JustCare

Category: Medicaid

  • Medicaid is a benefit for the middle-class

    Medicaid is a benefit for the middle-class

    Many people do not appreciate how important Medicaid is for middle-class families, reports Ron Lieber for the New York Times. While Medicaid benefits tens of millions of lower-income families, middle-income families often end up relying on Medicaid as they spend down their savings.

    Medicaid pays for nursing home and at-home care for people nearing the end of life who have exhausted their savings. It also provides health insurance to young people who are no longer eligible to be on their parents’ health insurance policies and are not yet making enough income to buy their own insurance. And, it provides health coverage to people with disabilities.

    Few Americans should assume that they or their loved ones won’t need Medicaid at some time in their lives. All it takes is one expensive health care condition and you can deplete your assets enough to qualify for Medicaid. Today, more than 72 million Americans are enrolled in Medicaid, and many more who qualify for Medicaid are not enrolled because of how complicated it can be to qualify.

    Medicaid is an extremely valuable safety net for all of us. And, right now, it is on the chopping block!

    What does Medicaid pay for? Nursing home care and at-home long-term care (which Medicare does not pay for) for people who have spent most of their savings (excluding the value of their homes.) Medicare only pays for limited skilled nursing and at-home care for people who are homebound and otherwise meet the eligibility requirements. This care is unaffordable for most Americans. Nursing home care now easily costs more than $100,000 a year for a semi-private room.

    Medicaid also offers health insurance to people with yearly incomes under $21,597. Eligibility turns on the state you live in, some of which are more generous than others.

    And people with disabilities who are unable to work are often covered by Medicaid, if their assets are low. Medicaid allows families members to continue to work. Without Medicaid, most people must rely on family caregivers, who are forced to quit their work to care for their loved ones.

    What can you do? It’s not yet clear whether Republicans will cut Medicaid. If they do, it’s likely that millions of Americans will be uninsured or underinsured. Americans should contact their representatives in Congress to let them know how grateful they are for Medicaid and urge them not to cut Medicaid.

    Moreover, Republicans do not have to cut Medicaid. If they want to reduce federal spending to pay for tax cuts for wealthy Americans, they have a choice. Republicans should end the waste and overpayments in Medicare Advantage, which the Congressional Budget Office estimates to total $1 trillion over the next decade.

    Here’s more from Just Care:

  • Some hospitals now provide at-home rehab services 

    Some hospitals now provide at-home rehab services 

    Felice J. Freyer reports for Kaiser Health News on how some hospitals now provide at-home rehab services for patients post surgery. At-home rehab can be helpful to patients who would otherwise have to wait in hospital until a rehab bed opens up for them.

    People with Medicare in Medicare Advantage plans often struggle to get rehabilitation services after a surgery or other procedure that leaves them in pain, unsteady and/or unable to care for themselves. The cost is high and insurers would prefer to deny the care and save money, even when lack of rehab services keeps patients from a speedy and full recovery.

    People in traditional Medicare are more likely to receive rehab services when needed post hospitalization. But, too often there are no rehab beds available. They are forced to sit in hospital until a bed opens up. And, sometimes the facility is located far from their homes and their loved ones.

    At-home rehab gets patients out of the hospital more quickly. Caregivers can more easily visit patients. And, patients are monitored remotely.

    The at-home rehab program is being tested in New York, Pennsylvania and Wisconsin. Some say it is working well. But, there are no rules surrounding how they should work, which patients qualify, or what services should be offered. And, Medicare does not cover these services as of now.

    In short, at-home rehab is only being offered by a few hospitals that are paid upfront to manage their patients’ care. In some cases, a state Medicaid program pays for the care.

    The trade association representing nursing homes and rehab facilities does not support this at-home rehab model. Skilled nursing facilities (SNFs) and rehab facilities are required to provide a range of services to their patients, which the at-home model does not require. Do these requirements necessarily improve patient care?

    Many SNFs and rehab facilities offer precious little to their patients, other than unhealthy meals, endless hours in bed, and a short period of physical and/or occupational therapy. One quarter of patients end up with bed sores, infections or other poor health outcomes. At home, patients could be up and about a lot more and trained on how to navigate their homes safely.

