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What are Medicare Advantage Plans?
Though it is a different 'part' of Medicare, Part C or Medicare Advantage is a method for beneficiaries to receive their standard Medicare benefits (Parts A and B) through a private carrier, possibly with additional benefits and/or costs. The federal government pays each Advantage plan a monthly amount to provide the same care as Original Medicare. Medicare Advantage plans may offer additional benefits as well.
There are seven types of Medicare Advantage Plans available in Colorado. Each operates differently in terms of networks, coverage and cost.
Home and Community Based Services (HCBS) is the umbrella under which Medicaid pays for medical care and services for those who are not eligible for straight Medicaid, but are unable to afford the needed services. When HCBS is referenced in context to seniors, usually it means the Elderly, Blind and Disabled (EBD) program, though HCBS programs exist for children, the mentally disabled, those with brain injuries and those with AIDS.
Any person receiving Medicaid can receive home health care services, provided theindividual meets the eligibility requirements. To receive home health services, the indivudal must need medically necessary services (as defined by a physician) for the treatment of an illness, injury or disability (including mental disorders); the amount, duration and frequency of service must be reasonable; the services must be part of the care plan; care must be provided on an intermittent (not 24-hour) basis, and the only alternative to home care is the hospital or emergency room.
What is Medicare? Who qualifies?
Medicare is the government financed health insurance program for seniors and others receiving Social Security benefits. All persons aged 65 and over are eligible for Social Security benefits, and disabled persons who have received Social Security for 24 months are eligible for Medicare. Individuals who have Lou Gehrig's disease can receive Medicare immediately upon approval of Social Security Disability Insurance (SSDI).
How does Medicare work?
Medicare has four parts that cover different health care aspects.
Part A pays for hospital stays and other related services like home care, and is free to individuals entitled to Social Security (individuals not entitled to Social Security can purchase Part A coverage for $441 per month in 2013). The deductible for 2013 is $1,184 per 60-day benefit period.
Medicaid offers a program called Consumer Directed Attendant Support Services (CDASS) that allows individuals to have an extremely high level of control over their Medicaid funded home health services. CDASS is open to individuals who are eligible for Home and Community Based Services (HCBS). What this means is individuals who receive CDASS will be assigned an individualized monthly allocation of funds that can be used specifically for hiring and paying for attendant services.
Caring for a family member who needs assistance with activities of daily living can be a very complex and confusing experience. Decisions can range from financial and long term planning to medical issues or direct care for a loved one. Below we aim to bring you resources for making these decisions.
For individuals who require ongoing care but are able to remain at home, home care agencies can provide additional assistance. They can provide a range of services from limited companionship services to care by a registered nurse.
What is Long Term Care?
Long term care is a term that encompasses a variety of services including medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community (i.e. a day care, in assisted living or in nursing homes. It is important to remember that you may need long term care at any age.