

WuesthoffProgressiveCareCenter8050 Spyglass Hill RoadViera, FL 32940321-752-1000www.wuesthoff.com

assisted liviNg faCilitiesAutumn House7999 Spyglass Hill RoadViera, FL 32940321-242-1006www.autumnhouseflorida.com

F inding care and placement for your loved one can be a difficult decision. Finding your path is much easier if you have a listing of resources. We have compiled such a list consisting of the

following sections: Nursing Homes, Assisted Living Facilities, In-Home Agencies, Adult Day Care, Care Management, Hospice, Hospitals, Other Resources (such as Placement Agencies, Geriatric Physicians, Caregiver Support) and Important Numbers. In addition to these listings, there are small group homes. Working directly with a Senior Placement Agency or Care Manager may help you make the decision for your loved one’s future. For a full listing of facilities or providers please visit the website of the Agency for Health Care Administration (AHCA). www.ahca.myflorida.com

Remember to “Be the advocate for your loved one and ask many questions.”

13

BentonHouseofTitusville497 N. Washington AvenueTitusville, FL 32796321-383-2112www.bentonhouse.com

Bethesda on Turkey Creek2800 Fordham Road NEPalm Bay, FL 32905321-723-3288www.bethesdaonturkeycreek.com

TheBrennityofMelbourne7365 Orchestra LaneMelbourne, FL 32940321-253-7450www.brennitymelbourne.com

The Brookshire85 Bulldog Blvd.Melbourne, FL 32901321-984-7966

BuenaVidaEstates2129 W. New Haven AvenueWest Melbourne, FL 32904321-724-0060www.buenavidaestates.org

CedarCreekLifeCenter4279 Judith AvenueMerritt Island, FL 32953321-454-7768www.cedarcreekalf.com

Century Oaks4001 Stack Blvd.Melbourne, FL 32901321-722-4440www.century-oaks.org

ClareBridgeofWestMelbourne7199 Greenboro DriveWest Melbourne, FL 32904321-954-4455www.brookdaleliving.com

Emeritus at Melbourne1765 W. Hibiscus Blvd.Melbourne, FL 32901321-733-7111www.emeritus.com

FountainsofMelbourne4451 Stack Blvd.Melbourne, FL 32901321-984-1494www.kiscoseniorliving.com

Glenbrooke at Palm Bay815 Briar Creek Blvd. NEPalm Bay, FL 32901321-956-3330www.seniorlifestyle.com

GrandvillaofMelbourne964 South Harbor City Blvd.Melbourne, FL 32901321-725-0300www.grandvillamelbourne.com

Hibiscus Court540 E. Hibiscus Blvd.Melbourne, FL 32901321-951-1050www.hibiscuscourtmelbourne.com

LaCasaAssistedLiving220 N. Grove StreetMerritt Island, FL 32953321-426-5505www.lacasaassistedliving.com

Ocean Breeze Gardens535 Jackson AvenueSatellite Beach, FL 32937321-610-7056www.oceanbreezegardens.com

PalmCottagesofRockledge3821 Sunnyside CourtRockledge, FL 32955321-633-1819www.palm-cottages.com

The Place at Merritt Island535 Crockett Blvd.Merritt Island, FL 32953321-454-2363www.theplaceatmerrittisland.com

RiverviewRetirementCenter4470 S. Washington AvenueTitusville, FL 32780321-383-2125

SandPointSeniorLiving1800 Harrison StreetTitusville, FL 32780321-383-6000www.brookdaleliving.com

Sonata at Melbourne 3260 N. Harbor City Blvd.Melbourne, FL 32935321-600-4747www.sonatamelbourne.com

SouthlandSuitesofMelbourne2680 Croton RoadMelbourne, FL 32935321-255-5443www.brookdaleliving.com

SterlingHouseofWestMelbourneI7300 Greenboro DriveMelbourne, FL 32904321-953-6464www.brookdaleliving.com

SterlingHouseofWestMelbourneII7200 Greenboro DriveMelbourne, FL 32904321-725-3100www.brookdaleliving.com

TitusvilleTowers405 Indian River AvenueTitusville, FL 32796321-267-4204www.titusvilletowers.com

TheTownSquareatViera1700 Wuesthoff DriveMelbourne, FL 32940321-255-6030www.wuesthoff.com

VictoriaLanding1279 Houston StreetMelbourne, FL 32935321-622-6730www.victorialanding.com

VieraManor3325 Breslay DriveMelbourne, FL 32940321-735-8850www.vieraassistedliving.com

iN-Home Care ageNCiesAll In-home Care Agencies hold a wide variety of licensing. They service clients for Medicare/Medicaid, Private Duty and Com-panion Care. Make sure to ask questions to see what service the agency provides.

