How can
I find out more about my health care options?
Call or visit Washoe
County Senior Services at 1155 E. Ninth Street in Reno, 775-328-2575,
and request Information & Referral. Information & Referral
is available in English and Spanish.
Can I get health insurance after I retire?
If you retire
before age 65, you should investigate any insurance options available to you
through your employer for retirement. Qualifying
for private insurance may be difficult and it will be costly. At
age  65
or over, you can get Medicare insurance. If you
have not paid into the Medicare system during your working years,
Medicare will be costly, but less expensive than private insurance. Some
people with disabilities can get Medicare prior to age 65.
What is Medicare?
Medicare is the federally-funded
medical insurance plan for Americans age 65 and over and for some people with
disabilities under age 65. Medicare Part A covers hospitalization. Medicare
part B covers doctor visits and other routine medical care. Medicare
part D covers prescription medication. For Medicare information
and counseling, please call or visit Washoe County Senior Services
at 1155 E. Ninth Street in Reno, 775-328-2575, and request to speak
with a State Health Insurance Assistance program (SHIP) counselor. SHIP
counselors are also available through a Statewide Call Center at 1-800-307-4444 or 1-800-MEDICARE.
What is Medigap?
Medigap is a private insurance that
covers the gaps left by Medicare. State and federal regulation of Medigap insurance
seeks to make it affordable to many seniors. For Medicare information and counseling,
including some Medigap questions, please call or visit Washoe County
Senior Services at 1155 E. Ninth Street in Reno, 775-328-2575,
and request to speak with a State Health Insurance Assistance program
(SHIP) counselor. SHIP counselors are also available through a
Statewide Call Center at 1-800-307-4444 or 1-800-MEDICARE. A Medicare
Supplemental Insurance Premium Comparison Guide is available by
contacting the Nevada Division of Insurance at 775-687-4270.
Do I need long-term care insurance?
Medicare generally does not pay
for long term care in or out of a care facility. Medicaid will generally cover long term
care if you meet low income and asset requirements. Not all
long term care providers accept Medicaid. You may benefit
from long-term care insurance if you want to protect your income
and assets or if you want to choose a non-Medicaid provider or facility.
As a veteran, can I get additional health benefits?
Maybe. Contact the Department of Veterans Affairs at 800-827-1000
or one of the assistance organizations listed on page 15.
How do I pay for Nursing Home Care?
Nursing home care now costs about $6,000 per month. Medicare may
pay for skilled care for a period of 20 to 100 days. Skilled care
is when a person needs physical or occupational therapy or has
an invasive medical procedure. Custodial care, which is all many
people may need, is not covered by Medicare. The sources of payment
for custodial (basic) care are long-term care insurance, private
funds or Medicaid.
Medicaid is a joint federal-state program. If you need Medicaid
to pay for a nursing home, certain assets are exempt, meaning you
get to keep those assets. Exempt assets are the family home with
an unlimited value if you are married (value limit is $500,000
for a single person); household goods; a vehicle; certain burial
arrangements; real estate up for sale; a family business; and up
to $2,000 of other assets in the name of the person in the nursing
home.
Spouses of nursing home residents also have additional rights
to help them stay out of poverty. A nursing home spouse can keep
up to $104,400 of savings plus all of his or her income and if
this amount is less than $2,610 per month, the at-home spouse can
keep part or all of the nursing home spouse’s income to provide
$2,610 per month for the at-home spouse.
If a person applying for Medicaid or his or her spouse has made
any gifts during the 60 months prior to applying for Medicaid,
a period of ineligibility will result. The person needing Medicaid
will be denied benefits for one month for each $5,714 that is gifted.
The penalty starts from the date Medicaid is sought.
Medicaid has the right to get paid back from the Medicaid recipient’s
estate upon that person’s death. However, Medicaid cannot seek
recovery of the cost of care so long as the widow or widower is
alive.
(Please note that these figures are for 2008 and change on a yearly basis.)
What are my rights associated with nursing homes?
