Elders Home, Health and Life Insurance: Questions and Answers

Question
Should we get a home equity line of credit in order to have money to pay for a nursing home, until we can get the parent's home sold?

Answer

There is no question that selling a house in the current real estate market is a challenge. Many people find themselves in your situation when loved ones need to move out of the house into a long term care facility, and their house is their only asset.

A home equity line of credit is an option, if your parents can qualify. To qualify, your parents will need to demonstrate that they have enough income to cover the monthly payments. They also need to have a good credit score, which many seniors lack. Sometimes, a local bank where your parents have been good customers will be able to structure a loan. Or if you are willing to co-sign the loan, your bank may accept that.

Because this situation is becoming more common, there are new programs springing up to help. Some realtors will guarantee to buy the house for cash if they cannot sell it within a predetermined time period. Other companies aggregate relatives and friends to jointly borrow the money. These programs may be available in your area.

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Question

If someone cannot pay their Medicare premium can they get an extension or will their plan be terminated? If they can't pay what will their termination date be? If an extension is granted how many days will they get?

Answer

It is hard to tell from your question which type of Medicare premium you are asking about. There are three kinds of bills you might have to pay: a monthly premium for Part B coverage; a Medicare Part D prescription drug plan; and a monthly premium for both Medicare Part A and B coverage through a Medicare Advantage managed care plan. But whichever of these Medicare programs you have, there is help available if you cannot afford the premiums.

Most people have their Medicare Part B premiums automatically deducted from their monthly Social Security benefits check. But some people who are not collecting Social Security benefits have to pay their Medicare Part B premium directly; they get a bill for their Medicare Part premium every three months. If you are one of these people but cannot afford the premiums, you can apply for one of several programs that can pay the premiums for you. These programs are Medicaid, Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI). These same programs can also help you if you are enrolled in a Medicare Advantage HMO or other managed care plan.

If you have a Medicare Part D prescription drug plan and are having trouble paying the premium, there is another special program that might help you. This is called the low-income beneficiary program.

You may qualify for one or more of these programs if you have low monthly income and few savings or other assets. Depending on which program you qualify for, you might get not only your Part B premium paid but also all your Medicare deductibles and copayments. If you qualify for a low-income subsidy, it may not only pay your premium but also reduce the cost of your drugs. Fortunately, you can apply for all of these programs at one time and in one place, at your state's own Medicaid office, which is usually at a local county social service or social welfare office.

To find out where to apply for Medicaid and these other programs in your state, go to the Benefits.gov web site and click on the name of your state. This will take you to a page which gives information about the local office where you apply for Medicaid, and tells you how to contact them so you can learn what paperwork, about your income, assets, and medical expenses, to bring with you when you file your application. You can also get free information about where and how to apply by calling the Eldercare Locator toll-free at 800-677-1116.

Another place to get excellent help with this is your local office of the State Health Insurance Program (SHIP) or Health Insurance Counseling and Advocacy Program (HICAP). This non-profit counseling service provides free, expert assistance with questions regarding Medicare, Medicaid and related programs. You can get the number of your state office of SHIP or HICAP from the Medicare web site's directory; the state office can then direct you to the local office nearest you.