How To Find The Best Medicare Elder Law Attorney Near Me

What Is Medicare And Why Must Seniors Know About This Program?

Medicare has long been a vital part of America’s healthcare landscape, especially for seniors. Many elder law attorneys handle cases involving Medicaid planning and VA (Department of Veterans Affairs) benefits claims, but the needs of seniors frequently overlap with Medicare as well, so having a broader understanding is useful both for estate planning and patient advocacy in elder law practice.
Medicare is a federal health insurance program, primarily for citizens aged 65 or older, and certain younger people with disabilities. Medicare is divided into four parts: Part A is usually premium-free, as long as the person has worked and made Medicare payroll deductions for at least 10 years. Part A covers hospitalization, and may cover skilled nursing facilities and home health care in some circumstances. It requires co-insurance and co-pays, and certain services, like dental work and outpatient prescription drugs, are typically excluded. Part B costs about $110/month (in addition to the Part A premium, if any), but Part B does not have as many co-pays and restrictions as Part A. It covers doctor’s visits, preventive tests, outpatient care, and other "durable" services such as x-rays, some home care services, and some medical equipment. It excludes dental care and eyeglasses, along with most emergency care while traveling outside the U.S. However, as with nearly all health insurance, there are many caveats, exceptions , and special circumstances. Part C (sometimes called Medicare Advantage) is less well-known. Beneficiaries can select coverage from a private insurer approved by Medicare. These plans provide services covered under Parts A and B, and often combine other programs such as Medicare prescription drug coverage (Part D) and wellness programs. Premiums, co-pays and coverage options vary from plan to plan, but in many cases the person is responsible for co-insurance, co-pays and deductibles, as well as monthly premiums. Part D is the outpatient prescription drug plan. Private insurers offer coverage through the plan, but Medicare sets the rules. This drug coverage is optional, and available to near-retirees during the three months before they reach age 65. There is a monthly premium, and a penalty for not enrolling on time. More details are available on the Medicare website. A recent article in Harvard Health – Are Medicare Beneficiaries Hiring Elder Law Attorneys? – points out that if you are considering hiring an elder law attorney to help you negotiate the Medicare landscape, you may want to consider that only 18% of those proposing to hire an elder lawyer for Medicare issues will actually do so. The other 82% will make do with gaining their knowledge via other means, such as friends, family and the internet.
As your cases involving patient advocacy and financial advice on Medicare, Medicaid and Norton’s are inevitably going to overlap, it’s worth your time to explore the Federal website at www.medicare.gov and get the lay of the land, as many of your cases will involve education on a senior’s options and what will follow.

What Is Elder Law And Its Connection To Medicare Benefits?

Elder law is an area that covers the planning and protection of assets, healthcare issues and quality of life issues for elderly citizens as well as their family members, and in many cases it overlaps with estate planning laws and, as such, it is common for these two areas of law to go hand-in-hand. With regard to health care issues, elder law involves Medicaid and Medicare and may require the efforts from an elder law professional to ensure the elderly have suitable, affordable and quality healthcare coverage as they enter into their senior years and possibly face chronic ailments, long-term care, or other medical challenges. Elder law in general acknowledges that those in senior years will likely have plans that will fall apart at some point along the way in terms of what services they need and when, and a legal professional can help families and patients plan for those getting older and help ensure wise use of resources, financial and otherwise, to meet these changing needs. Elder law is relevant to all people reaching maturity who are entering into their senior years, but it has particular significance to Medicare beneficiaries because once one becomes a Medicare beneficiary, the health care needs become more complex. There are financial responsibilities attached to being a Medicare beneficiary and even after the Medicare Trust Fund is exhausted, Medicare will remain in place but will be limited. For example, there is a real need to plan carefully for long-term care. The average annual rate for private room nursing homes is 91,250, so it is critical to consult with an adequate Medicare elder law attorney regarding long-term care planning and how you can make sure your financial situation remains stable.

Finding A Qualified Medicare Elder Law Attorney

There are myriad circumstances where legal representation is necessary or prudent, and there are numerous ways that an elder law attorney can assist beyond what an estate planning or family law attorney can provide. There are many complex rules and restrictions regarding eligibility and enrollment periods for Medicare and Medicaid programs. You may need the advice from a qualified attorney to ensure you have the options you need when you are near the end of your life or when a loved one is in need of long-term care (assisted living or nursing home care). An automated search online will not give you the same level of service. A qualified elder law attorney can clearly explain the issues at hand and help protect your assets while getting you the benefits you deserve. If you or a loved one is confronted with a long-term care issue or has applied for benefits that have been denied, talking to an elder law attorney to review your case will help you determine if you would benefit from legal representation. Some other scenarios where it can be helpful to talk to a qualified advisor in this field are:

How To Select A Skilled Medicare Elder Law Attorney Near You

As you begin your search, it is important to keep in mind that all attorneys are not created equally. Finding one that specializes in "Medicare law" is not enough – both the elder law and health law aspects are crucial in effectively navigating most Medicare cases. It is also important to have someone locally because Medicaid ("Medicare Savings Program") is administered by each state, so laws vary from state to state.
Online reviews of attorneys can provide insight into their competence. Compare those reviews to your own instincts as you speak with different attorneys. Make sure you get along with the lawyer you select. He or she will be privy to a lot of personal information and you must be comfortable sharing that information with them.
The best way to have an attorney willing to take your case is for you to pay the limited and reasonable fee rather than relying on contingency fees. Contingency fees are not allowed in many legal matters, including all public policy matters; which includes Medicaid and Medicare. If you are willing to pay a retainer or other upfront fee, you will have better luck getting someone to take your case if it is meritorious.

