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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.
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 do we mean by 'Original' Medicare?
Medicare Parts A and B, together often colloquially known as Original Medicare or Straight Medicare, are the direct government insurance most people think of when they think of Medicare. Together they provide hospitalization and medical services coverage, including doctor's visits, screenings, emergency room care, surgery, medical supplies and equipment, home care, skilled nursing care, hospital inpatient costs and hospice care.
Who is eligible and how much does it cost?
For Parts A and B, anyone 65 and older who is entitled to Social Security is eligible (those who are disabled and have been on Social Security for 24 months are also eligible). Those not eligible for Part A (meaning those individuals or spouses who have not paid into Social Security for at least 40 quarters) can buy-in to Part A (in 2013) for $243 a month (for those with 30-39 quarters) or $441 a month for all others in.
What is Medicaid?
Medicaid comprises a group of programs that provide health insurance to Colorado residents who meet the income and resource criteria for eligibility. Medicaid provides coverage for among others, physician services, prescription drugs (not covered by Medicare Part D), inpatient/outpatient hospitalization, durable medical equipment, laboratory and x-ray serves, medical supplies, medical transportation, podiatry, hospice, immunization and home health care.
How is Medicaid different than Medicare?
Medicaid goes to persons of all ages who meet low income and other guidelines. It provides a broader range of services than Medicare.
Medicare covers most people over age 65, regardless of income. The primary benefits are doctors' office visits and hospitalization. Home health and nursing home coverage are extremely limited.
Who Qualifies for Medicaid?
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.
The Colorado Gerontological Society is committed to serving Colorado's senior population and aging professionals. For more specific information and assistance, please contact us. We can often help with problem solving, counseling, resource referral and information distribution. We can send application forms and resource lists by mail, e-mail or fax and can help with filling out forms, applying for and appealing benefits and can provide limited grant assistance for hearing, dental and vision problems.
The intent of Adult Day Programs is to encourage the active participation of the senior population in a variety of activities ranging from social to educational pursuits. Whether utilized as a way to fill lonely hours or as a means of sharing knowledge and special life skills, these centers offer a safe, comfortable alternative to what may be inappropriate placement in full time care. Most focus on individuals unable to be left alone during the day.
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.
At some point in every individual's life, he/she will have to deal with legal issues. These can range the gamut from creating and filing a simple will to complex guardianship and probate proceedings. The take-home point is that legal issues can encompass an enormous range of problems, an obtuse legal system and no single answer to any problem.