    One at-home rehab program reports no bedsores, infections or other adverse events for their patients. But, this program provides services only when there is also an in-home fulltime family caregiver to help. Consequently, many patients do not qualify for the at-home program.

    Another at-home rehab program enrolls patients living alone and provides them with a call button to speak with a live person when needed. It’s not clear how well this program works. Home alone, patients needing rehab could be at serious risk of falling or otherwise hurting themselves.

    Here’s more from Just Care:

  • 2025: Programs that lower your costs if you have Medicare

    2025: Programs that lower your costs if you have Medicare

    Medicare only covers about half of a typical person’s health care costs, leaving people with average annual out-of-pocket costs of $7,000. So, even with Medicare, many people struggle to afford premiums, deductibles and other costs. Some people qualify for Medicaid, which fills most of the gaps in Medicare. But, if you do not qualify for Medicaid, there are other programs that lower your health care costs. Click here or contact your local State Health Insurance Assistance Program (SHIP) to find out if you are eligible for any of these programs and how to apply.

    1. Medicare Savings Programs. Depending on your income, Medicare Savings Programs, administered by Medicaid, help pay for Medicare premiums and coinsurance, even if you don’t qualify for Medicaid. There are three programs, Qualified Medicare Beneficiary (QMB), Specified-Low Income Medicare Beneficiary (SLMB) and Qualified Individual (QI). Income and asset limits, and how they are counted, are listed below for 2025, but vary somewhat by state. You might qualify for these programs in your state even if your income or assets are higher than the federal amounts listed below. States sometimes exclude certain income and assets when determining your eligibility. You should apply through your state Medicaid office.

    • Qualified Medicare Beneficiary (QMB)—100 percent of federal poverty level (FPL) + $20. If you have QMB, you should not have out-of-pocket costs for Medicare-approved services in traditional Medicare or for in-network services in a Medicare Advantage plan. It should cover premiums, deductibles, coinsurance and copays for Medicare-covered services.
      • Income limit monthly depends upon where you live but is around
        • $1,325 for individuals
        • $1,783 for couples
      • Asset limit
        • Individuals: $9,660
        • Couples: $14,470
    • Specified Low-income Medicare Beneficiary (SLMB)—120 percent of FPL + $20. SLMB helps pay your Medicare Part B premium, if you have Part A and Part B.
      • Income limit monthly depends upon where you live but is around
        • $1,585 for individuals
        • $2.135 for couples
      • Asset limit
        • Individuals: $9,660
        • Couples: $14,470
    • Qualifying Individual (QI)—135 percent of FPL +$20, helps pay your Medicare Part B premium if you have Medicare Part A and Part B.
      • Income limit monthly depends upon where you live but is around
        • $1,781 for individuals
        • $2,400 for couples
      • Asset limit
        • Individuals: $9,660
        • Couples: $14,470

    Several valuable items are not counted as income and assets. No matter what state you live in, the first $20 of your income and the first $65 of your monthly wages are not counted as income. In addition, half of your monthly wages, after the first $65 is not counted, nor are food stamps. Some of your assets are also not counted, including your primary home, if you own it, your car, your wedding and engagement rings, a burial plot and $1,500 in burial funds, your life insurance with a cash value less than $1,500, and your furniture, household and personal items. Your bank accounts, stocks and bonds are counted.

    Tip: If your income is low but too high to qualify you for Medicaid, it is worth looking into whether you qualify for any of these programs. According to MACPAC, an independent agency that advises Congress on Medicaid policy, slightly more than half the people over 65 who qualify for the Qualified Medicare Beneficiary program (53%) are enrolled. And, an even smaller share of people over 65 who qualify for the Specified Low-Income Medicare Beneficiary program (32%) are enrolled. About one in seven people over 65 (15%) who qualify for the QI program are enrolled.

