Continuum The

Issue 7 Fall 2016

If you have a Medicare Advantage

or prescription drug plan, Open En-

rollment runs October 15 through

December 7 and is the time most

people can make changes to their

plan. Even if you’re happy with your

current coverage, you might find

something that’s a better fit for your

budget or your health needs. If you

miss an Open Enrollment deadline,

you’ll most likely have to wait a full

year before you can make changes

to your plan.

If you or an elderly loved one are

covered by Medicare, here are six

important things you can do to get

ready for Medicare Open Enroll-

ment.

1. Confirm that Open Enrollment

applies to you.

The 10/15—12/7 Open Enrollment

isn’t for everyone. If you are a resi-

dent of a nursing home, recipient of

Medicaid, Extra Help, or the Medi-

care Savings Program, you receive

a Medicare Special Enrollment Peri-

od and can make changes through-

out the year. Also, if new to Medi-

care, you will be given an initial op-

portunity to make choices.

2. Review your plan notice.

Be sure to read any notices from

your Medicare plan about changes

for next year, especially your

“Annual Notice of Change” letter.

Look at your plan’s information to

make sure your drugs are still cov-

ered and your doctors are still in

network.

3. Think about what matters most

to you.

Medicare Advantage and drug

plans change each year and so can

your health needs. Do you need a

new primary care doctor? Does

your network include the specialist

you want for an upcoming surgery?

Is your new medication covered by

your current plan? Does another

plan offer the same value at a lower

cost? Take stock of your health sta-

tus and determine if you need to

make a change.

4. Find out if you qualify for help

paying for your Medicare.

Learn about programs in your state

to help with the costs of Medicare

premiums, your Medicare Part A

(hospital insurance) and Medicare

Part B (medical insurance) deducti-

bles, coinsurance and copayments

and Medicare prescription drug cov-

erage costs. You can do this by visit-

ing Medicare.gov or making an ap-

pointment with a local State Health

Insurance Assistance Program

(SHIP) counselor.

5. Shop for plans that meet your

needs and fit your budget.

Starting in October, you can use

Medicare’s plan finder tool at Medi-

care.gov/find-a-plan to see what oth-

er plans are offered in your area. A

new plan may cost less, cover your

drugs, or let you go to the providers

you want, like your doctor or

pharmacy.

If you find that your current coverage

still meets your needs, then you’re

done.

Remember, during Medicare Open

Enrollment, you can decide to stay in

Original Medicare or join a Medicare

Advantage Plan. If you’re already in

a Medicare Advantage Plan, you

can switch back to Original Medicare

and enroll in a Medicare drug plan.

6. Check your plan’s star rating

before you enroll.

Medicare Open Enrollment Ends December 7

Elder Law Practice of Timothy L. Takacs, PLLC 201 Walton Ferry Road, Hendersonville, TN

P2 / Questions about

Medicare during

Open Enrollment?

Our videos may have

the answers.

P5 / Are you low

hanging fruit for a

fraudster? These

tips will help you ruin

a scammer’s day.

P7 / Wondering if you

should hire your own

in-home caregiver?

Three questions will

help you decide.

P3 / Did you miss

September’s client

education meeting?

No problem! Read

the session recap.

Six things to do right now to pave the way for good decisions on 2017 coverage

Turn to Page 2

The Continuum / Page 2

The Medicare Plan Finder has been

updated with the 2016 Star Ratings

for Medicare Advantage and pre-

scription drug plans. Plans are given

an overall quality rating on a 1 to 5

star scale, with 1 star representing

poor performance and 5 stars repre-

senting excellent performance. Use

the Star Ratings to compare the

quality of health and drug plans be-

ing offered.

These are a few easy ways to get a

jump start on your Medicare Open

Enrollment. For more information,

call 800-MEDICARE [(800)633-

4227)], and say “Agent” or visit a

local State Health Insurance Assis-

tance Program (SHIP) counselor for

free, one-on-one, Medicare assis-

tance. To access SHIP in Middle

Tennessee, call (877) 801-0044.

If you are an Elder Law Practice cli-

ent with a Life Care Plan, Medicare

assistance is part of your service

package. Just give the office a call.

We are happy to help.~

Medicare Open Enrollment

Ends December 7

Donut Hole Getting Smaller

In 2017, if beneficiaries reach the

coverage gap known as the “donut

hole” in Medicare’s prescription

drug benefit, they will pay 40 per-

cent of the plan’s cost for covered

brand-name drugs and 51 percent

of the plan’s cost for covered ge-

neric drugs until they have reached

the end of the coverage gap.

