Linda L. Kordes, Attorney at Law
NEWS
- Oct 1, 2010 - The article focuses on the need for a well-drafted and executed power of attorney to delegate authority on behalf of an elderly or disabled person, and where none exists, the need to then commence a guardianship proceeding to obtain that same authority. Guardianships are expensive, time consuming, and, in many cases, difficult to win. Two case studies present unique issues of law within the scope of the Mental Hygiene laws, the statutes that govern most aspects of the guardianship proceeding.
- July 25, 2008 - The New York State budget reflects a substantial increase in the Medicaid resource limits: from $4,350.00 to $13,050.00 for a single applicant.
- Sept 19, 2007 - We are pleased to announce that we now accept American Express for all payments and services. This will provide our clients with a larger variety of payment options.
- Aug 6, 2007 - Anyone who does not wish to be kept alive in the event of a persistent vegetative state resulting from illness or injury should prepare specific written directives.
Guardianship Concerns in New York State
Medicaid Resource Limit Increase
American Express Now Accepted for Payments
Health-Care Proxies
Seniors Often Must Fight for Medicare Home Health Benefits
Medicare is mandated to cover your home health benefits with no limit on the time you are covered. Unfortunately, few Medicare beneficiaries get the level of service they are entitled to and many find their services cut off prematurely. Getting these benefits can be critically important. Medicare home health care benefits can mean the difference between being able to stay at home with a difficult medical problem or ending up in the hospital or a nursing home.
As a Medicare recipient, you are entitled to full home health benefits if you meet the following requirements:
- You must be confined to your home – meaning that leaving it to receive services would be a "considerable and taxing effort."
- Your doctor must have ordered home health services for you.
- At least some element of the services must be skilled – skilled nursing care, physical therapy, or speech therapy.
- You must receive the services from a certified home health agency.
Requiring an element of skilled care also will entitle you to Medicare coverage of social services, home health aide services, and the necessary medical supplies and equipment. You won't have to pay anything for the home health benefits, but you will have to pay 20 percent of the supplies and equipment.
“Under the law, you are entitled to 35 hours of service a week, but few Medicare beneficiaries who meet the home health care criteria actually get this level of service.”
Under the law, you are entitled to 35 hours of service a week, but few Medicare beneficiaries who meet the home health care criteria actually get this level of service. If your services are terminated prematurely, you will need to appeal. If you have to appeal, the good news is that most people win their cases. In fact, 81 percent are successful on appeal to an administrative law judge.
If you can you should continue to pay privately for the care during the process. Remember – the issue you are appealing is not the termination of service, but the denial of Medicare payment for the service.
In order to mount a successful campaign to get your services back, you should:
- Ask your home health agency to explain the cutback and write the information down.
- Ask your physician to call the agency urging them not to cut back the services and, then have the physician send a letter detailing the level of care you need.
- Consult with a Medicare assistance agency or your attorney to determine the likelihood of a successful appeal.
- If you decide to appeal, do so immediately and make sure you make arrangements to pay privately pending the result of the appeal.