Alabama Update Changes in the Law Affecting Seniors

Top Questions to Ask Your Healthcare Provider: A Guide for SeniorsAs we get older, our health needs change. Regular checkups and open conversations with your healthcare provider become even more important. But lets be honestmost doctor visits feel rushed or even overwhelming. You have so much you want to discuss with your doctor, only to leave the office and suddenly realize you forgot to ask all the questions you had intended to.Thats why you have to be prepared. Asking the right questions can help you better understand your health, avoid confusion, and feel more in control of your care. If youre a senioror caring for onehere are the top 5 questions you should ask your healthcare provider. Print them out, jot them down, or keep them in your phone. These questions can help make the most of every visit.1. What screenings or tests do I need at my age?This is one of the most important questions to discuss with your doctor. Prevention is key to better health. Health screenings give you the opportunity to catch potential health issues early before they become serious. Thats especially important as we get older, since the risk of certain conditions (like heart disease, diabetes, cancer, and osteoporosis) increases with age. Some screenings are age-based, while others depend on your personal and family history.  Common screenings for older adults may include: Blood pressure and cholesterol checks Bone density scan Mammogram or prostate exam Colon cancer screening Vision and hearing tests Diabetes screenings  Ask your provider: Am I due for any screenings? How often should I get these done? Do I need any lab work or imaging?   2. Are all my medications still necessary?Its common for many seniors to take multiple medications to manage different health conditions. But over time, your health needs can change, and so can your bodys response to certain drugs. Thats why its important to regularly review your medications with your doctor. Some prescriptions may no longer be needed, while others might interact with new medications or cause unwanted side effects. Asking about your current medications helps ensure youre only taking whats truly helpfuland nothing more.Always bring a list of everything you are taking, including over-the-counter drugs as well as vitamins and herbal supplements.Ask your provider: Do I still need these medications?Are there any side effects I should watch for?Can any of these medications intereact with each other - or with over-the-counter vitamins or supplements I take? 3. What vaccines do I need to stay protected?Many people tend to think vaccines are just for children. But that certainly is not the case. As we age, our immune systems become weaker, making us more vulnerable to certain infections. Certain illnesses, like the flu, pneumonia, shingles, and COVID-19, can be more serious in seniors. Thats where vaccines come into play. Staying up to date on recommended vaccines can help prevent complications and keep you out of the hospital.  Recommended vaccines for seniors often include: Flu shot (every year) Shingles vaccine (usually two doses after age 50) Pneumonia vaccine COVID-19 vaccines and boosters Tdap booster (for tetanus, diphtheria, and whooping cough)  Ask your provider: Am I up to date on my vaccines? Do I need the shingles or pneumonia shot? What about the flu or COVID vaccines?  4. How is my memory and mental health?Its normal to forget where you put your keys now and then, but memory loss that affects daily life shouldnt be ignored. The same goes for feeling down, anxious, or lonely. Your mental health is just as important as your physical health, and it deserves attention too.Memory issues and mental health concerns often go unspoken. The earlier you talk about it, the more options there are to support your wellbeing and independence. It can help to talk openly with your provider about how you're feeling emotionallyespecially after big life changes like retirement, loss, or illness. If needed, your provider may suggest counseling, support groups, or safe treatments. Ask your provider:Is my memory okay for my age?Should I be concerned about confusion or forgetfulness?How do I know if I'm just feeling low or if I'm dealing with depression or anxiety?5. What can I do at home to stay healthy and prevent illness?Staying healthy isnt just about doctor visitsits about the choices you make every day at home. From the foods you eat to how active you are, small lifestyle habits can have a big impact on your overall well-being. Your provider can guide you on safe, practical ways to support your health right from the comfort of your home.Ask your provider:What kind of exercise is safe for me?Should I be eating differently at my age?How can I improve my sleep or energy? Speak Up and Be a Partner in Your Healthcare JourneyYour doctor is your partner in healthbut youre the expert on how you feel. Dont be afraid to ask questions, bring notes, or speak up if something doesnt make sense or feel right. There are no wrong questions when it comes to your health. At VIPcare, we specialize in senior-focused primary care. Our providers take time to listen, answer your questions, and tailor care to your specific needs. From preventive screenings to chronic condition management, were here to support your health and your goals. Call (251) 257-2886 today to schedule an appointment or learn more at www.getvipcare.com.

