Editor’s Note: This is part of a series of columns that will be presented in this newsletter by Sam W. Boone, Jr., a local attorney whose primary practice areas include elder law, estate planning, probate and trust administration. It is hoped that the information will be valuable for caregivers and family members dealing with issues related to elder law.
The Florida Legislature in 2011 changed the landscape for people on Nursing Home Medicaid. Those changes are proving to be a headache for seniors and their caregivers around the state. And now with the “roll-out” date for most of the counties in North Central Florida coming on March 1, that headache has arrived to our area.
The Florida legislation essentially turned over control of Medicaid for elders needing assistance to for-profit managed-care companies. While many elder-law attorneys and other elder advocates argued for safeguards in the legislation, those safeguards were left out. The result is that elders and their caregivers have to be very careful about where they seek advice in this process.
Under the new law, most elderly people (or their decision maker), whether they live at home, in an assisted-living facility or a nursing-care facility, have to choose a managed-care provider.
It sounds simple enough, but it’s not. Whether you currently receive Medicaid, live at home, or in a facility and whether you have filed an application for Medicaid are all factors in the process. That’s important because the services you need or want impact your decision.
There are a number of questions to consider as you make this decision – and the only easy one is when – by March 1 for most of our area.
For most of our area, three plans have been approved by the state. These plans are offered by American Eldercare, Sunshine State Healthcare and United Healthcare of Florida. But these plans can be different and depending on your circumstances, can offer differing services.
So the first question is how do you find out about the services in each program. Next, what do you do ifthe new plan of care changes the services you have been receiving? Then you need to consider that the facility you are in or your Medicaid home-health provider may not be contracted with the plan. In that case, you might have to move or change your home-healthcare provider.
Then there’s the biggest problem of them all. If you don’t choose, the state will choose for you.
By this time you should have already received information about the plans and are acting on it. The decisions you make on this are critical in the continued care of your loved one. Do not rely solely on the choice counselors representing the plan providers. Elder law attorneys around the state, like me, can help with this process. In fact, three of my colleagues have created the Foundation for LTC Solutions. At the very least, examine their Facebook page at https://www.facebook.com/FoundationforLTCSolutions. This is a wonderful resource.
Sam W. Boone, Jr. is a Gainesville-based attorney practicing elder law and estate planning. He is past-
president of the Academy of Florida Elder Law Attorneys. To learn more about elder-law issues, go online to www. http://boonelaw.com, or call (352)-374-8308.