ACTELL Elderly Care2955 Pineda Plaza Way, Unit 123Melbourne, Florida 32940321-242-0950www.actellelderly.com

AgeAdvantageHomeCareServices1398 Palm Bay Road NEPalm Bay, Florida 32905321-676-0103www.ageadvantage.com

14 Stephen J. Lacey

Amedisys Home Health ofMelbourne3962 W. Eau Gallie Blvd., Ste CMelbourne, FL 32934321-751-1901www.amedisys.com

American Eldercare, Inc.160 Sarno Road, Ste 108Melbourne, FL 32935321-421-1521www.americaneldercare.com

CaregiversforSeniors768 Norse Street NWPalm Bay, FL 32904321-722-2242www.caregiversforseniors.com

Champion Home Health Care344 5th AvenueIndialantic, FL 32903321-608-3838www.championhome.com

ComfortKeepers327 S. Washington AvenueTitusville, FL 32796321-268-3310and West Melbourne321-733-2787www.comfortkeepers.com

ComfortsofHomeCare Associates Inc.517 C N. Harbor City Blvd.Melbourne, FL 32935321-255-0107and 1107 S. Washington AvenueTitusville, FL 32780321-383-8643www.comfortsohc.com

CornerstoneHomecareServices1900 Harbor City Blvd., Ste 320Melbourne, FL 32901321-821-7793www.cornerstonehomecarefl.com

CSI Nurse World1220 E. Prospect Avenue, Ste 209Melbourne, Florida 32901321-722-0009www.csicaregiver.com

FamilyHomeHealthServices2295 W. Eau Gallie Blvd., Ste CMelbourne, FL 32935321-752-4495www.fhhs.us

GentivaHealthServices8247 Devereux Drive, Ste 103Melbourne, FL 32940321-255-9995and1333 Gateway Drive, Ste 1020Melbourne, FL 32901321-725-4799www.gentiva.com

Health First Home Care200 S. Courtenay ParkwayMerritt Island, FL 32952321-434-5909www.health-first.org

Health First Home Companions220 S. Courtenay Parkway, Ste CMerritt Island, FL 32952321-459-1804www.health-first.org

HealthFirstPrivateDuty220 S. Courtenay Parkway, Ste CMerritt Island, FL 32952321-459-1804www.health-first.org

Home Instead Senior Care2351 W. Eau Gallie Blvd., Ste 1Melbourne, FL 32935321-751-1003www.homeinstead.com

InnovativeSeniorCareHomeHealth51 Carolina Street, Ste 104West Melbourne, FL 32904321-952-5550www.brookdaleliving.com

LevinHomeCareNurseRegistry1900 S. Harbor City Blvd., Ste 209Melbourne, FL 32901321-768-0958www.levinhomecare.com

MaximHealthCareServices1990 W. New Haven Avenue, Ste 105Melbourne, FL 32904321-951-0011www.maximhealthcare.com

MederiCaretenders1071 Port Malabar Blvd. NE, Ste 205Palm Bay, FL 32905321-308-0321www.almostfamily.com

NHC Home Care2395 N. Courtenay Pkwy, Ste 101Merritt Island, FL 32952321-459-9111

Parrish Home Health830 Century Medical Drive, Ste ATitusville, FL 32796321-268-6275www.parrishmed.com

ResCare Homecare635 S. Wickham Road, Ste 204Melbourne, FL 32904321-676-5088www.rescarehomecare.com

Senior Home Care5545 N. Wickham Road, Suite 110Melbourne FL 32940321-452-5633www.seniorhomecare.net

Senior Bridge1510 S. Harbor City Blvd.Melbourne, FL 32901321-728-9530www.seniorbridge.com

SeniorPartnerCareServices8085 Spyglass Hill RoadViera, FL 32940321-253-6336www.seniorpartnercare.com

VisitingAngels474 N. Harbor City Blvd., Unit 2Melbourne, FL 32935321-953-8730www.visitingangels.com

15

VisitingHomecare2415 S. Babcock Street, Ste EMelbourne, FL 32901321-574-1622www.getvhc.com

VNASpaceCoast1600 Sarno Road, Ste 201Melbourne, FL 32935321-752-7550www.vnatc.com

WuesthoffBrevardHomecare8060 Spyglass Hill RoadViera, FL 32940www.wuesthoff.com

YourCareofBrevardBrevard Alzheimer’s Foundation4676 N. Wickham RoadMelbourne, FL 32935321-253-4430www.yourcarebrevard.org

adult day CareAllOneFamilySeniorDayProgram585 N. Courtenay Parkway, Ste 101Merritt Island, FL 32953321-453-6577www.allonefamilyseniordayprogram.com