    2. Extra Help with Medicare Part D prescription drug coverage: You will automatically qualify for the Extra Help program, which is administered by Medicaid, if you qualify for Medicaid or any of the above low-income programs or receive Supplemental Security Income benefits. You can also apply for Extra Help independently. Extra Help pays for some or all of the cost of your Part D drug coverage and is estimated to be worth around $5,100 a year. The amount of help with cost-sharing depends on the level of your income and assets. In 2025, you may qualify if you have up to $1,976 in monthly income ($2,664 for couples) and up to $17,600 in assets ($35,130 for a married couple). With Extra Help your drug costs are no more than $4.90 for each generic/$12.15 for each brand-name covered drug, if your monthly income is above $1,325. Your drug costs are no more than $1.60 for each generic/$4.80 for each brand-name covered drug, if your monthly income is below $1,325. If your total drugs costs–what you and your health plan pay) go above $2,000 this year, you’ll pay nothing more. And, depending upon your income, you may pay only part of your Medicare drug plan premiums and deductibles. (Some states have State Pharmaceutical Assistance Programs that provide even more assistance.)

    3. Federally Qualified Health Centers (FQHCs) and other programs run by the Human Resources and Services Administration: FQHCs are located across the country and provide a wide range of services to underserved populations and areas on a sliding-fee scale. They might waive the Medicare deductible and coinsurance, depending upon your income.

    4. Hill-Burton programs offer free or reduced care at Hill-Burton facilities in 38 states. Hill-Burton does not cover services fully covered by Medicare or Medicaid. Eligibility depends on your family size and income.

    5. Veterans’ Administration: If you are a vet, the Veterans’ Administration (VA) offers low-cost services and prescription drugs directly. And, you can have VA coverage as well as Medicare.

    Keep in mind that you may be eligible for Medicaid based on your income after paying for some health care costs. To contact your state Medicaid office, click here.

    Here’s more from Just Care:

  • Getting public assistance? Beware of Medicare Advantage flex cards

    Getting public assistance? Beware of Medicare Advantage flex cards

    Maya Goldman reports for Axios on the risks of Medicare Advantage flex cards for people getting public assistance. The extra money people think they’re getting through a flex card could mean the end of your government housing or food benefits. UnitedHealth, Humana, CVS offer these cards to entice people to join their MA plans without warning people that the cards could mean the end of their public assistance, even if they don’t use them.

    How is it possible people can lose precious benefits? Government agencies can count flex cards as income. So, when people apply for Supplemental Security Income or rental assistance, adding the value of the flex cards to their income could disqualify them.

    Why are Medicare Advantage plans offering flex cards when they could be harmful to enrollees? It’s hard to imagine insurers are concerned with the risks of giving flex cards to disabled and low-income enrollees. They likely see the flex cards simply as a good hook to boost enrollment and profits.

    Some of the flex cards are specifically targeted to use on items such as groceries and electric bills. Each Medicare Advantage plan offers something different. But, the value of these cards can be significant, with an average value of nearly $1,000.

    People with Medicare and Medicaid could be far better off in traditional Medicare, with coverage from most providers in the US and without the prior authorization obstacles to care people face in Medicare Advantage. But, an extra several hundred dollars a year from a Medicare Advantage plan to offset grocery or utility costs is hard to pass up.

    Ideally, the Biden administration could direct agencies not to consider the flex cards as income, as more than 30 Democratic members of Congress have requested. But, regulations and statutory mandates for different agencies could get in the way of that. Alternatively, CMS should permit insurers to use the money in the flex cards for a different benefit, such as over-the-counter drugs, which would not be considered income.

    The Department of Housing and Urban Development (HUD) excludes most Medicare Advantage benefits from a person’s income when they apply for help. But, HUD is required by statute to count certain utility and rent benefits as income.

    One other concern: People can be misled about the flex cards. They can come with a bunch of limitations that prevent people from using them as they expected. Of course, the insurers profit more if people don’t use their flex cards.

    The insurers, for their part, have done nothing to address the serious issues their flex cards present for some of their most vulnerable enrollees.

    Here’s more from Just Care:

  • 2024: Programs that lower your health care costs if you have Medicare

    2024: Programs that lower your health care costs if you have Medicare

    Medicare only covers about half of a typical person’s health care costs, leaving people with average annual out-of-pocket costs of $7,000. So, even with Medicare, many people struggle to afford premiums, deductibles and other costs. Some people qualify for Medicaid, which fills most of the gaps in Medicare. But, if you do not qualify for Medicaid, there are other programs that lower your health care costs. Click here or contact your local State Health Insurance Assistance Program (SHIP) to find out if you are eligible for any of these programs and how to apply.

