Working Caregiver- Texas Help for Financial & Legal Assistance
Legal and Financial Security of Texas Seniors - Texas Elder Law & Texas Elder Assets
The following is an overview of legal documents that may be important in ensuring the Texas Elder Law and elder financial security of your family member. You will learn about long-term care insurance and sources for paying medical expenses. In addition, you will also review federal benefits such as Social Security, SSI, Medicare and Medicaid. Discover strategies for protecting your elder's assets and ways to legally protect your senior. After a lifetime of work your family member is entitled to all of the benefits!
Here are some things you should consider when shopping for any type of insurance:
Shop around. Prices can vary substantially from one company to another, even for policies with similar benefits. Get quotes from several companies before buying a policy.
Buy only from companies that are financially sound. Although there is no foolproof way to assess a company’s financial strength, a useful measure is the company's financial rating by an independent rating service such as A.M. Best , Dun and Bradstreet etc.
Choose companies that have a good track record for customer service. The number of consumer complaints against a company is a good indication of the company's customer service record. Your family and friends are other sources of information about a company's customer service. Ask them if they’ve had any experience with the companies you’re considering.
Buy only from licensed companies. Licensed companies belong to a guaranty association that will pay your claim if your insurance company goes broke. If you buy from an unlicensed company and have a claim, it might go unpaid.
Buy from an agent you know and trust. If you buy insurance through the mail or by phone, ask whether the company has a local agent or a toll-free number you can call if you have questions.
Try to find an agent that specializes in long-term care insurance. Because of the many variables in structuring a long-term care policy, it's important to have an agent who has the knowledge and experience to guide you through the process and help you choose the appropriate coverage for your individual needs.
Consider your needs. Although it’s difficult, try to anticipate what services you might need in the future and choose a policy that’s right for you.
As with any insurance purchase, it's important to protect yourself. Follow these tips:
Read what you are asked to sign before you sign it. Never sign a blank application form.
If an agent tries to rush you, be suspicious!
Ask questions and take notes when you talk to an agent. These could help later if there is a dispute over what you were told about a policy.
Don't buy insurance on the agent's first visit. Invite someone you trust to be present during the second visit. An agent shouldn't object.
Answer all questions on the application accurately. Most applications are detailed and lengthy and require expertise. Of course, the applicant and agent can sit side by side and complete together - and should do so - to ensure accuracy of info. Omitting or falsifying information could cause the company to deny your claims or cancel your policy.
Do not pay cash or make a check out to an individual agent. Always pay by check or money order to the company so you have a clear record of payment. Insist on a receipt signed by the agent on the company's letterhead.
Be sure you have the names and addresses of the agent and the insurance company. Know how to contact the agent and the company if you need help.
Long-term care refers to the many services used by people who have disabilities or chronic (long-lasting) illnesses. Long-term care insurance helps you pay for these services, which can be very expensive. A policy also ensures that you can make your own choices about what long-term care services you receive and where you receive them.
What You Should Know
Ordinary health insurance policies and Medicare usually do not pay for long-term care expenses. Medicaid, a federal/state health insurance program, will only pay for long-term care if you have already spent most of your savings or other assets.
Long-term care insurance should cover the cost of:
Help in your home with daily activities like bathing and dressing.
Community programs, such as adult day care, nurses aides, companions, errand service.
Assisted living services that are provided in a special residential setting other than your own home.
These services can include meals, health monitoring, and help with daily activities.
Care in a nursing home.
Medicaid is the State and Federal cooperative venture that provides medical coverage to eligible needy persons. Think of Medicaid as a type of health insurance for low-income families, children, and people who are elderly or have a disability. But unlike regular health insurance, you don't have to pay for it and most services are free.
Note: Medicaid is different in every state.
Eligibility
Families that have high medical bills they can't pay.
People who are elderly or have a disability and don't receive SSI may qualify for assistance in a nursing facility or intermediate care facility for people with mental retardation (ICF/MR). When there is a change in income, individuals may be eligible. They also may be eligible under a Medicaid waiver program or continue to qualify after being denied SSI.
Medicaid also covers certain Medicare recipients, such as premiums, deductibles, and co-insurance costs.
What are the minimum qualifications?
Medicaid is available to qualifying state residents of all ages and abilities. There are separate programs for families and children and for people who are elderly or have a disability. In general, the person must:
Be a resident.
Be a U.S. citizen or a noncitizen in certain recognized categories.
Meet certain resource and income limits, which vary by eligibility group.
How do my assets, such as home and bank accounts, and income affect whether a person can receive Medicaid?
The amount of assets and income you're allowed depends on the category under which you apply. Contact your local Department of Human Services office for more information. Proof of income and assets are necessary when application is made. In most cases, a homestead is not counted as an asset.
If the person does not qualify for Medicaid, can he or she still get help with any long-term care services?
Even if the person is not eligible for Medicaid, she or he may still qualify to receive a number of the community-based services. Community care services are provided on a first-come, first-served basis at little or no cost to the individual. Caution, there is usually a waiting list for enrollment. Contact the local Department of Human Services office for more information.
How does Medicaid work?
Each month the person receives a Medicaid Identification Card (ID). This card must be shown at each doctor appointment or when getting a prescription filled. There is no monthly ID card if your only benefit is payment of all or part of Medicare Part B premium.
Medicaid pays for most services, but not for everything. To make sure that the older adult receives benefits, follow these rules:
Do not pay for a service yourself and ask Medicaid to pay the person back. Payments are only made to providers, such as doctors, hospitals, pharmacies, or labs. Service providers or vendors must accept Medicaid. It will not pay if the person sees a non-Medicaid doctor who does not accept Medicaid as payment.
What's covered?
In most cases, Medicaid pays for doctors' services, laboratory and X-ray charges, medicines, nursing facility and hospital services, family planning, eyeglasses, hearing aids, ambulance, podiatry, chiropractic, and other health care services.
People who are elderly or have a disability who need help with daily activities may receive services in their homes. The state also offers some non-Medicaid community care services.
Medicaid often pays for regular medical checkups.
Will Medicaid pay if the person already has health insurance?
Yes, but the other insurer must pay first. Medicaid may pay for things not covered by the other policy. | 
