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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?
Acknowledgment of Disclosures and Authorization
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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Whatever medicare will not cover can either be paid out of pocket or by a privately purchased insurance policy usually thru AARP. That is called medigap.
There are many Medigap insurances available. A Medicare Advantage is an HMO/PPO that replaces traditional Medicare and a Medigap insurance. So instead of having the two(Medicare/Medigap) you will have only one insurance that will cover everything - including Rx. Highmark, Humana, Aetna have a good plans. It is important to make sure your physician is participating in the plan that you choose - whether a Medigap or Medicare Advantage.
Medigap (aka Medicare Supplement Plan) has better coverage, you have your choice of providers, but is more expensive and you need to also enroll in a separate Part D drug plan. Medicare Advantage (HMO) is less expensive, has drug coverage included, but there are copays to pay everytime you go to the doctor, hospital, SNF, etc. and your choice of doctors and hospitals is dependent upon the network. There are pros and cons to each. We just changed my mother over from the HMO plan to a medi-gap plan this year, as her out of pocket costs were sky-high on the HMO plan.
If you had insurance coverage when retired before the age you got medicare coverage, check to make sure that your employer does not have an obligation to cover costs not covered by medicare. If you secured health insurance in retirement privately it often becomes your medigap coverage in essence once medicare becomes your 'primary' health care coverage.
I would ask medicare to get you information on the medigap plans and the Medicare Advantage programs. Some people have liked the Medicare Advantage programs but they are in essence privatized Medicare benefits. The companies need to make a profit off the plans. I suspect if you're in failing health needing lots of services, you might be a person the private plans aren't looking for.
Medicare beneficiaries have two options to obtain Medicare benefits 1. "Original Medicare" (which is how it is officially termed), or 2. Medicare Advantage aka "Part C" plans.
(There are four "Parts" to Medicare. Part A covers hospitalization and hospital services under Original Medicare, Part B covers physician services under Original Medicare, Medicare Advantage plans are designated as Part C, and stand-alone Medicare Prescription Drug plans are designated as Part D.)
The two choices explained:
Original Medicare – 1. Beneficiary pays Part B and in some cases Part A premium to the US Treasury. 2. Beneficiary claims are paid to the provider by the US Treasury. 3. Beneficiary may see any provider that accepts Medicare (freedom of choice) 4. Beneficiary must pay deductibles and co-insurances. 5. Deductibles and co-insurances may be insured against by purchasing Medicare supplement insurance (also known as “Medi-gap insurance) from an insurance company. 6. Because the Medi-gap premium is fixed for the year, and in most cases all deductibles and co-insurances will be covered, the beneficiary knows in advance what the maximum out of pocket medical expenses may be for the year. 7. Beneficiaries must purchase a stand-alone Part D prescription drug plan.
Medicare Advantage – 1. Beneficiary pays Part B and in some cases Part A premium to the US Treasury. 2. Beneficiary contracts with a profit or not-for-profit corporation to provide medical benefits to the beneficiary. 3. Corporation or “managed care company” (many times an “HMO” – Health Maintenance Organization) receives a monthly stipend from the Federal government for each beneficiary enrolled in its program. 4. Corporation is responsible for all expenses incurred by the beneficiary and providers are paid by the corporation, not the US Treasury. 5. There are usually no deductibles but there are copayments required at the time of service. 6. Many plans do not have an out of pocket annual maximum limit on copayments. 7. Many plans do not require a premium to be paid (Part B/A premiums must continue to be paid). 8. Most plans require that beneficiaries use only providers that are contracted with the corporation. Some plans allow for non-contracted providers at a higher co-payment rate or other reimbursement schedule (lack of freedom of choice). 9. Many plans include Part D prescription drug cover at no extra charge.
Which plan is best for you or your loved one? As always, it depends. In larger service areas where there are many choices of contracted providers Medicare Advantage plans work well and are generally less expensive to use than Original Medicare with or without a Medi-gap insurance supplement. In general, it has been my experience that those beneficiaries who are younger and/or healthier are more satisfied with Medicare Advantage plans than those who are older and not as healthy. But if freedom of choice is your primary concern then the best option is Original Medicare.
