Doc Gallagher

About William Neil Gallagher
When Payments Start
LTCI policies provide that benefits can start as soon as the policyholder enters a nursing home or they can begin after a waiting period, usually of 30, 60 or 90 days. Policy premiums are reduced based on the length of the waiting period. New LTCI policies are characterized as either “guaranteed renewable” or “non-cancelable.” Guaranteed renewable policies provide that coverage must be continued as long as the insured pays the premiums.
William Neil Gallagher Bio:Age/Disability Test
To be eligible for benefits, the individual also needs to be either suffering from some form of disability or must be over age 65. For example, a 55-year-old with Alzheimer’s would meet this test as the Alzheimer’s qualifies as a disability. A 71-year-old, on the other hand, need not have a disability to qualify as long as he needs nursing-home care.
Financial Test
An applicant’s eligibility for Medicaid is also a function of financial status. The financial test varies depending on state law. However, in general, financial eligibility for Medicaid is determined by analyzing the individual’s assets and income. The Medicare Catastrophic Care Act (MCAA) of 1988 provided protection for “MCAA couples,” those couples in which only one spouse is institutionalized. Under MCAA, the non-institutionalized spouse is entitled to a minimum monthly needs allowance coming form the income or other resources of either spouse before any mandatory contribution to the costs of care for the institutionalized spouse is determined.
W. Neil Gallagher, Ph.D.

Most long-term care, as in a nursing-home facility, is intended to assist people with support services for such activities of daily living like dressing, bathing and using the bathroom. Medicare doesn’t pay for this type of care, which is basically custodial or non-skilled care. Custodial care is care that helps an individual with activities of daily living. It may also include care that most people do for themselves, for example, diabetes monitoring.

William Neil Gallagher Info:

Generally, the core benefits of every Medigap policy include:

  • A deductible for hospitalization days 61 though 90;
  • The deductible for the lifetime reserve hospitalization days 91 through 150;
  • An additional 365 lifetime reserve days with no deductible;
  • The first three pints of blood not covered by Medicare and
  • The Part B coinsurance, e.g., the 20 percent of allowable charges for outpatient services.

Gallagher Financial Group Plans
If a provider who does not accept assignment is caring for the individual, the individual pays the medical bill, and Medicare reimburses the individual for 80 percent of the approved charges. As a rule, Medicare covers up to 90 days of hospital care. The individual is responsible for paying a deductible of about 0 for the first 60 days of hospital care and a copayment of approximately 0 per day for the next 30 days.

A qualified long-term care insurance contract generally is treated as an accident and health plan. This allows long-term health insurance contracts to receive the same tax benefits as other health insurance plans. The amounts received underthese plans are excludable as amounts received for personal injuries or sickness. In 2004, the exclusion is subject to a 0 per day limitation for per diem contracts. For 2004, the amount of long-term care premiums eligible to be deducted as medical-care expenses was set at:

  • 0 for an individual age 40 or less at the close of the taxable year;
  • 0 for an individual over age 40 but not over age 50;
  • 0 for an individual over age 50 but not over age 60;
  • ,600 for an individual over age 60 but not over age 70;
  • ,250 for an individual over age 70.

More results:

Doc Gallagher W. Neil Gallagher W. Neil Gallagher, Ph.D.