When choosing a Medicare Plan you must stay with your options for that calendar year. By not signing up for Part B of Medicare you could have gaps in your coverage and pay a penalty. Traditional Medicare does not cover prescription drugs. You must choose coverage from a government approved private insurance company. You can appeal a coverage denial. If not granted the appeal at first, you can continue to appeal to the next level. You can apply for programs to help pay your Medicare costs such as, premiums, copays and deductibles. Medicare does not cover:
- Alternative Medicine
- Dental care
- Cosmetic surgery
- Vision Care
- Care received outside of the U.S.
- Nonemergency transportation
If you are eligible for Medicaid you qualify for:
- Adult Day Health Care
- Care Coordination
- Dental Care
- Durable Medical Equipment (e.g. wheelchairs, prosthetics)
- Hearing Exams, Hearing Aids and Batteries
- Home Care (e.g. home health aides, home attendants, personal assistants)
- Home Delivery of Meals and in a Group Setting
- Home Safety Modifications/Accessibility Improvements
- Housekeeping/Chore Services
- Medical and Surgical Supplies
- Nurse on Call 24/7
- Nursing Home Care
- Nutrition Services (including supplements)
- Personal Emergency Response System
- Physical, Occupational & Speech Therapies at Home or in a Nursing Home and Rehab
- Podiatry, Orthotics and Orthopedic Footwear
- Respiratory Therapy
- Skilled Services such as Nursing and Medication Management
- Social Day Care
- Vision Care (Exams, Glasses and other services)
When the time comes there are things you will need to know.
- What are your loved one’s Wishes and Desires?
- Has your loved one made plans for their future long term care?
- Would they like to remain home with assistance?
- Would they like to explore alternative housing?
- Have they identify who they would like to assist with long term care options?
- Have they taken steps in the area of Healthcare and financial planning (long term care insurance, healthcare insurance, living will, power of attorney)?
Important Document Worksheet
It is important to gather your loved one’s information in the event medical care is need. Medicare & Medicaid advisory Group has pulled together a list of documents and information to collect:
- Social Security #_________________
- Medicare #_______________
- Medicaid #____________________
- Veterans Administration Claim #________________
- List of Insurance Plans (medical, life, long-term care)
- List of Doctors and their Phone Numbers
- Medical History
- Medication and their Dosages
- Financial Information
- Legal Papers (e.g. Will)
- List of Medical Devices (e.g. Pacemakers, hearing aids, glassed)
- Driver’s License #_____________________
- Passport #________________________
- Name of Mortuary, Plot and Deed
- Birth Certificate
Care Giver Assessment
- Provide unpaid assistance with tasks of daily living?
- Offer emotional support and ensure a loved one’s safety?
- Frequently check up on your loved one by telephone or in person?
- Provide transportation for medical appointments, shopping or recreation?
- Shop for food and/or prepare meal?
- Act as an advocate and access resources?
- Help with household chores and repairs?
- Coordinate medical care, monitor and/or administer medications?
- Do you need support?
- Are you feeling overwhelmed?
- Have you been injured while caring for someone?
- Have you missed work because you need to care for a loved one?
- Do you feel depressed, anxiety or sick?
If you have answered yes to even one of these questions Medicare & Medicaid Advisory Group can help. Contact us today!
Nursing home residents can have a higher chance of getting an infection due to frailty from getting older, needing more help from caregivers who may not have clean hands, and open wounds or medical devices like IV tubes going into their body that break the skin providing a path for germs to enter the body. A nursing home should be tracking the common infections in its residents so they can be sure that actions are taken (i.e., infection prevention practices) to reduce the spread of germs to residents.
Shared living spaces and lots of visitors can make it easier for a contagious germ (like flu or diarrhea from norovirus) to spread quickly through a nursing home. While many facilities experience outbreaks, early detection and quickly alerting public health authorities can help limit the spread of the infection to more residents, staff and visitors.
Out breaks of infections do occur in nursing homes. It is important the facility staff have a process for notifying residents, family members and visitors so everyone can take steps to decrease the chance of spreading the infection or getting ill. Sometimes a facility might. have to restrict visitation or stop new admissions temporarily in order to stop an outbreak. In those situations, it’s very important that everyone is informed about what is happening.
A growing number of healthcare facilities are making flu shots a requirement for staff as a measure to protect patients and staff from flu. In nursing homes, giving a flu vaccine to staff can help reduce the spread of flu to residents. Even if a flu vaccine isn’t mandatory for staff, all staff should be offered the vaccine and a nursing home should know how many of their staff received the vaccine during the last flu season. The nursing home should also know what percentage of residents received the flu vaccine during the last flu season.
Coming to work sick is never a good idea, but it can be really dangerous if a person is working with frail or older people who are at an increased risk for getting a severe infection. Nursing homes should have sick leave policies that support staff to make the right decision to stay home when they are sick.
Cleaning hands before and after care for a resident is an important way to prevent the spread of infections. Residents and family members should feel comfortable and encouraged to provide helpful reminders to busy staff about cleaning their hands.
When a resident develops signs and symptoms which could be due to a contagious germ, like flu or norovirus, one way to protect the resident and others in the facility is to provide the ill resident with a private room until the cause of their symptoms is known. If a private room is not available, the facility should have a process to prevent spread of a contagious germ in a shared room. Other residents can get sick from germs picked up from contaminated surfaces or spread by unclean hands. Containing a contagious germ quickly can prevent spread to other residents, staff and visitors.
People can carry germs on their skin or other parts of the body for long periods of time without being sick. Having a process to clean and disinfect shared equipment before the next resident uses it is a way to ensure these germs are not spread to others.
When a person has new diarrhea it’s important to rule out contagious germs like C. difficile, as the cause. Diarrhea can contain large numbers of the germs causing it. Some of these germs, like C. difficile, are very tough and difficult to clean from the environment. One way to prevent the spread of infectious diarrhea is to have a separate toilet for an ill resident until the diarrhea goes away.
Residents and families are important partners in preventing the spread of infections and reducing misuse of antibiotics. Nursing homes should have materials to educate their residents, families and visitors on the facility’s infection prevention and antibiotic stewardship policies, and steps they can take to support a safe environment.