HeydaysSeniorDayProgram210 N. Grove StreetMerritt Island, FL 32953321-474-8289www.heydaysongrove.com

Joe’s Club4676 N. Wickham RoadMelbourne, FL 32935321-253-4430www.brevardalzheimers.orgMicco & Titusville Locations

River’sEdgeDayCare422 Martin Road SEPalm Bay, FL 32909321-727-7337

SarahCareofMelbourne1504 S. Harbor City Blvd.Melbourne, FL 32901321-676-3460www.sarahcare.com

SeniorCareofBrevard234 Willard Street, Ste ACocoa, FL 32922321-631-9014www.seniorcareofbrevard.com

YourSecondHomeAdultDayCare3702 N. Courtney ParkwayMerritt Island, FL 32953321-986-8500

seNior PlaCemeNt ageNCiesA Granddaughter’s Promise“Elder Placement Advisors”321-676-6553 – Office954-839-4889 – Chrissy Canavan321-536-6409 – Sarah Newmanwww.gdpromise.com

Senior-Linx“Resource and Referral Center”210 N. Grove StreetMerritt Island, FL 32953321-474-8289www.senior-linx.com

Care maNagemeNtAdvocatesfortheAgingPO Box 429Melbourne, FL 32902321-953-2273

Case Management & Counseling ServicesofBrevard1555 Port Malabar Blvd. NE, Ste 103Palm Bay, FL 32905321-956-6004www.casemanagementofbrevard.com

Indequest3661 S. Babcock StreetMelbourne, FL 32901321-453-7100800-422-7364www.indequest.com

KrasnyGuardianship&Case ManagementServicesP.O. Box 33095Indialantic, FL 32903321-752-7688 www.krasnyguardianship.com

One Senior Place Care Management8085 Spyglass Hill RoadViera, FL 32940321-253-6330www.oneseniorplace.com

PrivateCaseManagement2078 Meadowlane AvenueWest Melbourne, FL 32904321-674-6076

Total Long-Term Care ConsultantServicesPO Box 411928Melbourne, FL 32941321-752-0995www.tlcconsultantservices.com

HosPiCeHospiceofHealthFirst1900 Dairy RoadWest Melbourne, FL 32904321-952-0494www.health-first.org

HospiceofSt.Francis1250-B Grumman PlaceTitusville FL 32780321-269-4240www.hospiceofstfrancis.com

VitasInnovativeHospiceCare4450 W. Eau Gallie Blvd., Ste 250Melbourne, FL 32934321-751-6671www.vitas.com

WuesthoffBrevardHospice8060 Spyglass Hill RoadViera, FL 32940321-253-2222www.wuesthoffhospice.org

HosPitalsCapeCanaveralHospital701 W. Cocoa Beach CausewayCocoa Beach, FL 32931321-799-7111www.health-first.org

CirclesofCare400 E. Sheridan RoadMelbourne, FL 32901321-984-4900www.circlesofcare.org

16 stephen J. lacey

Health South Sea Pines Rehabilitation Hospital101 E. Florida AvenueMelbourne, FL 32901321-984-4600www.healthsouthseapines.com

Holmes Regional Medical Center1350 S. Hickory StreetMelbourne, FL 32901321-434-7171www.health-first.org

KindredHospitalMelbourne765 W. NASA Blvd.Melbourne, FL 32901321-733-5725www.kindredhealthcare.com

Palm Bay Hospital1425 Malabar Road NEPalm Bay, FL 32904321-434-8000www.health-first.org

Parrish Medical Center951 N. Washington AvenueTitusville, FL 32796321-268-6110www.parrishmed.com

VieraHospital8745 N. Wickham RoadMelbourne, FL 32940321-434-9000www.health-first.org

WuesthoffMedicalCenter–Melbourne250 N. Wickham RoadMelbourne, FL 32935321-752-1200www.wuesthoff.com

WuesthoffMedicalCenter–Rockledge110 Longwood AvenueRockledge, FL 32955321-636-2211www.wuesthoff.com

HealtH first agiNg iNstituteCenterforFamilyCaregivers3661 S. Babcock StreetMelbourne, FL 32901321-434-7628www.centerforfamilycaregivers.org

Geriatric PhysicianDr. “Visa” Srinivasan3661 S. Babcock StreetMelbourne, FL 32901321-727-3370

Geriatric PhysicianDr. Rosemary Laird220 S. Courtenay ParkwayMerritt Island, FL 32952321-868-5815