Online Tools Improving

Medicare continues to improve the

online tools and support available

to Medicare beneficiaries during

annual Open Enrollment. Look for

the following enhancements if you

log on to MyMedicare.gov:

If you’re using the prescription

drug tool on mymedicare.gov, a

“basket” of drugs will auto popu-

late based on the last 12

months of drug claims.

Sanctioned plans will show up

on the plan finder tool.

Some plans will have premium

“buy down” options where the

plan buys down a portion of the

member’s premium. Though not

much is known about this

change at press time, we do

know that this is NOT the same

as Medicare Savings Program.

Contact the plan directly to see

if you are eligible.

2017 Info Coming Soon

2017 Medicare premiums, deducti-

bles and co-insurance amounts

have not yet been released but are

expected to be announced in No-

vember.

Preventive Care Important

One important thing that isn’t

changing merits mention: Medi-

care’s preventive care program.

Certain preventive benefits – includ-

ing certain cancer screenings – are

available at no cost to beneficiaries

when provided by qualified and par-

ticipating health professionals. The

annual wellness visit provides bene-

ficiaries with the opportunity to sit

down with their doctor to discuss

their health care needs and the best

ways to stay healthy. It’s a benefit

worth taking advantage of every

year. ~

Medicare: What’s New? Continued from Page 1

New to Medicare? Need a refresher? The digital version of The Continuum

features an article on the A, B, Cs, & Ds of Medicare as well as a video ex-

plaining the different ways a person can get Medicare coverage. Read the

article and watch the video at http://www.tn-elderlaw.com/blog/the-

continuum-fall-2016/medicare-abcd.~

View More Medicare Videos

Still have questions? We’ve posted

a series of short educational videos

by Medicare Specialist Bonnie

Woodard and Public Benefits Spe-

cialist Berkley Crain. View the vide-

os at http://

www.tn-

elderlaw.com/

blog/the-

continuum-fall-

2016/medicare

-video-center

or scan the

QR code.~

The Continuum / Page 3

Client Education Recap

The delivery of healthcare to Medi-

care beneficiaries may be headed in

a new direction under the Affordable

Care Act. In July 2016, the Centers

for Medicare and Medicaid Services

(CMS) issued a final rule outlining

new policies that aim to shift Medi-

care payments from volume to val-

ue.

The Administration has set measur-

able goals and a timeline to move

the Medicare program, and the

health care system at large, toward

paying providers based on the quali-

ty, rather than the quantity of care

they provide to their patients. This

final rule includes policies that ad-

vance that vision and support build-

ing a health care system that deliv-

ers better care, spends health care

dollars more wisely, and results in

healthier people.

This amounts to a revamping of the

health care delivery system from

one revolving around providers to

one that puts patients at the center.

Healthcare providers work as a

team, sharing records, coordinating

care, avoiding duplication of effort,

and reducing out-of-pocket costs

for families.

How will these tentative first steps

toward reform translate to changes

in each Medicare

beneficiary’s ex-

perience? That

remains to be

seen. In the

meantime, Elder

Law Practice

staff members

will be keeping a

close eye on this

trend. Watch for

updates in future

issues of The

Continuum.~

Healthcare Delivery: Changes Ahead?

Elder Law Practice offers ongoing

education to clients and their fami-

lies. This article offers a brief recap

of the information shared by Elder

Care Coordinators Debra King and

Pati Bedwell during the September

Coffee Connections (for spouses of

clients currently living in a long-term

care facility) and Caregiver Chil-

dren’s groups (for adult children of

clients).

Nursing Homes & Assisted Living

Centers Are Regulated Differently.

The difference is best illustrated by

comparing the regulatory docu-

ments. Nursing homes must comply

with 750 pages of federal regula-

tions; documents detailing regula-

tions for assisted living centers are

approximately 50 pages long.

Residents’ Rights Differ by Care

Setting. The rights patients have

in different care settings are essen-

tially the same basic rights we all

enjoy as Americans. The more re-

strictive the care setting (and the

regulations that govern it), the more

difficult it is for a resident to access

the full range of rights as we know

them. That’s why it is important for

family caregivers to understand

residents’ rights.

Transitions and Bed Certifica-

tion. When transitioning from a

skilled care setting to a long-term

care center, bed certification is of-

ten an issue. Patients have the

right to refuse room transfers in

certain situations.

Care Planning is Mandatory. A

care plan should be created within

the first couple of weeks of admis-

sion. After that, meetings to discuss

care plans should be held at least

quarterly at times that are conven-

ient for the resident and family mem-

bers.

