Building the Case for Home Care

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Jan 18, 2015

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Connecticut - Southern Connecticut

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Building the Case for Home Care
There are many misconceptions about home care. This article explores two of the most common questions: when is it indicated; and how is it paid for?
When should you consider home care? There are two catalysts for home care: 1) medical need; 2) custodial need. Medical need typically follows a hospitalization or acute illness leaving you in need of highly skilled home care to help you improve your condition. Physicians must order home care services. The services are designed to improve your medical health to maximum improvement status. Often the intervention helps you regain your strength and stability after a period of illness. Thanks to a lawsuit brought by the Center for Medicare Advocacy, medical home care may now be paid by Medicare to prevent or slow the decline in condition. Custodial care may be indicated when a person is struggling to manage everyday tasks such as toileting, bathing and medication management or household tasks including homemaking, meal preparation or money management. It is more difficult to pinpoint that moment when custodial care is needed. Barriers may exist that prevent an individual from seeking assistance. Caregivers may feel guilt when they can no longer provide all necessary care. Seniors may feel that money saved over their lifetime should not be squandered away on their personal needs. It is sometimes difficult to accept ones frailty and the perceived loss of independence.

How is home care paid? Medical care is often covered by Medicare and Medigap plans. Most care is limited in duration and ends once the patient has met an improvement threshold as determined by a physician. Keep in mind that medical care makes no provision to help you manage household activities as described above. Custodial care is paid for by the individual, family, Long Term Care (LTC) Insurance (if you have a policy) or Medicaid. Long Term Care Policies vary widely based on coverage and cost. A relatively small percentage of todays seniors have LTC insurance although more baby boomers are considering the option. Medicaid will cover custodial care only after you have impoverished yourself. Medicaid requires an individual to use their own assets before Medicaid begins. An individual can have no more than $1,600 in cash to qualify. Connecticut offers seniors with somewhat higher assets limited access to home care with certain restrictions. Visit www.SWCAA.org , CT Home Care tab for more information.

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