Q. In May you had an answer from a woman worried about the financial consequences if her ailing husband had to go into a nursing home. I'm single and also worry about having to move into a nursing home. How much of my assets could I preserve?
A. Because the Medicaid program--which covers long-term nursing home care--is aimed at those with low incomes who cannot afford to pay for their own care, the program requires that those seeking coverage have few assets or income in order to qualify. The requirements on using up your income and assets before you qualify for Medicaid are more stringent for single persons than for couples. In recent years, limits on couples have been relaxed, recognizing that the surviving spouse will likely need assets and income to remain independent. But as a single person, if you have substantial assets, you would be required to "spend down" those resources in order to qualify. Some assets, such as your home, are excluded, but you would only be eligible for Medicaid if your countable assets are less than $2,000.
Q. I once had a diagnosis of cancer, but I've been free of the disease for nine years. Last September we got new insurance and I noticed that the plan says it will not cover anything involving a preexisting condition. Does that mean if I had a recurrence now I wouldn't be covered?
A. Most preexisting condition clauses are limited both in terms of how long they may extend into the future and how long a "look-back" period is allowed into your health history. For example, a plan may establish a one-year preexisting condition clause with a one-year look-back. That would mean in your case that since you have not been treated for that cancer in the past year, any future treatment (even within the first year of your coverage) would be covered.
Regulations on preexisting conditions are often established by state insurance offices for individual policies. For group plans that qualify under the Health Insurance Portability and Accountability Act, preexisting conditions can normally be no longer than 12 months and look-backs no more than six months. In addition, if you had prior group insurance, the exclusion period can be even shorter because you will be given credit for that earlier coverage.
Do you have questions about health care coverage? Changes are occurring in the medical marketplace, and the debate over costs, quality and access to care continues. The Washington Post free telephone information service can take your questions. Call POSTHASTE at 202-334-9000 on a touch-tone phone and enter category code 8500 (in Prince William County, 703-690-4110). Economist Marilyn Moon of the Urban Institute provides answers in a periodic column.