Powers of attorney

(This content was originally featured in the newsletter 7/15/2016)

The purpose of this article is to emphasize the differences between the two types of power of attorney forms available under Ohio law and explain some pitfalls in giving someone a power of attorney. In general, there are two types of power of attorney forms available under Ohio law: Health Care Power of Attorney (HPOA) and a Business Power of Attorney (BPOA). This part may be self-explanatory, but the HPOA is so another person can make health care decisions on your behalf, and the BPOA allows another person to make financial or business decisions on your behalf. The part that many people do not know is the effective date of each of these forms.

Generally, the HPOA is only effective when the person giving the HPOA becomes unconscious or unable to provide direction to medical personnel as to decisions that might need to be made regarding that person’s health. So, the person must not be able to speak for themselves, then the HPOA becomes effective which allows another person to make the decision. In the past, doctors would regularly allow spouses to make decisions for an unconscious spouse. However, because of the tightening of the HIPPA regulations, it now recommended that all people get a HPOA, even if you are married. Some doctors will even refuse to give medical information to a spouse without this form. Finally, most HPOA have a section called a living will. If you are permanently unconscious with no hope of resuscitation, by completing the living will, your HPOA will be authorized to direct the doctor to “pull the plug.” This is different from a DNR (Do Not Resuscitate) which would prevent a doctor from even conducting CPR if it would save your life.

Unlike the HPOA, the BPOA becomes effective immediately! I highly caution anyone considering getting one that they select someone who is very trusted and who won’t abuse the power. While the BPOA form can be limited in scope to one or a few financial areas, if full power is given under the BPOA, the person will have the ability to access (and clear) all bank accounts, investment accounts, and the person could even sell your home and collect the proceeds. When used correctly, the BPOA will allow the person appointed to manage the funds on your behalf and the funds will always be used on your behalf. However, because of the nature of the BPOA, the opportunity for fraud and misuse is high.

One overall benefit to having both forms comes in the form of avoiding a guardianship. In the event that you are no longer able to care for yourself, a Court may deem you incompetent and could appoint a guardian to manage both your health and living decisions as well as your financial decisions. However, where both a HPOA and BPOA are present, a court will be more reluctant to appoint a guardian because all aspects of the incompetent person’s life can be managed by those already appointed. Look for my future article on guardianships and what they mean for your family for more information.

-Attorney Michael Wagner

Medicare Advantage vs. Medicare Supplement plans

(This was originally featured in our newsletter on 7/1/2016)

They provide a single plan that combines help with hospital costs, doctor’s visits and other medical services, plus prescription drug coverage if you want it.

The plans are run by private insurance companies, and they all combine coverage for hospital stays with coverage for doctor visits.  You can choose a plan that includes drug coverage, often at no additional premium, or you can choose a plan without prescription drug coverage.

The different types of Advantage plans are HMO, POS, PPO, Special Needs, Private Fee for Service and Medical Savings Plans. You will need to do some homework to figure out which of the plans will best fit your needs.

Look at the monthly premium (if any) you’ll pay to join.  Then estimate your total cost sharing for services.  Find a plan where the maximum out-of-pocket spending fits your budget.  Consider whether a plan’s network (if it has one) gives you access to the doctors you want to see.

If you choose an HMO, POS, PPO and Special Needs Plans, your care is “coordinated”.  That means the plan may coordinate your coverage through a primary care physician who manages the care you receive from specialists and hospitals.  You may have to choose specific doctors and hospitals.  Start shopping by finding what’s available in your area.

     Medicare Supplemental coverage Is private insurance coverage that helps fill the gaps in Medicare Parts A and B.   These plans cover some or all of the expenses that Medicare Parts A and B do not cover like coinsurance, copayments, or deductibles.  These policies are sometimes refered to “Medigap” policies because they fill in the gaps.  There are ten standard plans identified by letter A through N.   Each plan varies in which gaps in coverage they fill, and each standard plan must offer the same basic benefits no matter which insurance company sells it.   It’s important to note that these plans are sold by private companies and usually the only difference between Medicare supplemental polices with the same letter sold by different insurance companies is cost.  On a side note, the more gaps filled in the plan,  the higher the premium.   These premiums vary widely from carrier to carrier so it’s a good idea to do some research.  Also, not all plans are available in all states.  

       In regards to coverage limits, all supplement policies provide an additional 365 days of hospital care during your lifetime beyond the Medicare lifetime reserve days.   In addition,  no Medicare supplemental polices will cover more than 100 days in a skilled nursing facility, and you can visit any provider or facility in the United States. 

     You can buy a Medicare supplemental policy at any time after you reach age 65 and join Medicare part B.   You have a guarantee right to buy any Medicare supplement policy available in your area during the six months after you turn 65 and enroll in Medicare Part B.  This period is known as your open enrollment period.   The best time time to buy a Medicare supplement policy is during open enrollment because during this period the insurance company can’t consider your medical history in setting premiums.   While the insurance company can’t make you wait for coverage to start during this open enrollment,  it may be able to make you wait for coverage related to a pre-existing condition.  

-Jackie Greene and Bev Cline