Family Involvement Makes a

Difference. Being an effective ad-

vocate for your loved one’s care is

always easier when you are a regu-

lar visitor. As the old adage goes,

the squeaky wheel gets the grease.

The digital edition of The Continuum

offers a closer look at the topic. Go

to http://www.tn-elderlaw.com/blog/

the-continuum-fall-2016/sep-recap.

The next Coffee Connections is set

for November 3 and the next Care-

giver Children’s meeting is set for

November 15. Invitational postcards

will be mailed in advance. The topic

will be driving issues.~

Patients’ Rights & Care Planning Focus of September Meetings

The Continuum / Page 4

TEAM TIDBITS: Passionate about Pets

THIS ISSUE: Scan the QR code on the right or

visit https://youtu.be/BdZHFFgTzrY to see Barbara

Boone McGinnis discuss disinheriting a child. This

video ignited a passionate discussion when it was

posted on the firm’s Facebook page in September.

Access the entire Elder Law Practice video library

at www.youtube.com/channel/

UCSfufjc21P6VpxCvEc2B4Xw. ~

Check out the Elder Law Practice YouTube Channel

Did you know that the digital edition

of The Continuum contains bonus

content? Call (615) 824-2571 or

email us at

continuum@tn-elderlaw.com to

subscribe. If you know someone who

might benefit from this publication,

we encourage you to share it.~

Elder Law Practice staff members

are passionate about their pets.

Tim Takacs’ four cats and Barbara

Boone McGinnis’ two dogs are just

a representative sample; almost

every Elder Law Practice employee

has at least one beloved fur baby.

Collectively, the Elder Law Practice

demonstrates its support to cuddly

companions in a variety of ways,

including donations to the local Hu-

mane Society. On more than one

occasion, Tim and Lynn Takacs

have requested that the staff take

donations of cash or goods for do-

nation to the Sumner County Hu-

mane Society in lieu of birthday or

holiday gifts.

Elder Law Practice also creates

pet trusts for clients who want to

leave money to be used for the

care of a dog, cat or other animal.

The trust puts someone in charge

of managing and spending the

funds, following a written set of in-

structions provided by the pet’s

owner. Until recently, most states

didn't allow trusts for animals but

now, almost all states allow for the

creation of trusts for pets, with no

human beneficiary. For more infor-

mation about pet trusts, the Ameri-

can Society for the Prevention of

Cruelty to Animals (ASPCA) website

does a good job of explaining the

basics. Visit http://www.aspca.org/

pet-care/pet-planning/pet-trust-

primer.

For a complete rundown of Elder

Law Practice staff members and

their pets, view the digital edition of

this article at http://www.tn-

elderlaw.com/blog/the-continuum-

fall-2016/team-tidbit-pets.~

Timely Tips for Caregivers

Sign up for A Matter of Balance

This nationally-recognized program

helps seniors reduce the fear of fall-

ing while increasing their activity

levels. The workshop series is

available at locations throughout

Middle Tennessee. For more infor-

mation, visit www.gnrc.org or call

(615) 255-1010 or (877) 973-6467.

Alzheimer’s Study Seeks

Patients

Clinical Research Associates is

conducting two clinical trials for Alz-

heimer medications in the Nashville

area. Participants must be be-

tween the ages of 55 and 85, have

been diagnosed with mild to mod-

erate Alzheimer’s and have no his-

tory of stroke. The study lasts a

total of 78 weeks. To participate,

call (615) 329-2222 or visit https://

www.clinicalresearchassociates.co

m/study/alz.

Did You Know?

If you are a Life Care Planning cli-

ent, caregiver advocacy support is

included in your service agree-

ment. If you’re not utilizing this ser-

vice, call your Elder Care Coordina-

tor at (615) 824-2571 to get started.

Dealing with Irrational Fears

It’s common for older adults to de-

velop persisting fears, worries and

complaints that strike family mem-

bers as paranoid, absurd or ridicu-

lous. Learn strategies to deal with

this challenging situation and down-

load helpful resources at http://

betterhealthwhileaging.net/qa-4-

things-when-aging-parent-

irrational/.~

The Continuum / Page 5

Q Do Medicare Managed Care

plans cover the Initial Preven-

tive Physical Exam and the Annual

Wellness Visit?

