Malti Patel

Q. Is it true that if you have low income you can get help paying Medicare premiums?

A. Yes. If your income and resources are limited, your state may be able to help with your Medicare Part B premium, deductibles and coinsurance amounts. State rules vary on the income and resources that apply. Contact your state or local medical assistance, social services or welfare office, or call the Medicare hotline, 1-800-MEDICARE (1-800-633-4227) and ask about the Medicare Savings Programs.

If you have limited income and resources, you also may be eligible for help paying for Prescription Drug Coverage under Medicare Part D.

Q. I did not apply for Medicare when I turned 65. Can I apply later?

A. A general enrollment period from January 1 through March 31 of each year permits people 65 or over who failed to enroll or dropped their Part B Medicare coverage to sign up. Their coverage will begin July 1.

Generally, a 10 percent premium penalty will be added to the monthly premium for each year you could have enrolled but did not. However, if you are covered by an employer or union group health plan through you or your spouse's current or active employment, you may qualify for a special enrollment period.

If you meet the requirements for a special enrollment period, you do not have to wait for a general enrollment period or pay a premium penalty. You have an eight- month special enrollment period if you have group health plan coverage from current employment at the time you first became eligible for Medicare. This special enrollment period begins with the month employment ends or the month your group health plan coverage ends, whichever comes first.

Q. I am 65 and my wife is 62 and receiving spouse's benefits. When does she qualify for Medicare benefits?

A. Most people must wait until age 65 to qualify for Medicare benefits. Some people can get Medicare at any age. This includes people who:

" Have been getting Social Security disability benefits for 24 months;

" Have kidney failure and require dialysis;

" Have had a kidney transplant; or

" Receive disability benefits because they suffer from amyotrophic lateral sclerosis (also known as Lou Gehrig's disease).

Q. Will Medicare cover my medical expenses outside of the U.S.?

A. Persons living or traveling outside the United States usually cannot benefit from Medicare. This is because, generally speaking, the program provides protection against the cost of hospital and medical expenses incurred in the United States.

There are rare emergency cases where Medicare can pay for care in Canada or Mexico. Also, Medicare can sometimes pay if a Canadian or Mexican hospital is closer to your home than the nearest U.S. hospital that can provide the care you need. If you get emergency treatment in a Canadian or Mexican hospital or if you live near one, ask someone who works at the hospital about Medicare coverage, or have the hospital help you contact the Medicare Intermediary.

Health insurance protection may be very important to anyone going temporarily abroad who plans to return to the United States. If you plan to return to the United States shortly after you are eligible for the medical insurance program, you may wish to enroll during your first enrollment period. If you expect to be abroad for a longer period of time, you may wish to enroll during a later general enrollment period.

A general enrollment period is held January 1 through March 31 of each year. Your protection will begin July 1 of the year you enroll. If you enroll during a general enrollment period, your monthly premium may be increased by 10 percent for each 12-month period you could have had medical insurance coverage but were not enrolled. You will have to pay this extra amount as long as you have Part B.

NOTE: If you are covered by an employer or union group health plan through your or your spouse's current or active employment, you may qualify for a special enrollment period.

Q. Does Medicare have an 800 number?

A. Yes. You may direct your questions to Medicare's representatives at their toll-free number, 1-800-633-4227. Hearing and speech impaired individuals may call their toll-free "TTY/TDD" number, 1-877-486-2048, during regular business hours.

These questions and answers are courtesy of Malti Patel, 1607 Wood Creek Lane, Allen, Texas-75002. Patel published a book "Lifting the Mists: A simple guide to a complex welfare system for elderly immigrants and their families." Contact Patel at [email protected] to order the book.

	Ramesh Parekh

What is "Long-Term Care?"

As we grow older, there are greater possibilities that we may not be able to perform our routine tasks such as bathing, dressing, eating, etc. Such needs generally arise because of a prolonged physical illness, a disability or a cognitive impairment (such as Alzheimer's disease). Long Term Care (LTC) is different from traditional medical care. LTC includes help with activities of daily living, home health care, nursing home care or care in an assisted living facility. The type of care can be either skilled or custodial care.

Cost of LTC

LTC costs can be high. The costs vary depending upon the parts of the country and the type of care needed. According to Genworth 2009 Cost of Care Survey, a sample of Median LTC costs in Tampa-St. Petersburg Area:

Nursing home private room - Annual ----- $82,125

Assisted living facility private one bedroom - Annual ----- $24,000

Home Health Aid Service - hourly rate ----- $17-$32

Who bears the burden of long-term care?

There are basically three sources of funds available for LTC:

1. Self-insurance - own or family and friends funds

2. Public program - Medicaid if qualified for the poverty level prescribed by the state.

3. Long-term care insurance

Reasons people buy LTC insurance:

1. Financial protection for retirement

2. Protecting families

3. Wealth and estate protection

4. Financial independence

5. Peace of mind

Recognizing the seriousness of the long-term care costs on an aging society like ours, Congress provided specific tax benefit for long-term care policy premiums. Many states, including Florida, have instituted state LTC Partnership Programs to encourage the public to get LTC coverage.

Long-term care insurance is a part of an individual's financial planning and risk management. You should consult a financial adviser for your specific needs and financial suitability.

Florida Resources for more information:

Florida Department of Elder Affairs - Tallahassee (850) 414-2000

National Association of Insurance Commissioners, Kansas City, Mont.; (816) 842-3600; www.naic.org

Ramesh Parekh, CPA, can be reached at (727) 461-9770 or e-mail [email protected] or [email protected]