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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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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.
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We can't know the future, so it's hard to say. You could pay that extra amount for years and wish you hadn't, but a serious medical condition may make you wish you had kept it. I'd check with an expert on insurance and your parent's health. Since she has both Medicare and Medicaid, she has better coverage than many. An expert on Medicare/Medicaid should be able to help you. Carol
Assuming she is over age 65 probably not. As a "dual-eligible" participating in both Medicare and Medicaid your mom's primary insurer continues to be Medicare. Medicaid now acts as her "secondary" and pays her Medicare deductibles and co-payments as well as her Part B Medicare premium. As a Medicaid recipient she is required to have a Part D Medicare Rx plan the premium for which is also subsidized; her Rx co-pays go down to $1 and $5 and there is no Rx "doughnut hole".
Some of my clients have employer based retirement health plans which they keep; others are in HMO's or other managed care plans which they prefer to remain involved with.
Unless there is some extenuating circumstance, there really is no reason to keep it. If anything, I would save the money to "buy-up" to a better Part D prescription drug plan.
As you may or may not know, different plans have different prices AND different formularies. The lower priced plans, those subsidized by Medicaid, may not have the meds your mom needs at some point. When and if that time arrives she can, as a low-income dual eligible, switch plans at any time of year to one that would meet her needs (and which will probably be more expensive).
Hi RLK~As previous mentioned in this forum, I would check with an insurance expert, or a department of elderly affairs to see if an additional insurance-Private Pay policy -would be worth having in your situation, and then act accordingly. As Carol stated-'who knows what the future holds with healh related insurance questions, and I am sure you do NOT want to buy a policy, you find that was not necessary. This can possibly be a complicated matter-and thus seeking some advice from an "expert"--is the way to go at this point.
If your Mom has both medicare and medicade coverage it may coverage all the medical bills which may have bill to her. You can call up the number on her cards to see what the coverage is for. Mt own mom took out Bluecross Blueshield many years before she got ill. She was in good health and the premium was not that high. I am glad she did and I set up the pre authorized withdraw from her account. you see when she got sick and was in the hospital I had Medicare and also well care and blucroos blueshiel to help me out. No bills were due. Only when she went into assisting living the mthere was a small amount for her medicines. She was in the hospital almost every year sometimes several times due to the illness later in life. There is no harm in calling. patrica61
Thanks to each of you for your time and thoughtfulness in answering my question about my mother's health care support needs. I truly appreciate it. RLK
Hello RLK, Medicare is her primary so she's covered up to 80% of all her medical bills; now the other 20% should come from Medicaid ( a state-supported program ), however, the additional monies that you are paying privately, such as a Medi-gap policy may not be necessary. I would call both Medicare and Medicaid to verify if additional funds are necessary.
Always confusion amongst Medicare managed care plan members...Do I have Medicare or not?
The answer to the question "....which is primary, Medicare or HMO?" is neither. Medicare HMO coverage (Part C) is offered by private corporations and accepted by beneficiaries INSTEAD of Original Medicare (Part A & B).
As such, ALL of your coverage is the responsibility of the HMO unless you switch back to original Medicare. You can not have two Medicare plans of any kind simultaneously.
By law Medicare managed care plans (Part C) must offer benefits equal to or greater than that offered by Original Medicare. Generally, HMO's require that contracted network physicians, hospitals, and suppliers by used. No benefits are available outside of the network without prior approval.
This contrasts with Original Medicare in that a beneficiary may go to any doctor or hospital that accepts Medicare.
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.
Carol
Some of my clients have employer based retirement health plans which they keep; others are in HMO's or other managed care plans which they prefer to remain involved with.
Unless there is some extenuating circumstance, there really is no reason to keep it. If anything, I would save the money to "buy-up" to a better Part D prescription drug plan.
As you may or may not know, different plans have different prices AND different formularies. The lower priced plans, those subsidized by Medicaid, may not have the meds your mom needs at some point. When and if that time arrives she can, as a low-income dual eligible, switch plans at any time of year to one that would meet her needs (and which will probably be more expensive).
The answer to the question "....which is primary, Medicare or HMO?" is neither. Medicare HMO coverage (Part C) is offered by private corporations and accepted by beneficiaries INSTEAD of Original Medicare (Part A & B).
As such, ALL of your coverage is the responsibility of the HMO unless you switch back to original Medicare. You can not have two Medicare plans of any kind simultaneously.
By law Medicare managed care plans (Part C) must offer benefits equal to or greater than that offered by Original Medicare. Generally, HMO's require that contracted network physicians, hospitals, and suppliers by used. No benefits are available outside of the network without prior approval.
This contrasts with Original Medicare in that a beneficiary may go to any doctor or hospital that accepts Medicare.