Medicaid updates

Medicaid recently lowered my spend down total by about $500 after I explained some issues: an account was closed which no longer generated income which had been added to the spend down total and they were suggesting I received $3400 from my John Hancock long term care insurance which reimburse $100/day.

This adjustment was a small victory but essentially meaningless as I have yet to be offered any additional home care from any of the long-term care companies and if I agree to the spend down, which would necessitate me switching from hiring independent HHA to working with an agency would mean getting half the hours of care for the same $100. An agency typical charges about $25/ hour for an HHA. An independent HHA can be hired for $12.50 or $15. The HHA working through the agency gets around $8-$12/hour. (I've gathered $12 is unusual)

I also received a notice from Medicaid stating that my mother had to enroll in Medicare Part D which relates to Rx coverage. She is already enrolled in Part D but this letter suggested that she could be disqualified from Medicaid or a Part D program would be chosen for her. I'm not sure how to even address this. Do I need to clarify to Medicaid that she's already enrolled in Part D? It seems very sad that we have a health care system that so difficult to access and utilize and most often very inadequate in it's care of the elderly. Some day many years from now (I sincerely hope) Americans will look back with some shame at this inadequate system....what are the priorities of a society if not to provide the most basic care to it's members? Especially, it's most vulnerable members....children and the elderly.

Guildnet

The Guildnet nurse came by for her assessment the other day. She was very nice (as were the nurses from Fidelis and CenterLight). I explained my situation to her. As was true with the other nurses, she was not clear on how Long Term Care Health Insurance interacted with Managed Long Term Care. I understand that this may be a complex issue that other departments handle but I imagine it's not that rare and is perhaps one of the most significant issues and barriers to getting care. At least that is the case in my mother's situation. She did a comprehensive assessment which consisted of numerous questions related to daily ability to function, and plugged the answers into her laptop computer. She appeared to be quite sympathetic to my mother's need for care (as did the other nurses) and did her best to help us make sense of all this.

At the same time, my mother, who may have dementia but who is also quite vain, did her best to minimize her need for care. The nurse seemed to pick up on this and did her best to get us the most hours of care available based on the assessment.

The end result was that she was offered about 5 hours a day. She suggested we keep on looking.
I have yet to schedule VNS and Elderserve but I'm not feeling overly optimistic at this point.

To date I've been offered the following:

Fidelis: 8 hours/day
CenterLIght: 16 hours/week
Guildnet: 5 hours/day

It seems likely that I will have to wait until my mother is no longer able to feed herself, wash herself, get up from a seated position and incontinent before I receive additional care. Meanwhile I hope that Medicaid won't simply close the case for lack of use.