January 2018 Newsletter

Effective January 1, 2018 


The current Medicare and Medicaid allowances for 2018 has been revised. I am sharing this information that was passed on to me by Benjamin D.Eckman, an elder law attorney practicing in New Jersey. 

Medicare Part A deductible: $1340 for each benefit period.

Medicare Part A hospital stay day 1-60: $0 co-insurance for each benefit period.

Medicare Part A hospital stay day 61-90: $335/day co-insurance for each benefit period.

Medicare Part A hospital stay beyond 91 days: $670/day co-insurance for each benefit period.

Medicare Part B Premium: $134/month

Medicare Part B Deductible: $183/year

Medicare Skilled nursing home co-payment day 21-100: $167.50/day

Medicaid Individual Resource Allowance: $2000.00

Resource Allowance for a Couple who both reside in a facility: $3,000.00

Medicaid Community Spouse Resource Allowance: Minimum $24,720.00; Maximum $123,600.00

Medicaid Monthly Maintenance Needs Allowance: Minimum $2,030.00; Maximum $3,090.00

Medicaid Monthly Personal Needs Allowance: $50.00/month

Medicaid Divestment Penalty Divisor: $423.95/day

Medicaid Income Cap Limit: When is a Miller Trust required? $2205/month

Principal Residence Equity Exclusion: $858,000.00

Community Spouse Monthly Housing Allowance: $609.00

Standard Heating & Utility Allowance: $501.00

Federal Estate Tax Threshold: $5,600,000

Federal Gift Tax Exclusion: $15,000.00

NJ Estate Tax Threshold: unlimited

NJ Inheritance Tax: Class A & E exempt

For more information go to: http://www.nj.gov/humanservice...

Taking The Next Step

The Next Step

At the start of the holiday season I included a newsletter article suggesting that holiday gatherings are useful times to evaluate possible changes in the health and safety of an aging parent or relative.

If you have assessed that there has been a change in cognitive functioning, the question is: What’s the next step?

For starters:

-Don’t panic and come across as a disciplinarian insisting upon immediate change;

-Be mindful that no one likes to feel like they are being managed or that they are losing their independence;

-Instead, share what you have observed and be prepared to have a number of discussions with mutual input about making adjustments.

The next step is to arrange for a comprehensive medical check up with an internist preferably a geriatrician*. It is important to determine the underlying cause of the cognitive decline. Some conditions are reversible*. It is recommended that someone attend the appointment to be a support and to understand the doctor’s evaluation and recommendation. If the doctor confirms that there is cognitive impairment, then it is important to recognize that there will be a need for someone, usually a designated family member, to take the reins when decisions have to be made.

It’s common for the individual to deny that there is a need to make changes and it’s not often easy to assume the reversal of roles becoming the caregiver. If you would benefit from tips and strategies to succeed in addressing these challenges contact me at: https://www.viviangreenkorner.... 

*What is a geriatrician: http://www.seniorcitizensguide...

*What causes reversible dementia? https://universityhealthnews.c...

Taking the Correct Medication at the Correct Time


As people age, they are often required to take more medication. In addition to prescribed medications, over the counter medications are also taken. For individuals with memory issues, remembering what to take, and when to take it can be a challenging. If an individual does show any signs of memory loss, completing these steps accurately can be too demanding. For safety reasons, someone needs to step in to pay attention to how medications are managed. Here’s what to look for:

  • Are pills dispensed individually from bottles or is a weekly pill organizer used?
  • How do they know what time of day to take pills?
  • Do they know how which pills to take and the quantity?
  • Do they know when to discontinue medication when it is no longer required?
  • How do they know when to refill medications? 

If there is any doubt that medications are not being managed correctly, it is time to take action. The first step is to confirm that all prescribed medications are needed. Sometimes a medication is prescribed following a hospitalization, but is not required to be taken on an ongoing basis.

Call the prescribing physician and review all medications. Check out the “still in effect” date of all over the counter medications.

Managing pills with a pill organizer is a common way to mange medications; however, there are now some great options to make life easier for caregivers to manage multiple medications. Here are some choices:

  • Automatic pill dispensers- This is a machine that is programed to dispense the exact pill(s) at the exact time. Some machines beep or give a voice command when pills are dispensed.
  • Blister Packs- This can be requested at your local pharmacy. The 30-day sheet is customized with date and time to take medication and you only need to push out the pill(s) from the back of the sheet. Convenient for travelling. Some pharmacies do not charge extra for this program
  • Multi-dose packs- Similar to the concept of blister packs; however, this is a 30-day supply with an individual daily strip. Each strip is customized with the prescription, dosage, date, day of the week and time to take the dose. Also convenient for travel.

To successfully change the existing system requires a conversation. Explain that there is an easier way to take medication that requires less time and effort. Keep in mind that due to changes in how the individual processes and retains information, you might get push back but work together with patience. If you need any tips or assistance contact me at: viviangreenkorner.com

Please feel free to Contact