Most nursing homes are required to comply with Medicare and Medicaid
regulations designed to protect you. Such regulations guard against
your improper discharge, require training of the nursing home staff
to ensure better care and guard against abuse and neglect by nursing
home personnel. Nevada Health Division’s Bureau of Licensure and
Certification is charged with enforcing such regulations as well
as the state’s own regulations. The state’s Division for Aging
Services’ Ombudsman program assists to make sure that nursing homes
are not violating resident’s rights. (See Resources) If you suspect
there are problems you should contact the above agencies. You also
may want to contact an attorney. (See Resources)
How can I help ensure that my affairs will be handled my way if I become unable to make my own decisions?
You can take certain legal steps. A power of attorney is a written
legal document that gives another person the right and authority
to act on your behalf. That authority will end if you become incompetent
– unless you have a durable power of attorney. A durable power
of attorney will remain in effect if you ever become incompetent.
This means that if you were suddenly unable to handle your own
affairs, someone you trust – your legal agent or attorney-in-fact—could
do so
for you. Or, you might choose to set up a springing power, which
would only become effective at a specified future date or event
(such as if you were to become incompetent).
You can authorize your agent to simply pay your bills. (This is usually a safer arrangement than adding someone else’s name to
your bank account). Or you can give your agent the power to handle
nearly all of your affairs. These powers of attorney all expire
when you die. Make sure that you understand all the terms before
signing a power of attorney. And be absolutely certain that your
chosen agent is both capable and trustworthy. Seniors have lost
their life savings to
unscrupulous agents – even to agents who are family members.
You can also prepare written, legal documents to take care of
decisions regarding your health care. They are called “advanced
directives.” Advance directives allow you to state your choices
for health care or to name someone to make those choices for you
if you become unable to make decisions about your medical treatment.
In short, an advance directive lets you make decisions about your
future medical treatment. You can say “yes” to treatment you want,
or say “no” to treatment you do not want.
The two most common forms of advance directives are “Living Wills”
and “Durable Powers of Attorney for Health Care Decisions.” In
Nevada, a living will is a declaration directing a physician to
withhold or withdraw life-sustaining treatment such as respirators
and kidney dialysis that will only delay your death. It will go
into effect if you have an incurable, irreversible condition and
you are not able to communicate your desires.
A “living will” should not be confused with a will or a living
trust, which serve different purposes.
Many people are concerned that if they execute a Living Will they
will not receive pain medication or food and water. Nevada law
specifically provides that the execution of a Living Will does
not affect the responsibility of your doctor to provide treatment
for your comfort or the alleviation of pain. With respect to food
and water, you may state in your Living Will that you do not want
food and water withheld or withdrawn.
In Nevada, a “Durable Power of Attorney for Health Care Decisions”
is a signed, dated and witnessed paper naming another person, such
as a husband, wife, daughter, son or close friend as your “agent”
or “proxy” to make medical decisions for you should you become
unable to make them yourself. You can include instructions about
treatment you want to avoid, such as surgery or artificial feeding.
If you choose to have an advance directive, you should make sure
that someone, such as a close friend or family member, knows you
have one and knows its location. You should keep it in a safe place
where it can be found easily. You should also keep a small card
in your purse or wallet which states you have an advance directive
and where it is located. Lastly, you should
ask your physician to make your advance directive part of your
permanent medical record.
If you are over the age of 60 and a Washoe County resident, you
may also obtain assistance from the Senior Law Project by calling
(775) 328-2592 or go to www.NevadaDirectives.org and download the
forms. You may also fill out the form at www.NVLivingWill.com. You
may have your advanced directives securely filed electronically
so that your health care provider can read it at LivingWillLockBox.com.
What is hospice care?
Hospice care is a program – usually a mix of physical, emotional,
spiritual and practical care – for the terminally ill. It may take
place in a patient’s home or in a specially designed facility.
A doctor’s prescription is required for participation. Payment
is often on a sliding scale based on income. Medicare covers hospice
care as do other insurance programs. |