    1. Medicare Savings Programs. Depending on your income, Medicare Savings Programs, administered by Medicaid, help pay for Medicare premiums and coinsurance, even if you don’t qualify for Medicaid. There are three programs, Qualified Medicare Beneficiary (QMB), Specified-Low Income Medicare Beneficiary (SLMB) and Qualified Individual (QI). Income and asset limits, and how they are counted, are listed below for 2024, but vary somewhat by state. You might still qualify for these programs in your state even if your income or assets are higher than the federal amounts listed below. States sometimes exclude certain income and assets when determining your eligibility. You should apply through your state Medicaid office.

    • Qualified Medicare Beneficiary (QMB)—100 percent of federal poverty level (FPL) + $20. If you have QMB, you should not have out-of-pocket costs for Medicare-approved services in traditional Medicare or for in-network services in a Medicare Advantage plan. It should cover premiums, deductibles, coinsurance and copays for Medicare-covered services.
      • Income limit monthly depends upon where you live but is around
        • $1,275 for individuals
        • $1,724 for couples
      • Asset limit
        • Individuals: $9,430
        • Couples: $14,130
    • Specified Low-income Medicare Beneficiary (SLMB)—120 percent of FPL + $20. SLMB helps pay your Medicare Part B premium, if you have Part A and Part B.
      • Income limit monthly depends upon where you live but is around
        • $1,526 for individuals
        • $2.064 for couples
      • Asset limit
        • Individuals: $9,430
        • Couples: $14,130
    • Qualifying Individual (QI)—135 percent of FPL +$20, helps pay your Medicare Part B premium if you have Medicare Part A and Part B.
      • Income limit monthly depends upon where you live but is around
        • $1,715 for individuals
        • $2,320 for couples
      • Asset limit
        • Individuals: $9,430
        • Couples: $14,600

    Several valuable items are not counted as income and assets. No matter what state you live in, the first $20 of your income and the first $65 of your monthly wages are not counted as income. In addition, half of your monthly wages, after the first $65 is not counted, nor are food stamps. Some of your assets are also not counted, including your primary home, if you own it, your car, your wedding and engagement rings, a burial plot and $1,500 in burial funds, your life insurance with a cash value less than $1,500, and your furniture, household and personal items. Your bank accounts, stocks and bonds are counted.

    Tip: If your income is low but too high to qualify you for Medicaid, it is worth looking into whether you qualify for any of these programs. According to MACPAC, an independent agency that advises Congress on Medicaid policy, less than a half the people over 65 who qualify for the Qualified Medicare Beneficiary program (48%) are enrolled. And, an even smaller share of people over 65 who qualify for the Specified Low-Income Medicare Beneficiary program (28%) are enrolled. About one in seven people over 65 (15%) who qualify for the QI program are enrolled.

    2. Extra Help with Medicare Part D prescription drug coverage: You will automatically qualify for the Extra Help program, which is administered by Medicaid, if you qualify for Medicaid or any of the above low-income programs or receive Supplemental Security Income benefits. You can also apply for Extra Help independently. Extra Help pays for some or all of the cost of your Part D drug coverage and is estimated to be worth around $5,100 a year. The amount of help with cost-sharing depends on the level of your income and assets. In 2024, you may qualify if you have up to $22,590 in annual income ($30,660 for a married couple) and up to $17,220 in assets ($34,360 for a married couple). With Extra Help your drug costs are no more than $4.50 for each generic/$11.20 for each brand-name covered drug. If your total drugs costs–what you and your health plan pay) go above $8,000 this year, you’ll pay nothing more. And, depending upon your income, you may pay only part of your Medicare drug plan premiums and deductibles. (Some states have State Pharmaceutical Assistance Programs that provide even more assistance.)

    3. Federally Qualified Health Centers (FQHCs) and other programs run by the Human Resources and Services Administration: FQHCs are located across the country and provide a wide range of services to underserved populations and areas on a sliding-fee scale. They might waive the Medicare deductible and coinsurance, depending upon your income.