These 4 Simple Actions May Deliver Big Payoffs for Mens HealthIts been 12 months since the last Mens Health Month. Have you seen your doctor?June is a great time to make an appointment for a physical with your primary care provider, and its also an ideal month to educate yourself about some of the issues that impact mens health. For example, did you know that men tend to die five years earlier, on average, than women? Or that men face higher risks for health conditions such as lung cancer, heart disease and HIV? And theyre also at risk for sex-specific cancers, including prostate cancer and testicular cancer (learn about those facts and more via the Office of Disease Prevention and Health Promotion).There are many simple actions men can take to benefit their health, this month and every month. Here are four ways to get started.Tip 1If you dont have a primary care doctor, select one. Establishing a relationship with a doctor is important. That person can help you feel better when youre sick, and they can offer advice on how to feel and stay your healthiest. And yet, according to a survey by the Cleveland Clinic, many men arent taking actions to stay healthy. Nearly two in five Gen Z men dont have a primary care provider (PCP). And when it comes to annual physicals, just 32% of millennials and Gen Z men get them, compared to 61% of Gen X and Baby Boomers. A primary care doctor can test your cholesterol and blood pressure, keep you up-to-date on immunizations and advise you on which screenings you need. A PCP visit is like a one-stop shop for your health!Tip 2If youre worried about your mental health, talk to a professional. Its tough to ask for help, and the statistics show that men, in particular, struggle when it comes to addressing their mental health challenges. According to the Anxiety and Depression Association of America, nearly one in 10 men experience some sort of anxiety or depression, but fewer than half seek treatment. If you find that youre feeling unhappy or irritable, and youre avoiding or not getting pleasure from activities you usually enjoy, talk to your doctor or connect with a therapist and share the way youre feeling. They may be able to help.Tip 3Strengthen your support system. Research shows that social connections are important for your mental and physical health; in fact, people with strong social connections may actually live longer. Prioritize connecting with old friends and open your mind to ways to meet new ones. Itll be good for all involved!Tip 4Practice good health habits. There are everyday actions you can take that are known to be good for your health. Those include regular exercise (aim for 30 minutes of movement, five times a week); eating a healthy diet filled with lean proteins, whole grains and lots of fresh fruits and vegetables; finding outlets to manage your stress, such as yoga or deep breathing; getting enough sleep; quitting tobacco; and moderating how much alcohol you drink (the US guidelines recommend two drinks a day or less for men and one a day or less for women).Making healthy choices isnt hard, but you may need to adjust to some changes in your routine. Before long, those healthy choices may make you feel good enough that you wouldnt want to choose any other way.Contact Blue Cross Blue Shield of Alabama located in Mobile at 251-344-2115.

Protecting Your Parents Assets From Nursing Home CostsNursing home care costs have been rising over time, with many older Americans who require long-term care unable to afford it.With proper planning, seniors may be able to rely on Medicaid to pay for this care and still retain some of their assets by exploring several different strategies.The aging U.S. population means that more people will likely need nursing home care in the coming decades. Meanwhile, the cost of nursing home care is increasing and expected to keep increasing.With the exorbitant cost of nursing home care, many families worry about depleting their loved ones life savings to pay for the care they need. Private health insurance does not cover nursing home care, and while long-term care insurance is available to cover nursing home costs, these plans are also expensive and may come up short for long-term stays.This leaves millions of Americans reliant on Medicaid to pay for nursing home care a far from perfect solution that usually involves spending down assets to qualify. With proactive Medicaid planning, though, it is possible for someone to qualify for Medicaid and still retain some of their assets. The sooner you start planning, the more options youll have for protecting your parents assets from nursing home costs. Odds of Needing Long-Term Care Are HighThe lifetime likelihood of needing nursing home care is relatively high. About 70 percent of people who turn 65 today will eventually need some type of long-term care, including nursing home care.About 1.3 million Americans aged 65 and older currently live in nursing homes, and about 40 percent of todays 65-year-olds will spend some time in a nursing home before the end of their lives.Women are more likely than men to need long-term care, and the older a person gets, the more likely they are to need it. At the same time, there has been a growing trend of younger adults (those under the age of 65) living in nursing homes, in part due to Medicaid eligibility expansion under the Affordable Care Act. Research shows that this group increased from 10.6 percent of total nursing home residents in 2000 to 16.2 percent in 2017.Medicaid expansion has led to more people of all ages qualifying for the joint federal and state health insurance program. Intended as the payer of last resort when it comes to long-term care, Medicaid has become the primary nursing home insurance for millions of Americans due to the absence of any other public program covering long-term care.In 2020, around 6 million Medicaid enrollees used the program to pay for long-term support and services. Around one in five enrollees received institutional care, such as care provided at a nursing facility.After age 65, more than a quarter of adults receive at least 90 days of nursing home care. Thirteen percent of them receive long-term Medicaid-financed nursing home care.Medicaid typically pays for 100 