A Yes, the Initial Preventive

Physical Exam and the Annu-

al Wellness Visit must be covered

by all Medicare Managed Care

plans following Centers for Medi-

care & Medicaid Service coverage

requirements and guidelines for

these services. Medicare Ad-

vantage plans are required by law

to cover all items and services cov-

ered under Medicare Parts A & B

that are available to Medicare ben-

eficiaries in the plan’s service area.

Q Do I need an attorney to

probate an estate in Tennes-

see?

A Yes. Probate is not a do-it-

yourself project. It can be a

very complicated process. Detailed

knowledge of Tennessee probate

law and court procedures is re-

quired. Tennessee law imposes a

number of deadlines that must be

complied with in order to properly

probate an estate.

Senior citizens are targeted more

frequently by financial fraudsters

and scam artists than any other age

group. This happens for a number of

reasons. Seniors are most likely to

have a substantial nest egg, own

their home and have excellent cred-

it. Seniors are less likely to report a

fraud, either because they don't

know who to report it to, are too

ashamed at having been scammed,

or don't know they have been vic-

timized. What can you do to make

sure you--or someone you love--

aren't bilked by a scammer?

Don’t open or respond to emails

from people you don’t know.

Never send bank account or

credit card information by email.

If you get a pop-up message

saying your computer has been

infected with a virus don’t click

Sidestepping Senior Scams

on it. Shut the computer down

instead.

Delete email messages that

ask you to verify bank account

information.

Don't offer unknown visitors

access to your home.

Don’t be rushed into having

work done. Get all estimates in

writing.

Never send money to a bill col-

lector who threatens you over

the phone.

Sign up for the national Do Not

Call Registry by calling (888)

382-1222.

Sign up for AARP Fraud Watch

Network at https://

action.aarp.org/site/

SPageNavigator/

FWN_Registration_Page.html.

Check the AARP Scam Tracking

Map at https://action.aarp.org/

site/SPageNavigator/

FraudMap.html.

Sign up for the Council on Aging

Top Ten Scams report at https://

www.ncoa.org/economic-

security/money-management/

scams-security/top-10-scams-

targeting-seniors/.

The digital edition of The Continuum

offers more tips. Visit http://www.tn-

elderlaw.com/blog/the-continuum-

fall-2016/sidestepping-scams.

A firm grounding in the facts, a little

diligence and a healthy dose of

skepticism will help you avoid being

ensnared in scams targeting sen-

iors.~

Q Does Medicare cover

Advance Care Planning?

A As of January 1, 2016, Medi-

care will cover advance care

planning as a separate service pro-

vided by physicians and other health

professionals. As with most other

physician services, beneficiaries are

subject to cost sharing for advance

care planning provided by their phy-

sician or health professional. There

is no cost sharing liability for ad-

vance care planning provided in

conjunction with an Annual Wellness

Visit.~

The Continuum / Page 6

Many clients tell us that more peo-

ple need to know about what we

do at Elder Law Practice. If you’ve

ever said or thought that, there’s

now something you can do to help:

write a review of Elder Law Prac-

tice on one or more crowd-sourced

online review websites.

Sites like Google, Yelp, Facebook,

and Better Business Bureau are

well known for their online reviews.

Other sites that specialize in the

legal field—Lawyers.com, Av-

vo.com, Justia.com, and Law-

yers.FindLaw.com, to name just a

few—feature client reviews of indi-

vidual attorneys and law firms.

If you’re happy with the service

you’ve received from the team at

Elder Law Practice, please consid-

er sharing your thoughts on an

October 20: Medicare Overview/Client Training Module. Educational gathering for Elder Law Practice clients. 1:30 p.m.—2:30 p.m. 201 Walton Ferry Road, Hendersonville. RSVP requested. (615) 824-2571.

November 3: Coffee Connections. Educational gathering for spouses of Elder Law Practice clients who are living in long-term care facilities. 2 p.m.—3 p.m. 201 Walton Ferry Road, Hendersonville. RSVP requested. (615) 824-2571.

November 10: Advance Directives Education. Elder Care Coordinator Debra King, LMSW presents a program on Advance Directives at Trinity Adult Day Care Fundraiser Seminar. 9 a.m.—12 p.m. Wesley Heights United Methodist Church, Tullahoma, TN.

November 15: Caregiver Children Meeting. Educational gathering for children whose parents are Elder Law Practice clients. 6 p.m.– 8 p.m. 201 Walton Ferry Road, Hendersonville. RSVP requested. (615) 824-2571.

December 15: Will I Lose My House to the Nursing Home? Attorney Barbara Boone McGinnis presents a Lunch & Learn presentation. 11:30 a.m.—1:30 p.m. Delmas Long Community Center, Goodlettsville, TN. RSVP requested. (615) 826-9622.