    4. Hill-Burton programs offer free or reduced care at Hill-Burton facilities in 38 states. Hill-Burton does not cover services fully covered by Medicare or Medicaid. Eligibility depends on your family size and income.

    5. Veterans’ Administration: If you are a vet, the Veterans’ Administration (VA) offers low-cost services and prescription drugs directly. And, you can have VA coverage as well as Medicare.

    Keep in mind that you may be eligible for Medicaid based on your income after paying for some health care costs. To contact your state Medicaid office, click here.

    Here’s more from Just Care:

  • Critical home care is no longer affordable for most people and too often not available

    Critical home care is no longer affordable for most people and too often not available

    Caring for an older person with multiple needs can take a toll physically, emotionally and financially. Reed Abelson reports for The New York Times on how reliable home care is hard to come by and not affordable over the long-term.

    Frank Lee, the husband of one woman with dementia, was tending to his wife morning, noon and night. He ended up putting her in a respite program at an assisted living facility so he could take a short break. While he was away, she fractured her sacrum. Mr. Lee was at a loss to find home health aides he could trust, the plight of many older couples.

    Eight million older adults suffer from dementia or need help with at least two activities of daily living, such as bathing and toileting. Only a small fraction of them–one million–have paid help outside a nursing home. Three million have no help.

    Our federal government does little to help people who need home health aides. Medicare only covers very limited home health health care and, then, only for people who are homebound and who need skilled nursing on an intermittent basis or skilled therapy. People with dementia don’t usually fit these criteria. If you don’t have Medicaid, you are generally out of luck in terms of government assistance and, even with Medicaid, there are often waitlists for home care.

    Most older adults are cared for by family, not professionals. They cannot afford $27 an hour, the going rate for a home care aide. Paying for fulltime home care usually means expenses of tens of thousands of dollars a year. Usually it is the older adult’s spouse or daughter  who takes on the role of caregiver.

    People who can afford to pay for a caregiver often cannot find one with the skills to take care of their loved ones. They are often forced to hire untrained caregivers. Paid caregivers in the US rarely earn a living wage; they often can’t count on fulltime work. And, they tend not to get health insurance benefits. It’s no wonder that there is a shortage of paid caregivers; they can get better jobs for the money.

    What to do? Plan ahead. Talk to your loved ones about likely long-term care needs. Even if you have limited resources, it is better to be prepared. Most people do not have these conversations. Families are often unprepared. Many families cannot save enough to offset the cost of long-term care. But, if you plan ahead, you could qualify for Medicaid.

    Keep in mind that long-term care needs can be extensive. Sometimes, two people are needed just to move someone from one place to another. Without assistance, simple tasks become huge burdens.

    Mr. Lee wonders “What’s the end game look like?” Is it right that he should watch his wife, who is already severely demented and unable to take care of herself or speak, deteriorate further? “As she disintegrates, I disintegrate.” When people are terminally ill–six months or less of life–Medicare covers hospice care, which covers some home care. But, good luck getting it if you’re in a Medicare Advantage plan. And, even in traditional Medicare, finding an agency that will provide hospice care can sometimes be challenging.

    Here’s more from Just Care:
  • Coronavirus: Should you get the 2023 booster shot?

    Coronavirus: Should you get the 2023 booster shot?

    The next Covid-19 booster shot should now be available from your local pharmacy, health clinic or doctor’s office. Medicare pays for it in full, whether you are enrolled in Traditional Medicare or a Medicare Advantage plan. If you are in a Medicare Advantage plan, the booster shot should be covered in full from network pharmacies, but perhaps not if you go out of network for the booster. Should you get the booster shot?

    The Food and Drug Administration just approved the booster as safe and effective. The booster shot protects people from the current Covid 19 variants in the US. The Centers for Disease Control panel of advisors believes that everyone over six months old should get it. Some argue that if only older adults are vaccinated, it will mean 100,000 additional hospitalizations.

    Fewer than one in five Americans got the Covid-19 booster that was approved in 2022. But, the data show that people who got the booster had a much lower likelihood of getting very sick or dying.

    Many people are getting Covid-19 now and more people are being hospitalized for it than earlier in the summer. More still are expected to be hospitalized this fall and winter.

