Elder law is not taught as a specific subject in schools. Elder law is a relatively new field that developed out of a need for professional services. As the average life expectancy rises, more people are living far into their golden years, and society has discovered that they have certain legal requirements that must be addressed.
If you live in California, you have even additional aspects to take into account, such as Medi-Cal eligibility. A skilled professional is required to guarantee that senior health insurance is properly set up and that all of the necessary documents are in place. That's why it's critical that you consult with an elder law attorney in Los Angeles as soon as possible.
In this article, we will discuss the benefits of hiring an elder law attorney to assist you with Medi-Cal and long-term care difficulties.
What do Elder Law Attorneys do on a daily basis?
As a senior citizen, elder law attorneys are focused on safeguarding your rights, ensuring that you have control over your end-of-life care, and ensuring that your assets are transferred seamlessly to your designated beneficiaries.
While there are some difficulties that can be resolved by any normal lawyer, Los Angeles elder law attorneys have specialized training and understanding in areas that have a greater influence on the elderly. One of these challenges is navigating health insurance, specifically Medi-Cal.
A Look at the Basics of Medical Insurance
In the United States, when we talk about health insurance, we frequently refer to Medicare and Medicaid. These are two different health insurance plans that are both supported by the government. Despite the fact that they sound similar and are often misunderstood, the two are vastly distinct from one another.
Medicare
Medicare is a government health insurance program for anyone over the age of 65 who have not yet reached the retirement age. It is broken down into four sections:
Part A of the policy covers hospitalizations, nursing homes, and hospice care.
Part B functions in the same way as normal insurance. Physician visits, outpatient care and preventative services are all included under this plan.
Part C, often known as Medicare Advantage Plus, is a private insurance plan that works in conjunction with Medicare that you can purchase from a private firm. This curriculum will meet all of your Part A and Part B requirements.
The final option is Medicare Part D, which is a prescription drug coverage program.
Because of the extensive coverage provided by Medicare, as well as the large number of people seeking for free healthcare, insurance claims are frequently denied. A Los Angeles elder law attorney can assist you in resolving issues and ensuring that you are properly covered.
Medicaid
Medicaid is a federal health-care program that provides coverage for low-income adults and children, as well as their families. Your capacity to get Medicaid benefits is based on your income level. In the case of health insurance premiums, out of pocket payments, and long-term care, it can be extremely beneficial.
In order to use this program to pay for nursing home care, you must complete complicated applications and adhere to stringent criteria. An elder law attorney can assist you in developing an appropriate strategy to maximize your benefits while also ensuring that all of your documentation is completed appropriately.
What exactly is Medi-Cal?
Medi-Cal is a state-funded variant of Medicaid that is available only to residents of California. It gives financial assistance to persons with insufficient financial resources to cover their healthcare expenses. When compared to other health insurance plans, Medi-Cal has one significant advantage: it covers nursing home expenses. As a result, it is also one of the most important sources of aid for senior citizens in California. More information on medical planning can be found here.
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What role do elder law attorneys play in the Medi-Cal system?
With Medicaid, as well as Medi-Cal, the problem is that there are income and resource limits for this program, which might exclude people who have worked hard for many years and have accumulated a substantial amount of savings. Learn more about medical planning in Orange County by reading this article.
Consider the following strategies for navigating the Medi-Cal maze with the assistance of an elder law attorney in Los Angeles, CA:
You may be eligible for Medi-Cal.
If you are denied Medi-Cal coverage, you may be forced to pay for all of your medical expenditures out of your own money. When you apply for nursing home coverage, the biggest challenge is that insurance companies can look at your income for the previous five years and determine that you are financially secure enough to not require Medi-Cal assistance. Unless you plan ahead of time, you may be excluded from receiving benefits purely on the basis of when you apply.
In light of the complicated nature of the Medi-Cal application, as well as the numerous criteria and standards that must be met in order to qualify, it is critical to have someone on your side who is familiar with how to get around these road blocks.
For example, one method of qualifying for Medi-Cal is to "spend down," or diminish your assets, in order to become eligible for benefits. In order to accomplish this, seniors can give away their assets, but they do so at their own risk. For example, they may be taken advantage of by a family member, or they may be subject to inheritance taxes if they give away significant sums of their estate.
An elder law attorney can assist you in establishing a trust that moves some or all of your assets away from you in order for you to qualify for Medi-Cal while also maintaining your capacity to use those resources in the future.
Make a Long-Term Care Plan.
Because of the nature of long-term care planning, many people are reluctant to engage in it. Instead of depleting your assets or placing your loved ones in a terrible situation, you should develop a long-term care strategy in advance of needing assistance. A hefty price tag is attached to the services provided by hospitals, nursing homes, assisted living facilities, and rehabilitation facilities when they are paid for out of pocket.
The use of Medi-Cal and long-term care is subject to a number of timeframes, laws, and rules, all of which affect when and how money can be spent. When it comes to assisted living facilities, Medicare will pay a portion of the cost, but only for a limited period of time.
Many people believe that Medi-Cal will take over when Medicare is no longer available, but this is only true if the program is set up appropriately. Fortunately, an experienced elder law attorney in Los Angeles will be familiar with the ins and outs of the system, ensuring that you obtain the appropriate type of Medi-Cal support when you require it the most.
Claims Disputes Should Be Settled
Qualifying for Medi-Cal is a difficult endeavor in and of itself, and yet qualifying is the easy part when contrasted to the real process of filing claims. Some of the most typical denial reasons are failure to properly complete the documentation and failure to meet critical deadlines. You may also encounter problems if the medical codes that were used to generate your bills are not covered by your plan, if you utilize an out-of-network physician, or if you have used up all of your coverage for the year.
It's a certain way to deplete your finances if you pay for these desperately required services out of your own pocket. As a result, your estate will be worth significantly less, and you will have far less to offer to your family and friends.
An elder law attorney understands how to present a claim in the most effective manner so that it is accepted the first time. If your claim is denied by Medi-Cal, Medicare, or your own insurance carrier, your attorney can represent you by filing the required appeals with the appropriate agencies. Even if employing a lawyer first appears to be an unnecessary investment, it will end up saving you and your estate a significant amount of money in the long run.
Schedule an appointment with a Los Angeles elder law attorney today.
A consultation with an elder law expert is essential before you begin the process of submitting an application for Medi-Cal benefits. At the very least, you can take advantage of a free consultation to ensure that you understand the process before proceeding. Your attorney can ensure that you submit your Medi-Cal application at the appropriate time and in the proper manner.
By enlisting the assistance of someone who is familiar with the system to assist you with your application, claims, and appeals, you are increasing your chances of being approved. You have worked hard to accumulate your assets, and you have contributed to these programs; consulting with a Los Angeles estate planning attorney is the best approach to protect your possessions while maximizing the benefits of Medi-Cal and other government assistance programs.
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