Sweating the details

The phrase “colorfully outspoken” doesn’t begin to cover it. The LOA Area Agency on Aging’s senior resources director, Shannon Abell, once gave a newspaper reporter such a blisteringly honest review of Medicare Part D that two people from the Medicare office in Philadelphia actually traveled to Roanoke to “take me to the woodshed,” as he puts it.

Shannon Abell

“Did he say anything that was factually wrong?” director Susan Williams recalls asking the officials.

Not technically. They just didn’t like the way he said it.

Which is to say: Abell reads the fine print, and he’s happy to recite it back to area seniors who are navigating the public benefits system. He’ll do it in language that’s easy to understand — and oftentimes blunt.

He can explain rules for the Medicaid spend down in excruciating detail, and not just because he’s read the footnotes to the addendum to the Medicaid manual. He also knows it from personal experience.

Abell, 54, had the paperwork in order, including six months of bank statements, when it came time to apply for a Medicaid nursing-home bed for his elderly father in 2003.

Eight years earlier, his parents had transferred ownership of their house to their only son. The move was well within the law, which states that assets must have been handed over to children at least five years prior to an application for Medicaid coverage.

A lifelong bachelor, Abell lived with both parents at the time. His father, a carpenter who built his North Roanoke County home with his own hands, did not want to see it sold to cover his or his wife’s long-term care.

“My parents knew that I had a financial mind, and I was already living with them, so it was an acceptable deal. Now it’s my home, and I’m going to take care of it.”

The transfer was perfectly legal, he adds, but it was not without risk. “If I run through a school bus and get sued for 10 million dollars, what do you think somebody’s going to put a lien against?

“Or what if I’m a drunk and I gamble away all the money?”

These are the questions Abell advises seniors to consider as they’re planning their own late-life care. “If you can afford it, you go to an elder-law attorney for good legal advice,” he urges, preferably when you’re in your early 60s and/or before you retire.

When Abell finished applying for Medicaid for his father, “I got out in the street, took a deep breath and didn’t have to think about it again.”

His dad’s funeral trust was already set up, the grave-opening fee already paid , and Abell had even written the obituary well in advance of his father’s death in 2006.

He still lives with his 85-year-old mother, Martha, who would have to live in a nursing home if it weren’t for her son’s willingness to look after her. He checks her pill box weekly to make sure she’s taking her medications correctly, pays the bills and double-checks her medical and insurance statements on a spreadsheet.

“She has four doctors and 12 medications. I looked at her pill box and noticed one day that she’d taken three of her vitamin D pills instead of one,” Abell says.

“I didn’t think that was right,” she told her son. “But you were so busy, I didn’t want to bother you.”

Bother away, Abell told her. He says the same thing to the seniors who call him at work.

The earlier you educate yourself, the better you’ll be able to advocate for yourself. “I had a Hollins professor with multiple Ph.Ds who had not a clue about applying for Medicare,” let alone what the Medicaid spend down was.

“There are a lot of people in Roanoke who would qualify for Medicaid but don’t know how to go about it,” he says. “It’s not a program where the government tries to make it easy. I mean, you don’t see them having fliers about qualifying for Medicaid sitting in the post office, do you?”