    The list price of the booster is $130. But Medicare pays for it under Part B. Medicaid also covers it. And, so does commercial insurance. If you are uninsured, the federal government’s Bridge Access Program covers the vaccine at Federally Qualified Health Centers and at Walgreens, CVS and some other pharmacies.

    While the booster shot might only keep people from getting Covid for a few months, it still reduces the likelihood of being hospitalized and dying for a much longer period of time.

    The booster was tested on monkeys and mice, not people. But, around the world, billions of people have gotten the booster safely.

    Should you get the booster shot? You probably should not get the booster shot if you’ve had Covid in the last two months. Otherwise, many recommend you get the booster shot soon. If you are planning to travel over the winter holidays, you might wait until early November to get the booster. You then increase the likelihood that the vaccine protects you from infection during your travels.

    Some doctors question the value of the booster for people who have had Covid-19 and have been vaccinated one or more times. They believe that this alone should keep them from getting seriously ill from Covid-19, even if they get Covid.

    Should you get the Covid booster, the RSV vaccine and the flu shot at the same time? It might be smart to space them out.

    Free Covid tests: The federal government is once again offering free Covid tests beginning September 25. Click here to get four free tests sent to your home.

    Here’s more from Just Care:

  • People with both Medicare and Medicaid can get Traditional Medicare at little cost

    People with both Medicare and Medicaid can get Traditional Medicare at little cost

    More than 12 million Americans with Medicare also have Medicaid. These “dual-eligibles” typically have few out-of-pocket health care costs, whether they are in Traditional Medicare or a Medicare Advantage plan. Still, the Kaiser Family Foundation reports that half of them choose a Medicare Advantage plan, even though Medicare Advantage restricts their access to health care providers and imposes other barriers to care.

    People with Medicare and Medicaid, “dual-eligibles,” can get coverage through Traditional Medicare, with Medicaid picking up deductibles and coinsurance costs, through standard Medicare Advantage plans, or through Medicare Advantage plans designed specifically for dual-eligibles. Because there is so much we don’t know about Medicare Advantage plans, including denial rates and wait times for coverage, much less how quality differs among these plans, dual-eligibles should be better off in Traditional Medicare, where it is far easier to get care than in a Medicare Advantage plan.

    In the ideal world, health systems would do a good job of coordinating people’s care. But, that’s not the world we live in. Still, a lot of people with Medicare and Medicaid opt for a Medicare Advantage plan. Misleading ads and sales agents can be convincing.

    About half of dual-eligibles are enrolled in corporate-run Medicare Advantage plans when they would likely have easier access to care in Traditional Medicare. Traditional Medicare covers your care from almost all health care providers in the US without prior authorization requirements. Black, Hispanic and Asian/Pacific Islanders are more likely to sign up for Medicare Advantage plans than non-Hispanic White people.

    About three in ten dual eligibles are enrolled in Medicare Advantage Special Needs Plans or SNPs, which are corporate health plans intended to coordinate their care and to work well with Medicaid in their states. But, it’s not clear how well these plans work. In fact, the Office of the Inspector General recently released a report expressing concerns about high inappropriate denial rates in some Medicaid health plans.

    One great Medicare program that coordinates care for dual-eligibles is PACE, the Program of All-Inclusive Care for the Elderly. If you are a dual-eligible, look into the non-profit PACE programs in your area. They are often unable to take new enrollees, but if you can get on a waitlist, do so. To qualify for the medical and social services they provide, you must be at least 55 years old and be able to live in your home safely but need a nursing home level of care. For more information on PACE, click here. Note: Beware of for-profit PACE programs.

    Here’s more from Just Care:

  • Medical debt rising for people who pay through their credit cards

    Medical debt rising for people who pay through their credit cards

    Millions of people max out their credit cards, and an increasing number max out because of a costly medical condition. Patients want to pay their medical bills, or they must pay their bills in order to receive care. But, these days, using a credit card to pay medical bills likely means a medical debt hike because interest rates are rising, reports Bob Herman for StatNews.

    Using a credit card when you are unable to pay off the debt as required by the bank issuing the card is a risky proposition and a particularly risky one now. Interest rates are rising. Credit limits are shrinking. Failing to pay the minimum jeopardizes your credit rating and could lead to all kinds of toxic consequences, including wage garnishment and lawsuits.