percent of nursing home costs and may be the only insurance option available for long-term stays. Long-term care insurance can be purchased, but most policies have limits on the maximum daily or monthly benefit amount and the total lifetime benefit, as well as terms and health requirements that may exclude coverage.A nursing home stay isnt necessarily permanent. About 15 percent to 20 percent of admissions are for short-term rehabilitation. Among current residents, the average stay is one year and four months. More than half of residents stay for at least 100 days, while 15 percent of older adults spend over two years in a nursing home.With nursing home costs running $250 to $300 per day in some states, costs can add up quickly. The average nursing home stay of little over a year, or about 485 days, could end up costing upwards of $150,000.Extrapolate these costs over multiple years, and they are unsustainable for many families. Medicaid Planning StrategiesWhether a nursing home stay lasts months, years, or is permanent, you may have crunched the numbers and determined that Medicaid is the only feasible payment option for a parents nursing home care.This is a good news, bad news scenario. The good news is that its possible for somebody who doesnt currently meet Medicaids income and asset limits to spend down their excess assets to meet limits. The bad news is that these limits are generally only $2,000, which requires significant planning, since the average net worth of Americans is more than $1 million, including nearly $1.8 million for those 65 to 74.Another upside is that not all a persons assets count against the limit. A home, for example, is typically exempt. Someone can also own one car without exceeding Medicaids asset limits.Many Medicaid spend down strategies take advantage of workarounds that allow nonexempt assets to be converted to exempt assets, thereby excluding them from Medicaid calculations. But these strategies often involve navigating a tricky five-year lookback period where past asset transfers are scrutinized to ensure applicants dont give away assets to qualify for Medicaid.Keeping these considerations in mind, there are financial planning strategies that can help to protect a parents assets from nursing home costs and a Medicaid spend down. Medicaid-Compliant Annuities (MCAs)MCAs, a type of single premium immediate annuity, allow countable assets (like cash or investments) to be converted into a stream of income that doesnt count toward the Medicaid asset limit. The payout structure must be based on life expectancy, and once purchased, the annuity cannot be cashed out or changed; funds in the annuity are no longer accessible as assets.Annuity income may affect your parents eligibility for other needs-based government programs, such as Supplemental Security Income (SSI). In addition, the state Medicaid agency must be the primary beneficiary in case of the annuitants death during the annuity period. Medicaid Asset Protection Trusts (MAPTs)Medicaid-compliant trusts, like MAPTs, hold assets for a set period, after which they transfer to beneficiaries (usually children or other family members).Assets in the MAPT are no longer considered part of your parents estate for Medicaid purposes. They are legally owned by the trust, not your parents, although they may be able to benefit from these assets, such as remaining in a home transferred to a MAPT.Creating a MAPT triggers a penalty period of Medicaid ineligibility under the lookback period thats based on the value of assets transferred. A MAPT is therefore most effective when implemented well in advance of potential Medicaid need, often in conjunction with a parents estate plan. Promissory NotesA promissory note is a legal agreement that allows your parents to lend money to someone (e.g., a family member) who agrees to repay the money with interest over time. This converts a lump-sum asset into a stream of income.Not all states recognize promissory notes for Medicaid planning. In states that do allow them, they may be subject to scrutiny by state Medicaid agencies. The note must clearly outline the repayment terms and the interest rate must be at or above the applicable federal rate (the minimum interest rate the IRS allows for private loans).Interest income from the loan may be taxed at a lower rate, and the terms can be customized to meet individual needs. For the Medicaid applicant, however, the effectiveness of a promissory note is largely dependent on the borrowers ability and willingness to repay the loan. Life EstatesA life estate lets your parents transfer ownership of their home to a child or other family member while retaining the right to live there for the rest of their lives. It removes the homes value from their countable assets for Medicaid purposes and may protect the family home from Medicaid estate recovery, a program that empowers states to recoup Medicaid expenses from the deceased beneficiarys estate.Medicaids lookback policy applies to life estates, so the transfer must be done well in advance of needing care. Your parents may also lose some control over the property, and there could be tax implications. Other Spend Down StrategiesA spend down strategy might additionally include a parent spending on needs or wants that can both enhance their quality of life and help them qualify for Medicaid.Paying off debts, making necessary home repairs, purchasing a new car, prepaying funeral expenses, or taking a family vacation are ways to spend down assets and derive an instant benefit.Gifting assets to loved ones outside of the lookback period can reduce countable assets and fit into a gifting while living strategy, but annual and lifetime gift tax exemptions apply.If only one spouse needs nursing home care, Medicaid allows the other spouse (the community spouse) to retain a certain amount of income and assets.Because state Medicaid laws and individual nursing home care needs vary, there is no one-size-fits-all strategy for protecting a parents assets from nursing home costs and a Medicaid spend down. To develop a personalized plan that avoids penalties or disqualification from Medicaid in your state and also maximizes asset protection, consult with Ashley Day.  Phone: 251-277-3377.