Disabling conditions cause millions of Americans to rely on long-term care. Medicaid is the primary payer of this type of care in the US. Seniors who utilize Medicaid long-term care plans or intend to switch a plan should understand the benefits provided.
What is long-term care?
Long-term care is necessary for seniors or people with disabilities who are unable to live independently. This type of care is provided to consumers in institutional settings, such as nursing homes and assisted living facilities. In-home care is also covered and allows seniors to live in their own homes.
What is offered by Medicaid long-term care plans?
Medicaid programs work stringently with states, providers and consumers to develop long-term support systems that enable aging adults as well as those with disabling conditions to be offered greater choices and control of a wide variety of care services that allow them to enjoy a good quality of life.
The Medicaid system is designed to be inclusive, meaning it supports seniors in living where they want to live and with whom. Aging adults who wish to age in place have a number of Medicaid resources that allow them access to quality services and supports in the community.
Seniors aged 65 and older who are eligible for Medicaid may qualify for Florida’s Statewide Medicaid Managed Care program. The Long-Term Care (LTC) Managed Care Program is one of two different programs that make up the Statewide Medicaid Managed Care.
A managed care plan contracted with the Agency for Health Care Administration (AHCA) to provide long-term care services offers specific forms of care. Seniors enrolled in the plan have access to companion care services, such as those provided by an in-home elder care agency.
Aging adults may also enroll in adult day centers, receive home delivered meals, be admitted to hospice, and have access to medication management services. Seniors may receive occupational, physical, and speech therapies. Respite care and transportation are included as part of the care services.
The abovementioned services are only a portion of what a qualifying senior is eligible to receive. However, all services are provided based on medical necessity; or they may be available in order to delay or prevent older individuals from entering a skilled nursing facility.
Can seniors switch Medicaid plans after making a first choice?
Health plans may be changed under certain conditions. During the first 90 days of enrollment, the senior has the right to switch to another plan offered in the same region. After this period, changes can only be made once a year during open enrollment.
Good reasons for switching include those when the original health plan provides a poor level of care, or the plan fails to provide the senior with care services that should be covered. Seniors can also switch when providers in the plan are inexperienced with their health care needs.
How do seniors protect themselves against Medicare fraud?
Medicare fraud is on the rise and unsuspecting seniors are most vulnerable to becoming victims. Healthcare fraud schemes cost the US government tens of billions of dollars in losses annually. Families and their elderly loved ones should protect themselves against these types of schemes.
Fake solicitations from Medicare peak around open enrollment period, which is October 15 to December 7. However, scams can happen any time of the year. Scammers intend to manipulate unwitting seniors into revealing their Medicare number, which can be used to file fake Medicare claims.
A senior’s Medicare number used to be based on their social security number. In 2018, the federal government changed this, giving recipients a unique identifying number instead. This Medicare number is sensitive information and should be protected as would a social security number.
Scams surrounding the new Medicare number have emerged. Medicare beneficiaries are not required to update their information, pay fees, or take action to activate their new card. The updated cards were mailed out to beneficiaries and the transition process has been completed.
Medicare will never call a beneficiary unless the senior has initiated contact. Older adults who receive an unexpected call from Medicare should hang up. The Federal Trade Commission warns that scammers use fake caller ID names to impersonate Medicare and attempt to deceive call recipients.
Seniors who receive Medicare benefits are also advised to examine their explanation of benefits statements carefully, looking for charges for services or products that make no sense. Direct questions about statements to The Centers for Medicare and Medicaid Services, which administers Medicare.
Report suspected fraud by calling the number on the back of the Medicare card. Seniors who believe they’ve mistakenly given out their sensitive information to a scammer should contact their local US attorney’s office and the state attorney general’s office.
Aging individuals interested in receiving quality long-term care services at home are encouraged to consult a reputable home care agency, such as Assisting Hands Home Care. We provide dependable elder care to seniors in the comfort and familiarity of home, allowing them to age in place.
Home care is an ideal alternative to nursing home care. Seniors are assisted with all the activities of daily living by professional caregivers. Our caregivers help older adults with personal hygiene tasks, prepare nutritious meals, provide transportation, give medication reminders, and perform fall-risk assessments.
Assisting Hands Home Care services keep seniors healthy both physically and emotionally. Pleasant companion care is included in our home care services. Our caregivers chat with seniors, take them on outings, and play games, thereby keeping loneliness and social isolation at bay.
Seniors who utilize our home care services enjoy independent living at home. Our comprehensive non-medical care supports the daily needs of the elderly at all levels of functioning. Care options, from respite care to 24-hour care, are flexible and meet a variety of scheduling needs.
At Assisting Hands Home Care, compassionate senior care is our number one priority. We are privileged to have an opportunity to give elderly individuals living in Sarasota, Florida, the best quality of life at home. Call us to schedule an in-home consultation and begin quality home care.
