Angela N. Manz Elder Law Update. News and important information for seniors and their families

In This Issue

Medicaid, Nursing Home Costs and the Rumor Mill

Quickly Determine What Services are Covered by Medicare by Downloading this Free App

Should You Obtain a Letter of Competency?

Medicaid, Nursing Home Costs and the Rumor Mill

One-half of all Americans who reside in nursing homes receive assistance from Medicaid to pay for their care. This is not surprising, given the extraordinarily high cost of long-term care. The real surprise is that half of all Americans don’t seek Medicaid assistance to cover nursing home costs. There are several reasons for this, but one of the most common can be summed up in a single word: hearsay. Or, if you prefer, the rumor mill.

Here are just a few examples of the myths surrounding the use of Medicaid to pay for nursing home care:

  • The healthy spouse will be kicked out of the family home
  • The government will take all of your assets
  • You'll have to live in an old, dilapidated facility
  • You'll receive inadequate care, or no care at all

Rumors like these often come from well-meaning family members, friends, and neighbors.

While none of them are true, many people believe that they are.

Rumors also spread by people we assume to be knowledgeable about the subject--nursing home intake staff, caregivers, doctors, nurses, and social workers.

They might tell you, for instance, that you are too wealthy to receive assistance from Medicaid.

Or that once you have moved to a nursing home you can no longer obtain Medicaid assistance to pay for your care. Again, these folks may mean well, but their information is often outdated or simply inaccurate. The fact is, Medicaid planning is complicated and the rules governing eligibility for various programs change constantly.

Even lawyers who do not focus on this area of the law may be a source of inaccurate information.

Don’t let rumors and misinformation prevent you from getting the financial assistance you need. Speak with an attorney who helps families obtain Medicaid assistance to pay for nursing home care on a daily basis.

Quickly Determine What Services are Covered by Medicare by Downloading this Free App

Does Medicare cover a test or procedure recommended by your doctor? You'll know at a glance if you use Medicare's new "What's Covered" app.

This free app lets you search for specific services or browse a list of alphabetized services to determine what is covered by Medicare Parts A and B. You can also access basic information about costs.

While the app provides an extensive list of the services, tests, and procedures covered (or not covered) by Medicare, it does not take into account a user's specific co-insurance, supplemental insurance, or deductibles.

The What's Covered app is part of an initiative by the Centers for Medicare and Medicaid Services (CMS) to modernize Medicare and empower beneficiaries. Other CMS initiatives include price transparency tools, improved online support, and a webchat option on the Medicare Plan Finder.

You can get the What's Covered app from the App Store or Google Play by visiting

Should You Obtain a Letter of Competency?

Maybe it's the son-in-law you've never really liked, let alone trusted, who wields undue influence over your daughter. Or the ex-spouse who continues to make trouble seven years after your divorce. Or the son whose irresponsibility and self-destructive behavior forced you to disinherit him.

If you have reason to believe that an estranged family member might challenge your will, trust, powers of attorney or other planning documents, you may want to consider obtaining a letter of competency. Why? Many such challenges are based upon claims of incompetency--that is, the legal documents are invalid because their creator was of unsound mind. A letter of competency will help dispel notions that your documents were created while you lacked the mental capacity to make sound financial and legal decisions.

A letter of competency is typically written by a primary care physician who is familiar with any changes in a patient's baseline mental and physical health. In some cases, obtaining this letter from a doctor who specializes in cognition or mental health, such as a neurologist or psychiatrist, might be a good idea.

A letter of competency should be printed on the doctor's letterhead and include the following basic information:

  • The patient's name and date of birth
  • The date on which the doctor-patient relationship was first established
  • The doctor's statement affirming the patient's ability to make independent decisions regarding finances, legal matters, and healthcare
  • Relevant medical diagnoses
  • Each relevant medical issue's date of diagnosis
  • The doctor's contact information

While the above information is typically included in a basic statement of mental capacity, it is a good idea to work with an attorney to determine if other facts or additional supporting evidence should also be included.

You'll want to store the letter of competency, along with your will, powers of attorney, trust, and other legal documents, in a safe place. It is wise to have your doctor keep a copy in your medical file as well. Of course, your attorney should also have all of your documents, including the letter of competency, readily available.

It may seem "crazy" to obtain proof of your mental capacity when creating or updating legal documents. However, it's better to be safe than sorry. The time and energy required to see a physician and get him or her to draft a letter of competency is minimal compared to the legal fees, stress, and family turmoil involved in lawsuits over the validity of legal documents.