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Friday, May 4, 2012

Medicare/Medicaid

After struggling with whether or not I wanted to go down this road, I finally had someone from DSHS come over and do an assessment of my situation.   It took three hours.  She was very good, and I could lay down the whole time while she sat at my table and fired off question after question about how I take care of myself.  She was really good at what she does.  It was scary for me to do, but I have no choice anymore.  When I first posted about this (here and at Inspire.com) some people responded by telling me to get an attorney if I was going on Medicaid.  I almost cancelled the appointment.
However, she made a phone call and told me that I would NOT lose Medicare if I had some help from Medicaid.  She said Medicaid would simply become my secondary insurance.  I was afraid I’d lose my prescription plan through part D, and of course, my disability which took me a long time to get and is my ONLY income.  I also went online to make sure that what she told me was true.  It is.  I can have both.  That’s good news.
She’s going to send me a packet of information and said a lot of stuff would be coming now… and she’s going to make sure I qualify for assistance in the home, but she thinks I do….I have to pay over $230 a month for 35 hours of assistance, but the total cost is around $700.  And If I had to pay for help out of pocket it would be a lot more than that….I checked.  And, I will just be billed for it.  I do not pay it directly to the caregiver and it does not come out of my disability check.  And after a few months, I get to keep what Medicare now deducts from my disability check, so that can go towards the $230.  So it comes to about 2 four hour days of help per week, which for me, is enough.  I need help with going to the store, cleaning and some meal preparation.  I didn’t realize how much trouble I had until I started talking to her.
She asked me good questions….I think people cheat a little because it’s embarrassing to admit you need help.  Or, on the other hand, people make themselves out to be worse than they are.  She also asked me some basic dementia questions…like spelling a word backwards, remembering the order and name of three words a few minutes after she tells me them…stuff like that.  I think I did okay with that.  But admitting I fell a few days ago, admitting people help me when they come over (they do) was hard.  But in the end, I THINK I will get what I need.  And as time passes, I may need more.  But I will not go into a nursing home.  Period.
She told me that in the 80’s more than ½ the people in nursing homes did not need to be there, but there was no alternative for people like me, who need some help but not the nursing kind.  I’m hoping and praying that things go well for me with this caregiver.  I get to interview and pick someone.  But I may get a nanny cam or some such thing, just in case.  One never knows, does one?  So if you have Medicare but need more help and live in the US, call your local DSHS office and make an appointment.

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