Approaching the finish line?

After many months of phone calls, paperwork, nurse assessments and anxiety, my mother was approved by 12 hours / day of home care by VNS. Today is November 24th and next Monday is the first, only one week away and still things are not quite in place.

Last Thursday I found that the home care agency is waiting for VNS to contact them before they can start services and VNS is waiting for Medicaid to send them their "list" showing my mother is approved. I spoke with a Medicaid caseworker on Friday and was happy to hear that my mother was on the approved list, and they were on board with the arrangements I made to divert John Hancock long term care insurance reimbursement from my mother to the home care agency which will effectively lower her surplus amount significantly (over $3000).

On Thursday VNS stated they were waiting for the list from Medicaid which would arrive on the 23rd and another on the 27th (Thanksgiving). I called VNS today and a worker told me I'd have to wait until they received this list. I expressed my concern that services were supposed to begin in one week but they explained that was procedure. After getting over my exasperation, the worker was sympathetic and stated she'd let me know tomorrow. She called me later today at about 4:00 pm to inform me that they received the list and my mother was on it.

Now I have to call VNS back tomorrow and hopefully get them to give the home care agency the thumbs up to put services in on the 1st of December. My concern is that VNS keeps on talking about the assigned nurse who will come in to do an assessment. This is fine as long as my mother is still getting home care. They seem to imply that the nurse would come in first and then assess again my mother's needs, which is disturbing since choosing VNS was contingent on the 12 hours they told me she would get. I'm staying hopeful that this will work out.

My advice is be persistent and call everyone: Medicaid, the managed long term care company and the home care agency that will be involved. I also found out last week that the home care workers who I had apply to the agency did not complete the process which is yet another area where something can go wrong. Managing the care of a loved one really is like a second job.

Finally....a light at the end of the tunnel!

A few weeks ago a VNS nurse came to make an assessment. After a short meeting and my explanation of the situation she entered the data into her laptop and came up with an assessment of 6 hours. I took her outside and explained the extent of my mother's memory issues and the sympathetic nurse consulted with her supervisor. She then informed me that my mother would be approved for 12 hours of daily home care! This was the first assessment that actually provided more care then we had been able to get with the long term care insurance. I signed the necessary papers.

I still wasn't sure how the John Hancock Long Term Care Insurance would interact with this VNS plan and the nurse was not sure either. She suggested I speak to someone at the office. What proceeded was numerous phone calls to VNS without any satisfactory answers until I reached the Director of Membership Development who stated that any services I wanted to add was our choice and had no influence on the 12 hours they were providing. She added a disclaimer that she thought this was the case but could be mistaken.

I followed up with staff at the home care agency and this information was confirmed and someone actually told me that this was commonly done....which makes me wonder why something so commonly done was not known by any of the 5 insurance agencies I spoke with prior to VNS, nor Medicaid staff!

I'm currently in the process of making the home care agency the payee so that my reimbursement from John Hancock is not counted as surplus income....but I'm hopeful.