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My mom — who has early stages of dementia — lives with us. Since she has Humana, her doctor wrote a referral to AccentCare. We got an in-home assessment, and she started therapy. However, when I asked one of the therapists about extended care (helping her with her breakfast or lunch, working her through her exercises, etc.), she informed me that because I work from home, the assessor filed that Mom didn’t need extended care.


That really infuriated me, because I’m upstairs in my home office 9-10 hours a day keeping our bills paid. Neither Mom nor my wife and I can afford to pay for private care, so we depend on what Humana will cover.


Does anyone work from home and also get Medicare/Humana-covered care for their loved one that lives with you?

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I'd talk to your mother's doctor or a lawyer about that one. You're at work all day. Wherever you do that work is irrelevant. You cannot do your job and babysit an elder with dementia at the same time.
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Reply to BurntCaregiver
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I agree with BurntCaregiver. Many employers state explicitly that employees have to have separate arrangements for care for their children if the employees work from home; I'd argue that the same general concept should apply for care for other family members (that is, you're not available to provide care for your mother when you're working, regardless of the location of the work).
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Reply to Rosered6
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Wow, that is very discriminatory and needs checking out with Humana. This is on THEM, not on Medicare. Medicare covers what it covers and that holds truly for any qualifying Medicare recipient. All the variety comes with the supplemental or advantage programs such as Humana, and this sounds to me on the face of it illegal. They are recognizing you are there as a physical presence AND as a helper, and you are NOT. You are there but working. Time to ride in on your white horse, flags flying!
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Reply to AlvaDeer
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You have to push back. I have not dealt with Medicare/Humana, but UHC administers my husband's medicaid as well as medicare. They go through all the tasks or medical needs of the patient and add up the time required for each, in 15 minute increments, and will give you the least amount of time for paid care, because it saves them money.
Call the assessor and go through an exhaustive list of tasks and cares needed for your mom, and argue to get more covered! I was eventually successful in arguing for more time as my husband's paid caregiver, because he requires 24 hour supervision, as well as extremely difficult cares!

You are also facing a limit on what Medicare will cover, typically only medical, and short term rehab therapy. If she is low income, she may be eligible for Medicaid assistance. As your mother's disease advances, Medicaid provides coverage for things Medicare doesn't, such as assistance with activities of daily living, which means help with breakfast, lunch and working through exercises, as well as personal cares, bathing, dressing, incontinence care, and mobility.

If she has too much income or assets to qualify for Medicaid, then use her money to pay for home care assistants.

It may not be feasible for her to continue living with you long term. As her care needs become more complicated, it will come time to transition her to a nursing home. This is something else for which Medicare offers limited coverage, but would be covered by Medicaid if she does not have the funds. It is only her income and assets that are considered for eligibility, not yours. If her housing cost is -0- because she lives with you, that will be taken into consideration of her overall ability to pay. She may have a share of cost, which will be calculated based on her ability to pay.
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Reply to CaringWifeAZ
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Your mother requires the same type of 24/7 memory care whether you work outside or inside your home out of economic necessity. The alternate arrangement is to move her to a facility for her care so you have more uninterrupted time to perform your job. Verify with her doctor and Humana insurance policy.
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Reply to Patathome01
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I would quickly adjust and you are now required to be in office. Even if the office is the local library. Or you must travel for work. You can just go to an airport and work from there.
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Reply to Beethoven13
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Ask for a reassessment. If need be, ask to speak to the assessor supervisor. Advocate - be the squeaky wheel - for your loved one and your family.
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Reply to Taarna
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That is unfortunate and I hope you get to work it out with your insurance provider.
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Reply to brendalm
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Can your employer right a letter stating that even though you work from home, its like any other job where your hours are 8 to 5. You must clock in and out. Your allowed lunch and breaks but you are monitored making sure your at your computer and available when needed. Your hours are not flexable.
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Reply to JoAnn29
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Oh hell no. It is so aggravating that people consider working from home as not real work!
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Reply to LoopyLoo
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