Health issues can arise at any given moment, and it is important to plan ahead — especially if you are 50 years of age or older. Before, during, and after a divorce, medical insurance and health issues should be given special consideration; arrangements should be made concerning how to pay for medical care and who should have access to your medical information.
Private Health Insurance
Most employers sponsor group plans for their employees. If you are not covered under such a plan, it is advisable to obtain private coverage in the individual policy market. Consideration should be given to your budget in terms of affordable monthly premiums which maintain your policy, tolerable deductibles for out-of-pocket charges before coverage will kick in, and acceptable co-payments for frequent visits to your physician. Typical policies afford a maximum amount of coverage often excluding preexisting conditions, so exclusion of special services, procedures, or treatments should be weighed when comparing policies. Additional information is provided by the American Association of Retired Persons (AARP) at www.aarp.org. Contact the Family Law firm of Iwanyshyn & Associates for a consultation at www.iwanyshyn.com or 412-848-9181.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
COBRA was passed by the U.S. Congress and applies to companies employing 20 or more individuals. It protects individuals covered by a group health plan when there is a special change of circumstances or "qualifying event". Often this is the case when one becomes voluntarily or involuntarily unemployed but also becomes relevant in situations such as divorce. COBRA guarantees health coverage and although is usually more expensive than for active employees, for which the employer pays a portion of the cost, in many cases it is less than private insurance. A person should however, shop around and not assume that COBRA coverage is the least expensive.
A covered employee's spouse, affected by a divorce, may elect a maximum of 36 months of continued coverage, but must have notified the plan administrator within 60 days following divorce or legal separation. The plan administrator must then give notice of the option to elect coverage within 14 days after being notified of the divorce. Additional information is available through your plan administrator, or by calling the federal Employee Benefit Security Administration (EBSA) at (866) 444-3272. The website of the Department of Labor provides answers to your questions and an overview of COBRA at http://www.dol.gov/dol/topic/health-plans/cobra.htm. The Allison Park, Pennsylvania divorce law firm of Iwanyshyn & Associates will be happy to assist you in determining the most cost effective health care coverage for you. Contact us at www.iwanyshyn.com or 412-848-9181.
Medicare (Federal Health Insurance)
The U.S. Department of Health and Human Services provides Medicare for people 65 years of age or older, under 65 with certain disabilities, and anyone in the final stages of Renal Disease who require dialysis or a kidney transplant. Although independent of income or asset considerations, Medicare eligibility requires a certain number of accumulated "work credits". Fortunately, an ex-spouse who lacks the necessary work record, particularly a stay-at-home ex-spouse will not necessarily be deemed ineligible for that reason alone. For those 65 or older, conditions must be met that the ex-spouse was legally married for at least 10 years prior to the finalization of the divorce, be unmarried or remarried after age 60, and ineligible for Social Security retirement or disability benefits on his or her own greater than half of the benefits payable on the account of the former spouse. The worker's spouse must be at least 62 years of age, but need not be entitled to Social Security if divorced for at least 2 years. If the divorced working spouse has died, a surviving spouse of age 65 or older (50 if disabled) may qualify if legally married for at least 10 years prior to finalization of the divorce, unmarried or remarried after age 60 (50 if disabled) after death of the ex-spouse, and ineligible for Social Security retirement or disability benefits on her or her own, which are greater than � of benefits payble on account fo the former spouse. Because income and assets are not criteria for Medicare, no special structuring of the financial terms of a settlement is required. However, the 10-year marriage requirement may lead to a postponing of the final decree of separation by an individual, to allow for the non-working spouse to qualify for such benefits. More information is available from the DHHS at www.medicare.gov or at (800) 633-4227. Iwanyshyn & Associates is the Pittsburgh Divorce Law Firm that can help you sort out these issues at 412-848-9181 or www.iwanyshyn.com.
