Lectures - Entitlement Programs, Medicare and Medicaid

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Lecture Notes
(from Instructor's Manual by Ronald J. Schwartz, J.D., L.L.M. for textbook
Law and Aging - Essentials of Elder Law - 1st Edition - Pearson Publications)

Entitlement Programs, Medicare and Medicaid

Topical Outline
a. Eligibility
b. Benefits
c. Part A Coverage
d. Part B Coverage
e. Medicare hospital patients' rights
f. Medicaid eligibility
g. Benefits
h. Transfer Rules
i. Medicaid rights of recovery
j. Medicaid application procedure
k. Institutional Medicaid/Home Medicaid
l. What is Medicaid Asset Planning?
m. New Legislation: the Health Insurance Portability and Accountability Act of 1996, (Kennedy-Kassebaum Bill), effective January 1, 1997

Learning Objectives
a. to be familiar with the rules for eligibility for Medicare
b. to be familiar with the basic benefits that Medicare provides in Part A and Part B
c. to understand and be familiar with patients' rights in a hospital, including premature discharge
d. to understand Medicaid and its eligibility rules
e. to understand Medicaid asset transfer rules
f. to understand Medicaid asset planning
g. to understand new legislation effective January 1, 1997 and hot it affects Medicaid asset transfers

Job Competencies
a. to be able to do an in-depth interview with a Medicaid applicant or their immediate family
b. to prepare an inventory of all assets of the applicant
c. to trace all assets that have been transferred within the past 36 months
d. to organize necessary documentation
e. to be familiar with Medicaid and Medicare rules and regulations
f. to understand Medicaid rules governing the recovery of assets

Key Concepts
One of the functions of an elder care attorney and his/her paralegal staff is to prepare Medicaid applications as well as advise clients of their rights as Medicare beneficiaries. Most of the clients who will be requesting assistance from an elder care law office will be Medicare eligible due to age or disability. Elderly clients who are seriously ill and candidates for a nursing home may require assistance in preparation of Medicaid applications. It is, therefore, crucial for the paralegal to understand Medicaid and Medicare eligibility and rights of recovery in this area.