Navigating Healthcare Benefits
Understanding and accessing healthcare benefits is a crucial part of healthcare decisions for seniors. As individuals age, they may begin to suffer from more health problems and require more frequent doctor visits, take more prescription medications, and may even require long-term care. Unlike their younger years, they cannot count on an employer-provided or privately purchased health insurance plan to cover all of these expenses. Instead, they must rely on Medicare for many of these expenses once they are aged 65 or older. But Medicare has gaps in coverage that individuals must understand exist and have a plan for managing those gaps. An elder law attorney can assist their clients with understanding their Medicare options, including Medicare Advantage plans, Medigap policies, and prescription drug coverage so that they can make an informed choice about which coverages meet their needs.
Medicaid may be another source of healthcare coverage for Ohio elderly individuals. While Medicaid provides general health coverage for individuals with limited resources and incomes, it can also provide long-term care coverage for those who meet eligibility requirements. Medicaid has strict eligibility requirements that can make qualifying for long-term care coverage complex, but an elder law attorney can assist their client with Medicaid planning to ensure that they have restructured and otherwise protected their assets in a way that makes them eligible for Medicaid long before they need to apply. An attorney can also assist with navigating the application process to help them secure the coverage they need.
At Rhodium Law, we are also prepared to assist veterans and their families with accessing the benefits they have rightfully earned by honorably serving our country. There are several benefits available to veterans and their families through the Department of Veterans Affairs, including healthcare services, long-term care support, and disability compensation. We can assist with applying for benefits, understanding which benefits veterans and their families are eligible for, and how to access those benefits. We can also assist with gathering any required documentation, and offer guidance on maximizing the benefits available so that, combined with other healthcare options and financial planning strategies, veterans and their families get the most coverage possible for their healthcare needs.
Who Makes Medical Decisions If You Are Incapacitated Without the Key Documents in Place?
Many people delay putting powers of attorney or living wills in place because they believe that their spouse, their parent, or their adult child or sibling are legally allowed to make these decisions for them simply because they are family. This is not true in all states. In Ohio, the law does stipulate that specific relatives in a specific order can make decisions on behalf of an incapacitated individual. The first person to make decisions is the individual’s spouse. However, it is important to note that this must be a legal spouse as Ohio does not recognize common-law marriages.
After the spouse, next is the majority of the individual’s adult children. This means that if the individual has two or more children, healthcare providers will consult by phone and/or in person with as many of them as they can and will act on the decision that is agreed upon by the majority of those children. Next is the individual’s parents, followed by a majority of adult siblings. Finally, if none of those relatives are available, the next closest relative available by phone or in person to consult with the healthcare provider will make the decision.
Relying on this next of kin order established by law is not always in the individual’s best interests. For example, if an individual has separated from their spouse, the spouse may still legally have the ability to make the decisions but they may not make decisions in the best interests of the individual. If the individual has two adult children, and each one wants a different treatment for their parent, this can result in no decision being made and the matter being referred to a court to appoint a guardian to make decisions. By completing a power of attorney and officially naming an individual to make these decisions, and informing them of what the individual would want if they could make the decisions themselves, the individual can ensure they receive quick, quality care and avoid family conflicts or stress.
What Happens If You Only Complete One of the Key Documents?
There are many reasons why an individual may not want to complete both documents. They may not complete a power of attorney because they do not have someone they trust to make these decisions for them. They may not complete a living will because they are not sure what their wishes are in an end-of-life situation.
If You Do Not Have a Power of Attorney
A healthcare power of attorney is valid from the moment it is signed, but it only takes effect when the principal is incapacitated. If the individual does not have a power of attorney and they are incapacitated, their healthcare provider will rely on the next of kin to make decisions. They will start with the individual’s spouse if there is one, and then move on to adult children, parents, adult siblings, or any other closest relative they can reach.
If the individual does not have anyone to represent their interests, how decisions are made may be based on the type of decision in question. Emergency decisions or those that must be made in a very short time period may be made by the physician or an ethics committee made up of physicians in the facility, such as a hospital or nursing home. For decisions that do not need to be made as quickly, the facility may go to court to have a guardian legally appointed for the individual. Once the court appoints a guardian, the guardian would make all healthcare decisions for the individual until or unless they are conscious and able to make their own decisions again.
If You Do Not Have a Living Will
Living wills are only used when the incapacitated individual is in a terminal, or end-of-life, condition. This means that they are expected to die from their condition, and the living will spells out their wishes for artificial nutrition, hydration, and other life-sustaining measures in the meantime. If an individual has not completed a living will but does have a power of attorney, the individual they appointed as power of attorney will be responsible for making those decisions for them.
While the individual may trust their power of attorney enough to make these decisions, they are still critical decisions that can put immense pressure on the person trying to make them. In addition to struggling to make the decision, they may consult with other loved ones for advice or they may have loved ones coming to them and insisting they take certain actions. This may add to the pressure and stress they feel about making the decision. A living will can eliminate the stress and pressure by telling them exactly what to do based on the individual’s wishes.
