Search Articles

Find Attorneys

Health Care Without Medicare

cover

Joseph A. Jackson, Health Care Without Medicare. (Solarian Press, Lenox, MA: 2000). Amazon.com price: $29.95 (click on book to find).

Built on an early 20th century medical model, our health care system is superb at treating acute problems but woefully inadequate when it comes to assisting those with chronic, long-term illnesses. Patients who allow federal programs like Medicare and Medicaid to dictate their course of treatment very quickly find themselves shunted off to nursing homes.

It need not be that way. Most patients would prefer to live independently in the community--and in many cases they can. What they lack is the knowledge to manage the complexities of long-term care planning, which requires not just medical know-how but expertise in elder law, financial services, insurance, social services, and counseling as well.

Enter the independent care manager, an individual who is highly skilled in at least one of these areas and is well enough versed in the others to offer sound advice and refer to a specialist when necessary. Health Care Without Medicare is an indispensable practice manual for this newly emerging army of foot soldiers fighting to help the chronically ill and disabled stave off long-term institutionalization.

The core of Health Care Without Medicare is a primer on the essential knowledge base that all care managers must possess. Readers will find chapters on the health care system as it is presently structured, the many forms depression can take, housing options, the medical problems of the chronically ill, estate planning, and how to complete a continuing-care needs assessment.

Author Joseph A. Jackson, who heads a care management company in western New England, uses the concept of Community LifeCare Planning (CLCP) to describe the multidisciplinary approach that care managers must follow if they are to help their clients achieve the goals of preserving independence and assets. CLCP involves mobilizing all of the resources available to the elderly individual, including health insurance; personal income and assets; community resources; family, friends and neighbors; and, most importantly, the client's own abilities.

No matter their specialty, everyone in the care management field should find something of use here. Nurse practitioners, for example, will likely skim the chapter on 'Medicine for Care Managers' but carefully study 'Estate Planning for Care Managers.' Elder law practitioners will doubtless do the reverse. The author makes clear that CLCP requires a team approach; no one can be an expert in every planning area. 'The care managers' greatest skill,' Jackson writes, 'may not be in providing the services themselves, but in connecting clients with the specialists who are best able to help.'

For those wishing to explore a particular area in greater depth, each chapter ends with a list of further resources. The useful appendices include Community LifeCare Planning forms, three case examples of care plan option reports and a sample estate planning/financial planning alliance.

Today's simplistic definition of health care is 'medical treatment only.' We can wait for the system to change, Jackson implies, or we can make creative use of what is currently at hand to help the elderly and others with chronic illnesses live independently and with dignity. Health Care Without Medicare is a pioneering guide for professionals taking the latter course.

Local Elder Law Attorneys in Your City

Elder Law Attorney

Firm Name
City, State

Elder Law Attorney

Firm Name
City, State

Elder Law Attorney

Firm Name
City, State


Created date: 11/08/2002
Medicaid 101
What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

READ MORE
How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

READ MORE
Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

READ MORE
What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

READ MORE
How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

READ MORE
Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

READ MORE
Medicaid Planning Strategies

Careful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.

READ MORE
Estate Recovery: Can Medicaid Take My House After I’m Gone?

If steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.

READ MORE
Help Qualifying and Paying for Medicaid, Or Avoiding Nursing Home Care

There are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.

READ MORE
Are Adult Children Responsible for Their Parents’ Care?

Most states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.

READ MORE
Applying for Medicaid

Applying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.

READ MORE
Alternatives to Medicaid

Medicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.

READ MORE
ElderLaw 101
Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

READ MORE
Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

READ MORE
Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

READ MORE
Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

READ MORE
Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

READ MORE
Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

READ MORE
Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

READ MORE
Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

READ MORE
Long-Term Care Insurance

Understand the ins and outs of insurance to cover the high cost of nursing home care, including when to buy it, how much to buy, and which spouse should get the coverage.

READ MORE
Medicare

Learn who qualifies for Medicare, what the program covers, all about Medicare Advantage, and how to supplement Medicare’s coverage.

READ MORE
Retirement Planning

We explain the five phases of retirement planning, the difference between a 401(k) and an IRA, types of investments, asset diversification, the required minimum distribution rules, and more.

READ MORE
Senior Living

Find out how to choose a nursing home or assisted living facility, when to fight a discharge, the rights of nursing home residents, all about reverse mortgages, and more.

READ MORE
Social Security

Get a solid grounding in Social Security, including who is eligible, how to apply, spousal benefits, the taxation of benefits, how work affects payments, and SSDI and SSI.

READ MORE
Special Needs Planning

Learn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.

READ MORE
Veterans Benefits

Explore benefits for older veterans, including the VA’s disability pension benefit, aid and attendance, and long-term care coverage for veterans and surviving spouses.

READ MORE