For more events, visit TN-ElderLaw.com or ElderLawEducation.com.~

Help Us Spread the Word

On the Calendar

online review site. The digital ver-

sion of this article provides direct

links to many of these online review

sites along with detailed instructions

for submitting a review. View it at

http://www.tn-elderlaw.com/blog/the-

continuum-fall-2016/write-a-review.

If you’re not sure what to say in your

review, use the following prompts as

thought starters.

1. Describe the problem that

brought you to the firm.

2. Talk about how the Elder Law

Practice staff helped you solve

your problem.

3. Explain how the firm’s services

benefitted you.

4. Leave a tip or advice for future

clients.~

To the world you may be one

person; but to one person you

may be the world.

― Dr. Seuss

The Continuum / Page 7

Guest Column

Caregiving and relationships are

closely interwoven. Trust, compas-

sion and integrity are at the heart of

caregiving and relationships. Choos-

ing a caregiver involves these ele-

ments. Whether your choice is a

neighbor two doors down or a friend

from church, finding a caregiver is,

logically, a relational choice.

Most people who need help with

their daily activities rely on unpaid

care provided to them by family

members and friends. More and

more, however, seniors and their

families are recognizing the benefits

of hiring caregivers, to help stay in

their homes longer, in comfort and

safety, and to give families peace of

mind. Likewise, many states and the

federal government are now setting

aside some funds to allow people

who otherwise could not afford it to

pay for outside help.

If you’re in the market for a caregiv-

er but aren’t sure whether to work

through a home care company or

hire someone yourself, consider the

following questions:

Do you know what services you

need?

Evaluate the help needed in the are-

as of health care, personal care and

household care. What will the care-

giver be required to do? Make a list

and be specific.

Are you equipped to make a good

hiring decision?

A lot will be riding on your choice.

Do you know where to look for good

candidates, and what screenings

and background checks to con-

duct? Do you know how to deter-

mine if a candidate is eligible to

work in the U.S.?

Are you willing to be an

employer?

If you hire someone yourself, you

become responsible for payroll tax-

es, worker’s compensation insur-

ance and other legal obligations.

Being an employer also means as-

suming certain risks. Not everyone

has the stomach for this.

If your answer to any of these

questions is no, consider looking to

the professionals for help. Most

home care companies can help

you determine what care is need-

ed. They know where to find quali-

ty people and run the background,

credit, reference, and employment

eligibility checks needed to make

sure they are fit to care for your

loved one. Home care companies

also assume all of the responsibili-

ties and risks of an employer.

By asking a few simple questions,

you'll be able to de-

termine what kind

of in-home caregiv-

er is the right fit for

your loved one—

and you.

Luke Metcalf is the

Medical Marketplace Director at

Caregivers by WholeCare. For

more information, call (615) 388-

3103 or email

luke@wholecareconnections.com.

If you find it in your heart to care for

someone else, you will have

succeeded.

― Maya Angelou

Securing Quality In-Home Care Relationships and accountability are key factors to consider

Information contained herein may contain general explanations of

laws. It should not be considered as legal advice. Please seek counsel

from an attorney regarding legal planning.

Copyright 2016

The Continuum is a quarterly newsletter designed to

enhance the service Elder Law Practice of Timothy

L. Takacs, PLLC provides to clients. Please direct

feedback, questions and comments to continu-

um@tn-elderlaw.com.

Phone: (615) 824-2571

Fax: (615) 824-8772

Toll-Free (866) 222-3127

Family Education Website:

www.tn-elderlaw.com

Professional Education Website:

www.elderlaweducation.com.

201 Walton Ferry Road

Hendersonville, TN 37075

*** NOTE: If you did not receive this issue by mail but would

like to be added to the mailing list for future issues, please

call (615) 824-2571. ***

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PAID

NASHVILLE, TN

PERMIT NO. 3731 Tim Takacs, CELA

Certified as an Elder Law Attorney by the

National Elder Law Foundation

Certified as an Elder Law Specialist in Tennessee

Barbara Boone McGinnis, JD, Attorney

Lisa Proctor, Office Administrator

Pati Bedwell, Elder Care Coordinator

Debra King, LMSW, Elder Care Coordinator

Bonnie Woodard, Medicare Specialist

Joshua Bey, Public Benefits Specialist

Berkley Crain, Public Benefits Specialist

Ann Elise Walston, Legal Assistant

Chelle Guidry, Legal Assistant

Bo Siler, Office Assistant