what kind of attorney do i need for advice about medicare & medicaid issues

by Cortney Zulauf 6 min read

If you feel you are entitled to Medicare and are not getting it, or there is a service that you feel should be covered that is not, contact a Medicare attorney. An attorney who is an expert at Medicare law can look at your situation and advise you as to whether you should be seeking additional coverage or benefts.

An experienced elder law attorney can serve as an advocate for you, increasing your chances of being approved for benefits.

Full Answer

Do I need a lawyer for Medicare benefits?

Although Medicaid and Medicare are run by the United States government, individuals do have rights under law. If you feel that those rights have been abused in any way, you need to speak to an experienced attorney. The hospitals, clinics and physicians who work with you should be forthcoming about your Medicaid or Medicare benefits.

When should I contact a Medicare attorney?

An experienced elder law attorney can serve as an advocate for you, increasing your chances of being approved for benefits. Medicare Fraud. On the other hand, if you are accused of obtaining Medicare benefits under false circumstances (called Medicare fraud), you could face fines or even jail time. An attorney can help defend you against these claims and reach an ideal …

Do I need a lawyer or a Medicaid planner?

Medicare Attorneys. If you feel you are entitled to Medicare and are not getting it, or there is a service that you feel should be covered that is not, contact a Medicare attorney. An attorney who is an expert at Medicare law can look at your situation and advise you as to whether you should be seeking additional coverage or benefts.

Do elder law attorneys provide Medicaid planning services?

Mar 22, 2022 · Elder law attorneys, also called elder care attorneys, estate and trust attorneys, or Medicaid lawyers, assist persons in preparing for long-term care and death. They assist seniors in a large and diverse array of legal tasks. This encompasses retirement planning, estate planning, creating wills and durable power of attorney, appointing guardianship, creating trusts, and in …

Who is the best person to talk to about Medicare?

If you've contacted 1-800-MEDICARE (1-800-633-4227; TTY: 1-877-486-2048) about a Medicare-related inquiry or complaint but still need help, ask the 1-800-MEDICARE representative to send your inquiry or complaint to the Medicare Ombudsman's Office.

What is a Medicare advisor?

What Are Medicare Advisors? Medicare advisors are insurance agents, Medicare brokers and Medicare underwriters. They work for private companies that are under contract with Medicare to sell certain Medicare plans — Medicare Advantage plans and Medicare Part D prescription drug plans.

Who do you call with questions about Medicare?

1-800-633-4227For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

How can Medicare problems be resolved?

Your plan is the best resource to resolve plan related issues. Call 1-800-MEDICARE. Call 1-800-633-4227, TTY users should call 1-877-486-2048. If your concern is related to Original Medicare, or if your plan was unable to resolve your inquiry, contact 1-800-MEDICARE for help.Dec 1, 2021

Why do Medicare advisors call?

If someone calls claiming to be from Medicare, asking for your Social Security number or bank information to get your new card or new benefits, that's a scam. Don't give personal information to a caller claiming to be from Medicare. You can't trust caller id.Mar 15, 2019

Does Medicare representatives come to your house?

Hard Facts About Medicare Medicare will never call or come to your home uninvited to sell products or services. SSA representatives may call Medicare beneficiaries if they need more information to process applications for Social Security benefits or enrollment in certain Medicare Plans, but, again, this is rare.May 24, 2021

Are you automatically enrolled in Medicare if you are on Social Security?

Yes. If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. (Medicare is operated by the federal Centers for Medicare & Medicaid Services, but Social Security handles enrollment.)

What are the 4 types of Medicare?

There are four parts of Medicare: Part A, Part B, Part C, and Part D.Part A provides inpatient/hospital coverage.Part B provides outpatient/medical coverage.Part C offers an alternate way to receive your Medicare benefits (see below for more information).Part D provides prescription drug coverage.

How long does it take to get Medicare Part B after?

Most Medicare provider number applications are taking up to 12 calendar days to process from the date we get your application. Some applications may take longer if they need to be assessed by the Department of Health. We assess your application to see if you're eligible to access Medicare benefits.Dec 10, 2021

How do I deal with Medicare?

If you've called 1-800-MEDICARE (1-800-633-4227) with a question or complaint about Medicare but still need help, ask the 1-800-MEDICARE representative to send your question or complaint to the Medicare Beneficiary Ombudsman. The Ombudsman staff helps make sure that your question or complaint is resolved.