Questions To Ask A Medicare Lawyer

Questions to Vet Potential Attorneys:
While not all elder law attorneys will have a meeting with a prospective client before the engagement, the questions below can be used to vet those that do. These questions are designed to determine whether the attorney or law firm and staff have the relevant experience, and understanding of the long term care and Medicaid programs based on your specific needs.
Q: How long have you and your staff been working in this legal area?
Q: Do the attorneys at your firm regularly take continuing legal education in areas related to elder law, Medicaid eligibility, long term care or disability planning?
Q: Is your long term care and special needs planning work performed by a certified elder law attorney (CELA) or accredited estate planner (AEP)?
Q: Are you certified by the National Elder Law Foundation?
Q: Do you attend any conferences related to elder law , special needs planning or disability planning?
Q: Are you a member of the National Academy of Elder Law Attorneys or the Academy of Special Needs Planning?
Q: Are you an active member of the local NAELA chapter or the local Special Needs Planning Council?
Q: How many cases have you completed similar to our situation?
Q: How often is the attorney you work with in the office and available to respond to telephone calls and e-mails? How often is this attorney away from the office or out in the field?
Q: Do your attorneys work collectively as a team or does one attorney oversee all cases in the firm?
Q: Do the attorneys work with any other professional service provider, such as a CPA or financial advisor, to plan and coordinate the entire picture for a family?
Q: Will you accept and search for alternative care options and non-nursing home strategies to reduce long term care costs?
Q: Are there hidden costs or charges?
Q: How will you communicate to us the progress you have made in achieving our objectives?
Q: Can you provide references from previous clients?
Q: Do you think we are a good fit?
Q: How long will the consultation take and do you charge for the initial consultation?

How Much Does A Medicare Elder Lawyer Charge?

The cost of hiring a Medicare elder law attorney actually can be fairly affordable, but it depends on the particular problem you are facing. First, most elder law attorneys will be willing to spend some time upfront to get the basic details of your situation and let you know if they can help with your specific case at no charge. This is a good opportunity to ask them about their associated fees. Most attorneys will charge an hourly fee for work accomplished and will generally have a minimum fee for any job you hire them to do. Some attorneys will have a flat, set fee for most or all of their services. If you are in a position where you can plan ahead, there may be some flexibility if you are able to hire an attorney early on in the process, such as when a loved one needs to transition to a nursing home.
If the work is on the simple side – such as a not-too-complicated asset transfer to preserve eligibility for Medicare or aiding with the compilation of documents for an application – you might just spend a few hundred dollars.
On the other hand, if you have more complex affairs to sort out and need more involved and ongoing representation, expenses can run into the thousands. Either way, though, hiring an elder law attorney who knows the ins-and-outs of Medicare will likely save you money overall. Money and time spent early on with an attorney who is experienced and knowledgeable will help you avoid costly mistakes and long delays in getting a loved one the benefits they need.

Case Studies On How A Medicare Elder Law Attorney Can Assist

Scenario 1: Navigating Medicare’s Coverage Gaps
Brian, age 70, needed surgery on his heart and a five-day hospital stay. His wife, Chantel, assumed they would be responsible for the co-pays and post-operative care while Brian worked on his recovery. However, Brian didn’t have the Medicare supplemental insurance he qualified for through his employer. He also wasn’t eligible for Medicaid assistance – even though the couple had limited income as retirees. After reaching out to a local elder law attorney, the couple realized Brian was automatically entitled to add-on coverage via the Veterans Administration – and that he could use this add-on insurance for upcoming procedures.
Scenario 2: Coordinating Post-Surgery Care with Medicaid Assistance
After suffering a heart attack, Janet, age 66, was found dazed and confused at home. Fortunately, one of Janet’s friends had a Parent Tool Kit filled with legal documents to help her handle the emergency. Janet’s friend discovered two tragic truths. The first was that Janet had not been routinely taking her medications; the second was that she had become so forgetful that she was in the early stages of dementia , which would require long-term care. After consulting with an elder law attorney, Janet’s friend was able to transfer Janet’s finances to Janet’s longtime social worker. Janet’s social worker will be able to get Janet’s finances in order and will be responsible for Janet’s post-surgical care. Medicaid will pay for Janet’s continued stay in a skilled nursing facility.
Scenario 3: Preserving Assets While Qualifying for Medicaid
James and Barbara, age 77, had made plans to pay for their daughter’s college education by purchasing a traditional whole life policy. But when James learned that he would need to stay in a nursing/rehab facility for at least four months, he was devastated – and confused about the family’s finances. His mother-in-law was able to help him find an elder law attorney, who advised that James could apply for Medicaid assistance in an assisted living facility instead of a nursing home rehabilitation. Consistent with James’ wishes, the elder law attorney was able to provide counseling and also to save his life insurance policy.