Caregivers Los Angeles

If you have insurance such as Medicare or Long Term Care please let us know. As you may qualify to get services.

Medicare Covers

What’s home health care?

Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).

Examples of skilled home health services include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

The goal of home health care is to treat an illness or injury. Home health care helps you get better, regain your independence, and become as self-sufficient as possible.

If you get your Medicare benefits through a Medicare health plan, check with your plan to find out how it gives your Medicare-covered home health benefits.

If you have a Medicare Supplement Insurance (Medigap) policy or other health insurance coverage, tell your doctor or other health care provider so your bills get paid correctly.

If your doctor or referring health care provider decides you need home health care, they should give you a list of agencies that serve your area. They must tell you whether their organization has a financial interest in any agency listed.

What should I expect from my home health care?

  • Doctor’s orders are needed to start care. Once your doctor refers you for home health services, the home health agency will schedule an appointment and come to your home to talk to you about your needs and ask you some questions about your health.
  • The home health agency staff will also talk to your doctor about your care and keep your doctor updated about your progress.
  • It’s important that home health staff see you as often as the doctor ordered.

Examples of what the home health staff should do:

  • Check what you’re eating and drinking.
  • Check your blood pressure, temperature, heart rate, and breathing.
  • Check that you’re taking your prescription and other drugs and any treatments correctly.
  • Ask if you’re having pain.
  • Check your safety in the home.
  • Teach you about your care so you can take care of yourself.
  • Coordinate your care. This means they must communicate regularly with you, your doctor, and anyone else who gives you care.

To See full article see MEDICARE.GOV

Long Term Care Insurance

Unlike traditional health insurance, long-term care insurance is designed to cover long-term services and supports, including personal and custodial care in a variety of settings such as your home, a community organization, or other facility.

Long-term care insurance policies reimburse policyholders a daily amount (up to a pre-selected limit) for services to assist them with activities of daily living such as bathing, dressing, or eating.  You can select a range of care options and benefits that allow you to get the services you need, where you need them.

The cost of your long-term care policy is based on:

  • How old you are when you buy the policy
  • The maximum amount that a policy will pay per day
  • The maximum number of days (years) that a policy will pay
  • The maximum amount per day times the number of days determines the lifetime maximum amount that the policy will pay.
  • Any optional benefits you choose, such as benefits that increase with inflation

If you are in poor health or already receiving long-term care services, you may not qualify for long-term care insurance as most individual policies require medical underwriting. In some cases, you may be able to buy a limited amount of coverage, or coverage at a higher “non-standard” rate.  Some group policies do not require underwriting.

Good To Know

Many long-term care insurance policies have limits on how long or how much they will pay. Some policies will pay the costs of your long-term care for two to five years, while other insurance companies offer policies that will pay your long-term care costs for as long as you live—no matter how much it costs. But there are very few that have no such limits.

Most people buy long-term care insurance directly from an insurance agent, a financial planner, or a broker. Some important points:

  • States regulate which companies can sell long-term care insurance
  • States regulate the products that companies can sell
  • There are more than 100 companies offering long-term care insurance nationally, but 15 to 20 insurers sell most policies
  • The best way to find out which insurance companies offer long-term care coverage in your state is to contact your state’s Department of Insurance

State Partnership Programs

Residents of some states may be able to find long-term care coverage through a State Partnership Program that links special Partnership-qualified (PQ) long-term policies provided by private insurance companies with Medicaid. These PQ policies:

  • Help people purchase shorter term, more complete long-term care insurance
  • Include inflation protection, so the dollar amount of benefits you receive can be higher than the amount of insurance coverage you purchased
  •  All you to apply for Medicaid under modified eligibility rules if you continue to need long-term care and your policy maximum is reached
  • Include a special “asset disregard” feature that allows you to keep assets like personal savings above the usual $2,000 Medicaid limit.

The following example shows how a Partnership-qualified policy works:

  1. John, a single man, purchases a Partnership policy with a value of $100,000.
  2. Some years later he receives benefits under that policy up to the policy’s lifetime maximum coverage (adjusted for inflation) equaling $150,000.
  3. John eventually requires more long-term care services, and applies for Medicaid. If John’s policy was not a Partnership-qualified policy, in order to qualify for Medicaid, he would be entitled to keep only $2,000 in assets. He would have to spend down any assets over and above this amount.
  4. But because John bought a Partnership-qualified policy, he can keep $152,000 in assets and the state will not recover those funds after his death. John would only have to spend down his assets over and above the $152,000 in order to be eligible for Medicaid.

Since Partnership-qualified policies must include inflation protection, the amount of the benefits you receive can be higher than the amount of insurance protection you purchased. For example, if you have a Partnership-qualified long-term care insurance policy and receive $100,000 in benefits from it, you can apply for Medicaid and, if eligible, retain $100,000 worth of assets over and above the state’s Medicaid asset threshold. In most states the asset limit is $2,000 for a single person. Asset limits for married couples are often higher.

States must certify that partnership policies meet the specific requirements for their partnership program, including that those who sell partnership policies are trained and understand how these policies relate to public and private coverage options. To find out more about your state’s program, including which insurance agents are selling partnership policies, or to find out if your state offers a partnership program, contact your state’s Department of Insurance.

Employer

Many private and public employers, including the federal government and a growing number of state governments, offer group long-term care programs as a voluntary benefit, and generally:

  • Employers do not typically contribute to the premium cost (as they do with health insurance), but they often negotiate a favorable group rate
  • If you are currently employed, it may be easier to qualify for long-term care insurance through your employer than it is to purchase a policy on your own
  • You should check with your benefit or pensions office to see if your employer offers long-term care insurance.

The U.S. Office of Personnel Management has additional information about the Federal Long Term Care Insurance Program for employees of the federal government.

See More at LONGTERMCARE.GOV

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