Everyone is correct. Even if you have Medicare insurance, there's always a part (unless you have Medicaid and Medicare) that will come out of your pocket. If you don't qualify for Medicaid, you may want to look into Medigap insurance as they would cover whatever your primary medicare insurance you have. Normally Medicare pays up to 80%, Medigap will cover the remaining 20%. Check with your medicare plan first but do not just get theirs, be smart about it and check with others as well. Nowadays, they are very competitive prices out there due to the Obamacare reform. Good luck. By they way, if you or whoever you are looking for this Medigap insurance for.... remember first check with your primary doctor to see if you might qualify for Medicaid first.
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.
A Medicare Advantage is an HMO/PPO that replaces traditional Medicare and a Medigap insurance. So instead of having the two(Medicare/Medigap) you will have only one insurance that will cover everything - including Rx. Highmark, Humana, Aetna have a good plans. It is important to make sure your physician is participating in the plan that you choose - whether a Medigap or Medicare Advantage.
I would ask medicare to get you information on the medigap plans and the Medicare Advantage programs. Some people have liked the Medicare Advantage programs but they are in essence privatized Medicare benefits. The companies need to make a profit off the plans. I suspect if you're in failing health needing lots of services, you might be a person the private plans aren't
looking for.
Elizabeth
Medicare beneficiaries have two options to obtain Medicare benefits
1. "Original Medicare" (which is how it is officially termed), or
2. Medicare Advantage aka "Part C" plans.
(There are four "Parts" to Medicare. Part A covers hospitalization and hospital services under Original Medicare, Part B covers physician services under Original Medicare, Medicare Advantage plans are designated as Part C, and stand-alone Medicare Prescription Drug plans are designated as Part D.)
The two choices explained:
Original Medicare –
1. Beneficiary pays Part B and in some cases Part A premium to the US Treasury.
2. Beneficiary claims are paid to the provider by the US Treasury.
3. Beneficiary may see any provider that accepts Medicare (freedom of choice)
4. Beneficiary must pay deductibles and co-insurances.
5. Deductibles and co-insurances may be insured against by purchasing Medicare supplement insurance (also known as “Medi-gap insurance) from an insurance company.
6. Because the Medi-gap premium is fixed for the year, and in most cases all deductibles and co-insurances will be covered, the beneficiary knows in advance what the maximum out of pocket medical expenses may be for the year.
7. Beneficiaries must purchase a stand-alone Part D prescription drug plan.
Medicare Advantage –
1. Beneficiary pays Part B and in some cases Part A premium to the US Treasury.
2. Beneficiary contracts with a profit or not-for-profit corporation to provide medical benefits to the beneficiary.
3. Corporation or “managed care company” (many times an “HMO” – Health Maintenance Organization) receives a monthly stipend from the Federal government for each beneficiary enrolled in its program.
4. Corporation is responsible for all expenses incurred by the beneficiary and providers are paid by the corporation, not the US Treasury.
5. There are usually no deductibles but there are copayments required at the time of service.
6. Many plans do not have an out of pocket annual maximum limit on copayments.
7. Many plans do not require a premium to be paid (Part B/A premiums must continue to be paid).
8. Most plans require that beneficiaries use only providers that are contracted with the corporation. Some plans allow for non-contracted providers at a higher co-payment rate or other reimbursement schedule (lack of freedom of choice).
9. Many plans include Part D prescription drug cover at no extra charge.
Which plan is best for you or your loved one? As always, it depends. In larger service areas where there are many choices of contracted providers Medicare Advantage plans work well and are generally less expensive to use than Original Medicare with or without a Medi-gap insurance supplement.
In general, it has been my experience that those beneficiaries who are younger and/or healthier are more satisfied with Medicare Advantage plans than those who are older and not as healthy.
But if freedom of choice is your primary concern then the best option is Original Medicare.