Where are the home health aides?

Thank you everyone so much, I went to our local Medicaid office today. They told me to start filling out the Medicaid Pp wk and get it turned in, She also told me I can pay an agency to come in the home and that care would allow me to spend down the assets and satisfy Medicaid. However she was not agreeable about me doing a Caregiver Agreement, so I could be paid by that same money for a spend down of assets, to take care of them. When the spend down is done then they will qualify and then I would be eligible to be paid as a caregiver 16 hours a day, Medicaid will only let you work 16 hours, you need to sleep she said so they would provide a Sitter or a home health aide in the home for 8 hours paid by Medicaid.. as long as they qualify for 24/7 care. She told me their are tons of programs within Medicaid and that when it is time for them to go to a NH this will hurry up the process and be much less waiting and far less paperwork.


I didn't talk to United Health Care today, but I will reach out tomorrow about the home health aide situation.

ICope
If Medicare were the answer I would suggest you change insurance.
You do need to find an insurance that has providers in your area. You have found at least one doctor and some pt.

Any insurance you see advertising, on tv or in the mail, is a private company, not original Medicare. They use original Medicare as an example of what they claim to offer. And in some areas an advantage plan actually will offer similar services. The trick is what areas and which plan, what level providers, hospital, home health, etc and if those providers will stay with them. They all claim to offer everything Medicare part A&B offers. Plus they will also say they have Vision or dental or a ride to the moon etc. They may list it but often don’t have providers who will actually provide it. You need to understand the providers are private business as well and can’t be forced to take the advantage care business. I’m sure they would if they got paid enough. But you and I can’t sort that out. We just need to understand what we are signing on for when we accept the seemingly “free” services an advantage plan leads with. Sorry for the rant but it is so disheartening when trying to deal with insurance. Especially when a person actually needs coverage.

Let me rush to tell you that original Medicare doesn’t provide 35 hours of care either. But they do offer a weekly nurse who will tend wounds, set up meds, do blood work, bring in an aide to help with baths and the PT and OT You would find them helpful. I did. But they don’t provide hours of care such as you are looking for so you can return to work.
Community Medicaid offers up to several hours a week but it isn’t dependable or enough hours from what I’ve heard. Your folks need 24/7 care and the only place you are going to get it from a provider is in a NH or private pay.

Get them on Medicaid and into a NH. Find your Area Agency on Aging for help making sure they qualify. There is one for every county. Being in a NH is not without a need for over site. Anyone with a loved one in facility care will tell you that. But, at least you can return to work and you will know they have someone with them 24/7 who is providing the basics.
Go to….
Health.Mo.Gov
and explore the options for seniors.

Medicare advantage plans are NOT Medicare. They are a way to get people off of traditional Medicare. That the government allows insurance companies to use the word Medicare in the names of such plans increases the mistaken belief that these plans are as good as the real Medicare. But I digress.

Most agencies are expensive and require a 4-hour per visit minimum. Their rates are also going up because home health aides know their worth and many have gone private or moved agencies for better pay. That means that those who remain available for rock-bottom prices through agencies on that list you were given are few and far between. There's also a waiting list.

Geaton's suggestion of going on Nextdoor is your best bet if you want to get someone in fast. Also check your local newspaper for situation wanted ads.

My mother had a Medicare Advantage plan that specialized in NOT paying for services. The plan was so bad, in fact, that PERA discontinued it after one year and went with a traditional Medicare plan instead.

That said, I've never heard of Medicare paying for in home health aides for 35 hours a week. Medicaid yes. So perhaps the doctor is confusing Medicare services with Medicaid services, writing an order for something Medicare does not cover.

Good luck to you

Did you already try this?
https://www.medicare.gov/care-compare/?redirect=true&providerType=HomeHealth

Maybe contacting your county's department for the aging, or social services.
or
Maybe the below, perhaps they can help or suggest.
https://www.alz.org/greatermissouri/about_us

From your Title, I thought you were talking about someone who was housed in a long term care facility. Where are the aides and some other long stories? Many examples. I've only been in a little over a year.

Wow, SW Missour-ah. Right where I grew up!

OK, this is a question now for United Health Care Advantage plan.
You have the insurance and are paying for the insurance and this is covered. They are apparently not covering well enough for agencies to cover them, and the problem here is often that agencies pump up the cost so much because honestly you are paying the agency AND THE AID.l

You are going to need to get the skivvy from your insurance plan.
We would, I betcha, have the same problem anywhere. This happens when the insurance covers things, but not well enough to make an agency, a nurse, and yes--sadly--even a doctor interested in the patient. So to say they won't treat a patient with low paying insurance.

Often, in illness, when a person is seeking care, but is on SSDI or on Medicaid the doctors just say they aren't accepting new patients or they don't take such patients.

Call your insurance. Tell them your experience. Ask them where to go next.
So sorry you're going through this and can imagine you're quite desperate.

Join Nextdoor.com for that community and post that question... Nextdoor.com is an intranet of actual non-anonymous neighbors in that community. You're more likely to get quicker, more accurate answers.

I wish I could help you, but I have never known Medicare or advantage plans to pay for a home health aide for ongoing daily care. Medicare advantage plans tend to be even more limited in their coverage so I’d be interested to hear back what you learn. In addition to contacting the insurance provider, you might also ask the doctor if they have ever had success with ordering these services. The therapy that they qualify for is based on skilled medical needs vs daily care needs. I’m sorry you’re in this situation, I’ve seen how difficult it can be.

Ask the doctor to send In a VNA Nurse they Provide different services .

Sounds very frustrating and exhausting. I agree with mstrbill that we need a little more information – something doesn’t quite add up. It’s probably just a typo but:

UHC is a Medicare advantage plan. You describe a list provided by “UHC/Medicaid”. But Medicaid has nothing to do with the current situation, so a list that includes Medicaid-accepting facilities would indeed not be helpful. (unless your father also qualifies for Medicaid – but then I think you wouldn’t have this problem.).

UHC is, presumably, contracted with some home health services (and also presumably, not all – that’s how advantage plans commonly work). They should know who they are contracted with. Can you go back to them and ask for a list of home health agencies they are contracted with? That should narrow it to places that your insurance will pay for.

Sorry if you’ve already done this, but I can’t understand why a list provided by UHC would include places they would not pay for.

Have you called the Medicare Advantage plan's office? I think that is who you need to call. Medicare Advantage has nothing to do with UHC/Medicaid. Medicaid is a separate program for low income and low asset people.