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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
My husband with advanced Alzheimer's is now home and in my care 24/7. He has UHC MA-PPO but they are telling me that Medicare no longer covers an aide. He has had an RN, PT and OT coming but no help with changes, bathing, dressing, etc.
I see there have been no answers yet and I think it’s because there aren’t any good answers to your question. Unfortunately, the world forgot about us caregivers and there is no help available for us unless you have Medicaid. If you did, they would pay for a nursing home. I believe if your husband was hospitalized for a time, they send out a nurse and PT a couple times a week for an hour or so but that’s it. I suggest going on care.com and finding some help, just a couple of hours a week is sometimes enough. It’s helped me and they background check them too.
I am by far not an expert on this topic so I'm not sure if this might be a resource for you or not. I suppose it would depend on your financial situation as well as your comfort level, but a while back when I was doing some research for a friend that needed assistance with her relative, I found care.com to be useful. There are caregivers on that site with varying levels of training and once you create an account (not difficult) you can read the brief bios, list in your profile what you are seeking and hours you would want the person available and then what you are willing to pay. I know when my friend hired someone that she interviewed and checked her references, she found it very reasonable. She noticed there were a variety of hourly rates the workers were requesting and some were quite flexible schedule wise also. You, for instance, might only need someone 2 hrs a day for 3 days at 20 per hr which is 120.00 per month. Not sure if something like this would be workable for you or not. Good luck in your search!
1. Bathing, toileting, dressing, changing incontinent supplies, and transferring are examples of custodial care. Your husband needs long term custodial care (LTC), not short term custodial care. None of the Medicare programs cover long term custodial care. And only some private LTC insurance plans cover that kind of care at home. It is too late to get a private LTC insurance plan, and there is no public benefit that covers LTC custodial care at home.
2. Medicaid can cover LTC care in a Medicaid Skilled nursing facility (SNF), usually with a monthly co-pay based on the income of the person and in some cases the spouse at home. Each State has its own rules for how much of the ill spouse’s income the at-home spouse can keep, if any, and it can thereby lower the ill spouse’s monthly co-pay.
3. When you are providing 24/7 care for your husband, it is definitely time for you to find a SNF that will take him. You will in time lose your own health if you continue to provide this much custodial care long term for a bed bound spouse with Advanced dementia.
4. If your resources cannot afford private pay in a SNF, then you will need to find a Medicaid certified SNF. Hire a good elder law attorney near you for at least a consultation to determine if your husband qualifies for LTC Medicaid in a SNF near you. You can find elder law attorneys at www.NAELA,org.
5. Preserving own health at this point is at least equally important to finding the professional LTC care for him. I think that these two needs are interdependent.
Thank you so very much! I am in the process of finding aides to help me at home. We’ve restructured some finances to eventually get help from Medicaid but his aggressive decline might impede his acceptance. I appreciate your very informative answer and will continue in my search so that I may also keep myself healthy.
If someone with a Medicare Advantage (MA) plan loses access to a home health aide, here are the main options:
1. File an Appeal with the MA Plan - Ask the plan for a written denial, if you haven't received one. - File a fast (expedited) appeal if the aide is medically necessary and stopping it could harm the patient’s health. - Submit a doctor’s note explaining why the aide is essential.
2. Switch to Original Medicare During AEP - The Annual Enrollment Period (AEP) runs from Oct 15 to Dec 7. - During AEP, you can drop the MA plan and return to Original Medicare (Part A and B). - This may restore access to home health aide services, as long as: - The patient is homebound, - A doctor certifies the need, - They are receiving skilled care (like from a nurse), and - A Medicare-certified home health agency provides the services.
Note: Switching to Original Medicare may not guarantee access to a Medigap plan unless the person qualifies for a special right. Otherwise, they may have to go through medical underwriting.
3. File a Complaint with Medicare - Call 1-800-MEDICARE if you believe the MA plan didn’t follow Medicare rules or failed to provide a proper denial notice.