What are the disadvantages of Medicare?

Cons of Medicare AdvantageRestrictive plans can limit covered services and medical providers.May have higher copays, deductibles and other out-of-pocket costs.Beneficiaries required to pay the Part B deductible.Costs of health care are not always apparent up front.Type of plan availability varies by region.More items...•Dec 9, 2021

What is Medicare Part C called?

Medicare Advantage PlansMedicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by Medicare-approved private companies that must follow rules set by Medicare.

What to do if you are denied Medicare?

If you have been denied such coverage, the best thing to do is to consult with a lawyer who specializes in Medicare and Medicaid law. Simply accepting a denial on a claim may not be a smart course of action. Many times, you do have legal recourse.

What happens if you are accused of fraud?

Otherwise, you put your rights at incredible risk and can end up facing a huge array of penalties and legal repercussions.

Do you have rights with Medicare?

It is important to keep in mind that when problems arise concerning Medicare and Medicaid, you do have rights. Familiarizing yourself with a few basic facts is a good way to begin:

Is Medicare and Medicaid confusing?

Medicare And Medicaid. The Medicare and Medicaid system in the United States can be tremendously confusing. When you are denied Medicaid benefits or otherwise have problems with a social welfare program, it can feel like you are all alone.

What is Medicare for seniors?

Medicare is the federal health insurance program for people who are age 65 or older. Almost all seniors are enrolled in Medicare, which pays for outpatient visits, hospital stays, prescription drugs, and much more. There are four different parts of Medicare, and each part covers a different aspect of health care.

How long do you have to enroll in Medicare?

Once you are eligible, you have seven months to enroll in Medicare (called the “Enrollment Period”) before you have to pay a late enrollment fee. Because most people pay into Medicare when they work, they won’t have to pay a premium for Medicare Part A. – even if they have health insurance through their employer.

What is Medicare Part C?

Medicare Part C is the least-used type of Medicare coverage. It is a type of health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits. If you have Medicare Part C, often called a Medicare Advantage Plan, most Medicare services are covered through the plan instead of Medicare Parts A and B. ...

Can an attorney help with Medicare?

An attorney can help defend you against these claims and reach an ideal conclusion for your circumstances. If you would like to learn more about Medicare or if you need the assistance of an attorney to help you navigate the Medicare process, contact Alperin Law today to schedule your consultation.

Does Medicare cover nursing home care?

Medicare Part A covers inpatient hospital stays (including emergency room visits), care in a skilled nursing facility, hospice care, and some home health care. However, Part A will not cover care in a skilled nursing facility for a long-term resident. If you or a loved one needs long-term care in a nursing home or assisted living facility, ...

What are the different types of Medicare?

There are four main parts to the Medicare Plan: 1 Medicare Part A covers nursing care, hospice care, certain types of home health care, and inpatient hospital stays. 2 Medicare Part B covers many doctor’s services, as well as preventive services, medical supplies, and outpatient care. If you qualify, Part A and Part B are free, although there may be some services that are not covered or not fully covered and must be paid for. 3 Medicare Part C, or Medicare advantage, is designed to provide private insurance that covers any gap between what your regular Medicare covers and what you need covered. You will have to pay for Medicare Part C. 4 Medicare Part D provides prescription drug coverage.

What is Medicare insurance?

What Is Medicare? Medicare insurance is a public, government-run and funded insurance plan that provides health coverage for Americans 65 and older. Those with End-Stage Renal Disease are also eligible for Medicare, as are people with certain disabilities even if they are not yet 65.

What is Medicare Part B?

Medicare Part B covers many doctor’s services, as well as preventive services, medical supplies, and outpatient care. If you qualify, Part A and Part B are free, although there may be some services that are not covered or not fully covered and must be paid for.

What is the role of a Medicaid attorney?

On the other hand, Medicaid attorneys often focus more on the legal aspects of Medicaid planning, such as creating Medicaid asset protection trusts or Qualified income trusts, which makes them the better option for this type of assistance.

What do elder law attorneys do?

What Elder Law Attorneys Do? Elder law attorneys, also called elder care attorneys, estate and trust attorneys, or Medicaid lawyers, assist persons in preparing for long-term care and death. They assist seniors in a large and diverse array of legal tasks, which encompasses retirement planning, estate planning, creating wills and durable power ...

What is Medicaid asset protection trust?

One such strategy that elder law attorneys can implement is a Medicaid asset protection trust (MAPT). This type of trust not only prevents one from becoming ineligible for Medicaid due to gifting assets ...