MEDICAID (State Administered Medical Care Funding)
Unlike Medicare, Medicaid is means-tested (income or asset determinable), and the financial arrangement of a divorce settlement can have a significant impact on eligibility, such as sudden ineligibility after a divorce due to failing to meet lower income and resource limits as a result of a higher settlement, or due to a decrease in assets as a result of a lower settlement. Excess assets can be "spent down"', by purchasing legitimate goods or services needed by the individual or converted into non-liquid assets such as a primary residence, automobile, funeral arrangements, etc. In some cases, it is advisable to take a lesser amount in financial support but a larger piece of material assets to avoid being pushed out of range of the Medicaid income limit by a sudden influx of financial assets. This balancing process should be carefully structured, since certain assets are excluded in determination of Medicaid eligibility, and others are counted. Unlike the fluidity of transfer of assets between spouses, divorced individuals have a harder time transferring assets out of the eligibility threshold. Especially if you foresee needing long-term care, consider whether it would be more beneficial to you to receive a larger settlement and smaller amount of material assets, or vice versa. Let the Pittsburgh Family Law Firm of Iwanyshyn & Associates help you determine the best settlement at www.iwanyshyn.com or 412-848-9181.
A significant issue resulting from divorce is who will make health-care decisions for you should incapacitation ever occur. It is strongly advisable to set out your wishes for such care and decision-making in writing, by way of a legally enforceable living will, medical power of attorney, durable power of attorney, or a springing durable power of attorney.
A Living Will...
...is a signed document outlining an individual's wishes in the event of incapacitation and may include such topics as heroic measures or life-sustaining treatments. A copy is given to a trusted family member but its terms cannot be overridden by anyone except you. If you already have such a document and it is in the possession of your soon-to-be ex, it is suggested that you revoke the previously executed document and create a new one to be left in the possession of another person that you trust. We, at Iwanyshyn & Associates can help you prepare this document. We are the North Hills Family Lawyers at www.iwanyshyn.com or call us at 412-848-9181.
A Medical Power of Attorney...
...unlike a living will, grants someone else the authority to make medical decisions on your behalf, should you become incapacitated. The same suggestion is even more important in this case, regarding the creation of a new document, to be left with someone you trust with your life, and who will be making life and death decisions regarding your care. Let us prepare your Medical Power of Attorney at Iwanyshyn & Associates, 412-848-9181 or www.iwanyshyn.com.
A Durable Power of Attorney...
...like a medical power of attorney, merges the concepts of a living will and a medical power of attorney, in that it designates an individual to act in your place. The powers can be medical, financial, or a combination of both, and the document is immediately enforceable upon being executed. Again, it is strongly advised in this case to create a new document and leave it with someone other than your soon-to-be ex. We are the Pittsburgh Family Law Firm of Iwanyshyn & Associates at www.iwanyshyn.com or call us at 412-848-9181.
A Springing Durable Power of Attorney...
...is almost identical to a durable power of attorney, except that it does not become legally enforceable until such time as the person becomes incapacitated. This document falls under the advisory to re-create and re-distribute as well. We are the Pittsburgh Family Lawyers who can prepare this document for you at www.iwanyshyn.com or call us at 412-848-9181.
PROTECTION OF MEDICAL INFORMATION
The federal government enacted the Health Insurance Portability and Accountability Act (HIPAA) to regulate the privacy of individuals' medical records and information. The act provides that the patient must be allowed access to his or her medical records, and that the physician and his employees maintain the patient's privacy regarding dissemination of such confidential information. Waivers of consent must be made in writing and signed, at such time as a health care provider presents a need to do so. The choice whether or not to release, and to whom you will release your records is entirely yours. If such a waiver was previously signed allowing access to your spouse, it may be advisable to end such an agreement. For more information about HIPAA, log on to www.hhs.gov/ocr/hipaa/. Let the Allison Park Family Law Firm of Iwanyshyn & Associates at www.iwanyshyn.com help you with this issue or call us at 412-848-9181.
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