East Central FloridaMemoryDisorderClinic3661 S. Babcock StreetMelbourne, FL 32901321-768-9575www.ecfmdc.org

otHer resourCesAging&DisabilityResourceCenter800-963-5337www.sraflorida.org

AgencyforHealthCare Administration (AHCA)888-419-3456www.ahca.myflorida.com

BrevardAlzheimer’sFoundation4676 N. Wickham RoadMelbourne, FL 32935321-253-4430www.brevardalzheimers.org

Aging Matters(formerly Community Services Council)3600 W. King StreetCocoa, FL 32926321-639-8770www.agingmattersbrevard.org

Meals on Wheels321-639-8770

FloridaDepartmentofElderAffairs(CARES Unit)1970 Michigan Avenue, Bldg. J WestCocoa, FL 32922321-690-6445www.elderaffairs.state.fl.us

One Senior Place8085 Spyglass Hill RoadViera, FL 32940321-751-6771www.oneseniorplace.com

Senior Resource Alliance988 Woodcock Road, Suite 200Orlando, FL 32803www.seniorresourcealliance.org

imPortaNt NumbersAARP–Florida1-866-595-7678

BrevardCountyTRIADPO Box 410518Melbourne, Florida 32941321-632-6688 or call 2-1-1

CommunityCarefortheElderly(CCE)321-631-2746

Elder Abuse Hotline1-800-96-ABUSE (1-800-962-2873)

Elder Helpline1-800-963-5337

FloridaDepartment ofChildrenandFamiliesMedicaid Services1-866-76ACCESS or 1-866-762-2237

Long-Term Care Ombudsman Program1-888-831-0404www.ombudsman.myflorida.com

Medicare1-800-633-4227www.medicare.gov

National Family CaregiverAssociation1-800-896-3650www.nfcacares.org

SHINE (Serving Health Insurance Needs of Elderly)Melbourne, FL 321-752-8080www.FloridaSHINE.org

SunflowerHouseCaregiver Resource Center Merritt Island, FL321-452-4341

Social Security1-800-772-1213www.ssa.gov

VeteransAdministration1-800-827-1000Viera Office 321-633-2012 www.va.gov

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RockledgeHealth First Health Plans 6450 US Highway 111/9/13, 9:30 am

VieraOne Senior Place8085 Spyglass Hill Road11/11/13, 1 pm11/18/13, 5:30 pm11/23/13, 9:30 am12/2/13, 9:30 am & 5:30 pm12/17/13, 1 pm

Viera Pro-Health & Fitness8705 N Wickham Road11/6/13, 9:30 am11/6/13, 1 pm

HEALTH INSURANCE HOSPITALS MEDICAL GROUP OUTPATIENT SERVICES

Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, co-payment, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings call 1.800.716.7737 or TDD/TTY relay 1.800.955.8771. *One gift card available to all Medicare eligibles who RSVP and attend a sales seminar with no obligation to enroll in the plan.

Y0089_EL3495 Accepted 09212013

My Medicare Advantage plan must let me keep my doctor.

GIFT CARD

Medicare Advantage Must-Haves

Extensive network of doctors

Vision, hearing and dental allowances

No or low doctor copays

Free $10 gift card

Medicare Advantage Must-Haves: How to Get Exactly What You Need.

Not a Health First Health Plans member? Attend one of our sales seminars and learn how our 2014 Medicare Advantage plan benefits can work for you. Don’t wait, RSVP today!

At Health First, we know that keeping your own doctor is important to you. That’s why we continually add more doctors and specialists every day, so that we can grow our network and serve you better. It’s just another way that Health First Health Plans puts your needs first in everything that we do.

Get a FREE $10 gift card* – just for attending one of our sales seminars.

MelbourneHealth First Medical Group1223 Gateway Drive11/8/13, 9 am11/15/13, 9 am12/6/13, 9 am

Health First Holmes Regional Medical Center1350 S Hickory Street11/12/13, 9:30 am11/22/13, 3 pm11/27/13, 9:30 am12/5/13, 10 am & 2 pm

Melbourne Pro-Health & Fitness611 E Sheridan Road 11/2/13, 9:30 am

Palm BayThe Knowledge Exchange5151 Babcock Street11/7/13, 9:30 am & 1 pm11/14/13, 9:30 am & 1 pm11/21/13, 9:30 am & 1 pm11/26/13, 1 pm12/4/13, 9:30 am & 1 pm

www.HealthFirstHealthPlans.org









Y0089_EL3495 Accepted 09212013


GIFT CARD





Free $10 gift card


















Y0089_EL3495 Accepted 09212013


GIFT CARD





Free $10 gift card










Finding Your Path-The Senior's Guide

Documents

Transcript of Finding Your Path-The Senior's Guide