How long does Medicaid look back?

The look back period is 5 years in all states except California (Medi-Cal has a 2.5 year look back).

What is a medicaid planner?

For persons who have Medicaid cases that are fairly simple and straightforward, a Medicaid planner, also called a Medicaid specialist or a Medicaid Advisor, might be a good option. Working with a professional Medicaid planner can be a lot more cost efficient than working with a Medicaid attorney.

How does Medicaid annuity work?

This strategy reduces one’s countable assets, while at the same time , protecting some of them for family. Essentially, Medicaid applicants gift approximately half of their “excess” assets (assets over Medicaid’s limit) to their loved ones and then purchase an annuity with the remaining “excess” assets. (An annuity turns countable assets ...

How long does it take for Medicaid to pay for long term care?

Medicaid attorneys and specialists also assist with crisis planning, which occurs when a senior needs Medicaid benefits within 30-60 days.

How to check if I have Medicare?

To learn about Medicare plans you may be eligible for, you can: 1 Contact the Medicare plan directly. 2 Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week. 3 Contact a licensed insurance agency such as Medicare Consumer Guide’s parent company, eHealth.#N#Call eHealth's licensed insurance agents at 888-391-2659, TTY users 711. We are available Mon - Fri, 8am - 8pm ET. You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.#N#Or enter your zip code where requested on this page to see quote.

What is a durable medical power of attorney?

If the person being cared for becomes incapacitated, a durable medical power of attorney or other advance directive will generally allow the agent to make decisions on his or her behalf, including actions related to Medicare.

What can a power of attorney do?

Depending on the state, a power of attorney may grant broad authority to handle finances, sell real estate, and make charitable donations–or it can be limited to medical decisions. To help a Medicare beneficiary, the power of attorney or other advance directive needs to grant the agent the ability to make health-care decisions for the principal.

What is springing power of attorney?

Springing power of attorney: legal authority only begins in certain circumstances or when a specific event occurs, such as mental incapacitation. Durable power of attorney: legal authority is granted once the document is signed and stays in effect throughout the principal’s life. For a caregiver of a Medicare beneficiary, ...

How to find an elder law attorney?

You may want to ask your family and friends for elder law attorney recommendations. The following organizations may also be able to help: 1 The National Academy of Elder Law Attorneys (NAELA) assists lawyers, bar associations, and others who work with older clients and their families. Their website offers referrals, tips, and resources for finding an elder law attorney. 2 The National Elder Law Foundation certifies elder law attorneys and can help you locate certified attorneys in your area. 3 The American Bar Association (ABA) website has a Lawyer Locator tool that allows you to search for specialty lawyers in your area. 4 State bar associations may offer legal information and referrals. 5 Your Area Agency on Aging (AAA) may be able to provide guidance around legal issues and finding an attorney.

What is elder law?

Elder law is a broad field that encompasses estate planning, Medicare law, Medicaid law, insurance issues, nursing home issues, and planning for future health needs. You may want to get help from an elder law attorney if you are creating documents for your future care needs.

What is the ABA website?

The American Bar Association (ABA) website has a Lawyer Locator tool that allows you to search for specialty lawyers in your area. State bar associations may offer legal information and referrals. Your Area Agency on Aging (AAA) may be able to provide guidance around legal issues and finding an attorney.

What is the LSC program?

Federally funded programs are listed on the website of the Legal Services Corporation (LSC). State bar associations may offer reduced or free (pro bono) legal services. The Administration on Aging lists hotlines you can call to get legal help regardless of your finances.

Medicare Eligibility, Applications and Appeals

Find information about Medicare, how to apply, report fraud and complaints.

Medicare Prescription Drug Coverage (Part D)

Part D of Medicare is an insurance coverage plan for prescription medication. Learn about the costs for Medicare drug coverage.

Replace Your Medicare Card

You can replace your Medicare card in one of the following ways if it was lost, stolen, or destroyed:

Medicare Coverage Outside the United States

Medicare coverage outside the United States is limited. Learn about coverage if you live or are traveling outside the United States.

Voluntary Termination of Medicare Part B

You can voluntarily terminate your Medicare Part B (medical insurance). It is a serious decision. You must submit Form CMS-1763 ( PDF, Download Adobe Reader) to the Social Security Administration (SSA). Visit or call the SSA ( 1-800-772-1213) to get this form.

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