Summary: If the aide was denied under an MA plan, you can file an expedited appeal with medical support. If that doesn’t work, consider switching to Original Medicare during AEP but check how that change affects other coverage, like Medigap.
I hope this also helps others facing the same issue. It’s good to know there are still options.
Start looking for programs that will help you. If there is an Adult Day Program get him involved with that. If he goes 3 days a week that gives you a much needed break. Ask at your Senior Service Center if there are any programs that you would qualify for. If your husband is a Veteran check with your local Veterans Assistance Commission and see if he qualifies for any programs or benefits through the VA. He could qualify for a LOT or a little depending on where and when he served.
Unfortunately, he is now bed-ridden so, day care is out. I am trying to find independent services since they would be more reasonable than agency. I will contact Senior Services to see if they can help too so, thanks for that reminder!
In home usually provides an aide for bathing 2 or 3 times a week. Medicare Advantages are contracted with Medicare and must provide parts A&B. Call Medicare and see if what UHC says is true. If not true, call United and tell them Medicare told you otherwise.
I'll need to look online more for Medicare benefits. I checked out UHC website and aide services are not covered. I called them too to be sure I was reading it right. Thank you!
I consulted with them while at the hospital. They were great but from what I've read and seen online, they also won't provide services for bathing, changing, etc. I'll keep pushing forward to try and get him up and walking with PT & OT thru home health. It's been a month though and so far, we haven't had much success. We'll see where this all ends up! Thank you for your input!
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
2. Medicaid can cover LTC care in a Medicaid Skilled nursing facility (SNF), usually with a monthly co-pay based on the income of the person and in some cases the spouse at home. Each State has its own rules for how much of the ill spouse’s income the at-home spouse can keep, if any, and it can thereby lower the ill spouse’s monthly co-pay.
3. When you are providing 24/7 care for your husband, it is definitely time for you to find a SNF that will take him. You will in time lose your own health if you continue to provide this much custodial care long term for a bed bound spouse with Advanced dementia.
4. If your resources cannot afford private pay in a SNF, then you will need to find a Medicaid certified SNF. Hire a good elder law attorney near you for at least a consultation to determine if your husband qualifies for LTC Medicaid in a SNF near you. You can find elder law attorneys at www.NAELA,org.
5. Preserving own health at this point is at least equally important to finding the professional LTC care for him. I think that these two needs are interdependent.
1. File an Appeal with the MA Plan
- Ask the plan for a written denial, if you haven't received one.
- File a fast (expedited) appeal if the aide is medically necessary and stopping it could harm the patient’s health.
- Submit a doctor’s note explaining why the aide is essential.
2. Switch to Original Medicare During AEP
- The Annual Enrollment Period (AEP) runs from Oct 15 to Dec 7.
- During AEP, you can drop the MA plan and return to Original Medicare (Part A and B).
- This may restore access to home health aide services, as long as:
- The patient is homebound,
- A doctor certifies the need,
- They are receiving skilled care (like from a nurse), and
- A Medicare-certified home health agency provides the services.
Note: Switching to Original Medicare may not guarantee access to a Medigap plan unless the person qualifies for a special right. Otherwise, they may have to go through medical underwriting.
3. File a Complaint with Medicare
- Call 1-800-MEDICARE if you believe the MA plan didn’t follow Medicare rules or failed to provide a proper denial notice.
Summary:
If the aide was denied under an MA plan, you can file an expedited appeal with medical support. If that doesn’t work, consider switching to Original Medicare during AEP but check how that change affects other coverage, like Medigap.
I hope this also helps others facing the same issue. It’s good to know there are still options.
If there is an Adult Day Program get him involved with that. If he goes 3 days a week that gives you a much needed break.
Ask at your Senior Service Center if there are any programs that you would qualify for.
If your husband is a Veteran check with your local Veterans Assistance Commission and see if he qualifies for any programs or benefits through the VA. He could qualify for a LOT or a little depending on where and when he served.