    Each time the Fed raises its interest rate, the cost of borrowing money for just about any reason is likely to increase. Credit limits could shrink, leaving people with more debt on their credit cards than is permissible. They are potentially liable for higher penalties if they don’t pay the debt back. And, getting credit is also likely to be more difficult.

    If you can’t pay your medical bill, whatever you do, think twice before agreeing to a credit card from your hospital. The card might seem appealing and help you at the moment, but it could have exceptionally high interest rates. Credit card interest rates are already very high, as much as 21 percent. People who owe more are likely to be charged higher rates because they present greater credit risk.

    One hospital credit card, CareCredit does not charge interest for as long as 24 months if cardholders pay off their debt. But, people who do not pay off their debt can be stuck with interest from day one. And, the interest rate charged is currently 27 percent for new accounts.

    Anyone who is struggling to pay for medical care should look into Medicaid eligibility requirements in their state. Many states allow you to “spend down” to Medicaid eligibility levels, meaning that even if your income is above eligibility levels, if your medical expenses bring that income down to below eligibility levels, you could qualify for Medicaid. Assets will be considered, but the value of your home, if you own it, is not considered. If you qualify, Medicaid could retroactively cover some of your care.

    Here’s more from Just Care:
  • PACE helps older adults stay in their community

    PACE helps older adults stay in their community

    The Program of All-inclusive Care for the Elderly (PACE) is a home and community-based program designed to keep older adults who are at risk for nursing home placement living in their community.  PACE is a partnership between a local sponsoring organization, and Medicare and Medicaid health insurance programs. To become a PACE “participant,” a person must be nursing home eligible. While a person can pay privately for services, most participants have Medicare, Medicaid, or both insurance programs.

    The PACE philosophy: PACE members are called “participants” because they are encouraged to participate in their care–decision making and active care–whenever possible.  The overarching goal of the PACE Model of Care is to keep people living in the community and out of institutional care.  While an individual does not need to visit the PACE Center, which offers adult day programs with wrap around health services, it promotes socialization and addresses common problems of isolation, loneliness, and boredom.

    Who can get PACE? Programs of All-Inclusive Care for the Elderly (PACE®) serve individuals who are age 55 or older, certified by their state to need nursing home care, able to live safely in the community at the time of enrollment and live in a PACE service area.

    How does PACE work? PACE works by providing care and services in the home, the community, and at the PACE center. It is team-based care that provides everything covered by Medicare and Medicaid if authorized by your health care team.  If your health care team decided you need care and services that Medicare and Medicaid doesn’t cover, PACE may still cover them.  The team provides comprehensive coordinated care and includes the PACE participant, physician, nurse, social worker, recreational specialist, rehabilitation specialists, and transportation specialists.

    Services: Delivering all needed medical and supportive services, a PACE program is able to provide the entire continuum of care and services to older adults with chronic care needs while maintaining their independence in their home for as long as possible. Services include the following:

    • adult day health care that offers nursing; physical, occupational and speech/language therapies; recreational therapies; meals; nutritional counseling; social work and personal care;
    • medical care provided by a PACE physician familiar with the history, needs and preferences of each participant;
    • home health care and personal care;
    • all necessary prescription and over-the-counter medications;
    • medical specialties, such as audiology, dentistry, optometry, and podiatry and speech therapy;
    • respite care; and
    • hospital and nursing home care when necessary.

    See more at: http://www.npaonline.org/policy-advocacy/value-pace#services

    Find a PACE program near you: Currently, there are 144 PACE organizations in 30 states serving 58,000 people. To find out if you or a loved one is eligible, and if there is a PACE program near you, visit www.pace4you.org or www.Medicaid.gov, or call your Medicaid office.

    Beware of for-profit PACE programs: Government audits find for-profit PACE program neglects patients, delays needed care and cancels critical care.

    Learn what to do to ensure safety at home for people aging in their communities. And, see how one new program is helping older adults remain at home with assistance from a handyman, occupational therapist and nurse. For those who like technology solutions, check out how sensors can offer peace of mind to caregivers.

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    This post was originally published on March 2, 2016

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