Medicaid and Senior Care in the New Year

 
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Budget Cuts

Next year is only 6 days away, but many seniors and their families are worried about what it’ll mean for themselves. Minnesotans, for example, are facing potential benefit cuts in January that could result in reduced care…or even none at all. The state feels that Medicaid spending has runaway, and the Department of Human Services (DHS) will implement stricter rules that make it more difficult for seniors to qualify for home-based services, saying “the changes will save taxpayers nearly $50 million in the next four years.”

However, what this amounts to is about 2,800 seniors suddenly being removed from the program and left to find – and pay for – assistance on their own. Basic essential activities like washing themselves or cooking meals will take on added difficulty, as seniors will soon face having to take them on themselves without the aid of others. Seniors most affected by the change are the 22,600 low-income seniors who take part in Medicaid’s “Elderly Waiver” program, one which averages about $1,200 per month per senior that allows them to pay for services and supplies that allow them to stay in their own homes longer.

Now, the new criteria under the “Elderly Waiver” program will mean that seniors will have to either show need of assistance in a minimum of four activities of daily living, or one critical activity (e.g. using the toilet, transferring themselves from one location/structure to another, etc.) But to safeguard against seniors suddenly going homeless, the DHS has said it will not apply the cuts to seniors who are at risk of neglect or homelessness, or who have suffered a fall-related broken bone in the last 12 months (among other protections.)

First Time Use

For Americans who aren’t yet seniors, January 1st is the first day they’ll be able to test drive their ObamaCare health insurance. There’s no way to predict exactly how it’ll go, especially in light of the website’s difficulties, but here are a couple of things to look out for:

  • Latecomers who have put off signing up for health insurance have been given an extra day to ensure they’re not one of the expected 500,000 without health care on New Year’s Day.
  • Anyone whose plan has been canceled still has an option to get health insurance through a recent introduction called the “catastrophic health plan” (a sort of “light” version of insurance), making them temporarily exempt from the law’s individual mandate.
  • First time premiums payments aren’t officially-officially due (just this once!) until January 10th, with users still being considered covered from the first of the month.
  • The administration will be sending reminder emails to people who have experienced errors signing up for insurance on the website.
  • Doctors will continue to provide healthcare to high-risk people and sort out insurance issues later, instead of demanding patients wait a month or two.
  • More people are eligible for Medicaid than for private insurance, meaning they have to pay less. One side effect of that is the volume of applications will increase, but the government has let those 36 states allow people to sign up with incomplete files.

 

Whether you’re a senior on Medicaid or a boomer with private health insurance, 6 days marks the start of the new year and what life will be like under ObamaCare.