Do you know what you’re entitled to, and how many resources are available to seniors? The costs of long-term care can deplete a life savings in the blink of an eye. Let us help you in the decision making process, and show you the way through the maze of programs and benefits and prepare the applications to qualify. These programs are, by definition, complicated, bureaucratic, and overwhelming for most older adults and their families. We act as your means of access to these agencies and programs.
Medicaid Applications and Community Medicaid
Medicaid is a program managed by the states and funded jointly by the states and federal government to provide health insurance for certain individuals and families with low incomes and resources. Medicaid is the largest source of funding for medical and health-related services for people with limited financial resources; among the groups served by Medicaid are eligible low-income seniors, people with disabilities, parents, and children. Medicaid requirements for eligibility, services, and payment are complex and vary considerably, even among states of similar size or geographic proximity. In addition, state legislatures may change Medicaid eligibility, services, and/or reimbursement during the year. Medicaid currently covers 53 million Americans, paying for nearly 60 percent of all nursing home residents in the United States.
Social Security Retirement Benefits, Supplemental Security Income (SSI), and Social Security Disability Insurance (SSDI)
Social Security has two distinct meanings in American life. Specifically, it refers to the old age insurance system established by the Social Security Act of 1935. It also describes a much broader goal: protection for all citizens against a wide range of suffering, including poverty, homelessness, disability, and ill health. It is also known as the Old Age, Survivors and Disability Insurance program (OASDI), in reference to its three components. In the calendar year 2004, it paid out almost $500 billion in benefits.
The largest component of OASDI is the payment of retirement benefits. Throughout a worker's career, the Social Security Administration keeps track of his or her earnings. The amount of the monthly benefit to which the worker is entitled depends upon that earnings record and upon the age at which the retiree chooses to begin receiving benefits. As of 2005, the earliest age at which benefits are payable is 62.
A Supplemental Security Income (SSI) system, enacted in 1972, established a national system of means-tested assistance for the elderly and disabled poor. SSI is a monthly stipend provided to individuals, such as those who are permanently disabled, who prove to the Social Security Administration that they cannot work and have no other assets or income. The SSI program provides federal monthly cash assistance to help meet the costs of basic needs of food, shelter and clothing. In New York State, SSI eligibility assures concurrent access to important medical coverage under the various state Medicaid programs.
Upon becoming totally disabled, Social Security Disability Insurance (SSDI) is available to workers who have worked long enough and recently enough to be covered, regardless of his or her age. The worker must be unable to continue in his or her previous job and unable to adjust to other work. Additionally, the disability must be long-term or expected to last for at least one year or to result in death.
Medicare and Supplemental Coverage
Medicare is a program of national health insurance for persons who are over the age of sixty-five or seriously disabled. Medicare subsidizes people who meet one of the following criteria: over the age of 65 and has been a U.S. citizen or permanent legal resident for five years; or disabled and has collected Social Security for a minimum of two years; or undergoing dialysis for kidney failure or who is in need of a kidney transplant; or has Amyotrophic Lateral Sclerosis (ALS-Lou Gehrig's disease). Medicare helps people at a time in their lives when they may have serious health problems but lack the funding for treatment.
Medicare is divided into two parts, A and B. Part A coverage encompasses Major Medical costs such as in-patient hospital, skilled nursing facility for up to 100 days, home health and hospice care. Part B coverage encompasses almost all the necessary medical services, including doctors' services, laboratory and x-ray services, and wheelchairs.
The U.S. Department of Veterans Affairs was established to operate programs to benefit veterans and their families. Established in 1989, its predecessor was an independent agency, the Veterans Administration, which had been created in 1930. The department is divided into the Veterans Health Administration, the Veterans Benefits Administration, and the National Cemetery System. It manages veterans’ hospitals and clinics, and oversees the eligibility and disbursement of disability pensions, veterans' educational assistance programs, vocational rehabilitation for disabled vets, and the mortgage loan guaranty program. If you or an elder family member served in the military, you may qualify for some or all of these benefits.
Home Energy Assistance Program (HEAP)
The low-income Home Energy Assistance Program (HEAP) is a federally funded energy assistance program. New York's benefit program is structured in such a way that higher benefits are provided to those households that have larger percentages of their income spent on energy costs; contain a vulnerable individual; and have the lowest income. Vulnerable individuals are defined as adults aged 60 or older, or disabled individuals, or children under the age of 6. Eligibility for the program is based on income and an eligible housing situation.
Elderly Pharmaceutical Insurance Coverage (EPIC) Program
EPIC is a New York State sponsored prescription plan for senior citizens who need help paying for their prescriptions. Over 340,000 seniors already belong and are saving, on average, over 80% of the cost of their medicines. New York State residents can join EPIC if they are 65 or older, and have an annual income of $35,000 or less if single, or $50,000 or less if married. Seniors who receive full Medicaid benefits or have other prescription coverage that is better than EPIC are not eligible for EPIC benefits. There are both fee plans and deductible plans, and co-payments apply. Almost all prescription medicines are covered, including insulin, insulin syringes, and needles.
School Tax Relief Program (STAR)
STAR is the New York State School Tax Relief Program that provides a partial exemption from school property taxes. All New Yorkers who own and live in their one-, two-, or three-family home, condominium, cooperative apartment, manufactured home, or farm dwelling are eligible for a STAR exemption on their primary residence.
The “Basic” STAR exemption is available for owner-occupied, primary residences regardless of the owners’ ages or incomes. Basic STAR works by exempting the first $30,000 of the full value of a home from school taxes.
The “Enhanced” STAR exemption is available for the primary residences of senior citizens, age 65 and older, with yearly household incomes not exceeding the statewide standard. For qualifying senior citizens, the Enhanced STAR program works by exempting the first $50,000 of the full value of their home from school property taxes. For property owned by a husband and wife, or by siblings, only one of them must be at least 65 years of age as of December 31 of the year in which the exemption will begin to qualify for the Enhanced exemption. Their combined annual income, however, must not exceed the STAR income standard.
"Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." Margaret Mead
"Without community service, we would not have a strong quality of life. It's important to the person who serves as well as the recipient. It's the way in which we ourselves grow and develop." Dr. Dorothy Height
The availability of community services is often overlooked by our elder citizens and their relatives. Churches, synagogues, mosques, community centers, scouting organizations, schools, religious and fraternal organizations, libraries, chambers of commerce, community councils, philanthropic, civic and business groups – just to name a few – all provide services to benefit the community and its residents. Our professionals are knowledgeable in the community services available throughout the region, and make referrals to programs on behalf of our clients.