Are you sure you want to exit? Your progress will be lost.
Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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I acknowledge and authorize
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I consent to the collection of my consumer health data.*
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I consent to the sharing of my consumer health data with qualified home care agencies.*
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Your gonna need to look into MADP & by 2/14/20! Medicare Advantage Disenrollment Period (1/1 - 2/14/2020) Why? well.... Please realize that IF you are on an “advantage plan”, you have basically made the decision to exit original / traditional MediCARE & moved your health insurance coverage to a much more narrow system that is designed to have you use & actually go to providers, facilities etc. that are “in network” for the specific Advantage Plan you signed up for. MC won’t likely be in network, ever.
To get the most out of an Advantage Plan -imo - you have got to use MDs, clinics, labs, hospitals etc. that are “in network”. All have signed off negotiated rates with Plan. That is part of the way that Advantage Plan are able to appear cheaper. Often much much cheaper than a Original Medicare & a “gap / supplemental” would be.
To get low or no-cost, you have to HAVE TO stay “in network” Out of network may cost you anywhere from 20%-80% of whatever rack rate the provider or facility bills you & the out of network terms of the agreement on the Advantage Plan you picked.
And for institutional care - NH or MC - that’s almost always going to be out of network. If your elder is in NH, their not likely to be able to do an appointment with old ophthalmologist and get themselves over to that doctors office at the medical center downtown. Once in MC or NH, they are now under the care of the MD who is medical director of NH and get all their care done at NH (or MC) unless seriously ill and then they get hospitalized. Unless there’s something extraordinary, once in MC or NH, it’s going to be all routine care... like flu shots, taking temps, BP/pulse reading, medication management AND all orders for care and drugs come from the MD / medical director of the MC or NH.
So what to do??..... I’d suggest you ask the MC to have a care plan meeting ASAP. You need to find out what gap insurance the MC and the medical director participate in (if any). Then do the MADP paperwork to get back into original MediCARE then get a gap policy Lr do LTC Medicaid application.
THIS iS IMPORTANT- between 1/1 and 2/14 is MADP, MediCARE Advantage Disenrollment Period. You can get out of that Advantage Plan & back into original MediCARE with no problems. But you gotta do this ASAP. And the MC can tell you at the care plan meeting what gap or supplemental plan works best or if your elder needs to go to a MCO (managed care organization) & which one or perhaps go onto Medicaid.
Advantage plans really tout about being zero or low cost premiums or have some sort of “silver sneakers” gym membership or other “free” stuff. But imho they really only work if you are healthy (so you can actually get to whatever clinic, lab, PT they own), don’t really travel (so always able to go into their hospital) and have 2 -3 big hospital / clinic systems with speciality care units that compete against each other to get Medicare age enrollees and your not needing long term care.
A current trend by states for Medicaid for “duals” (both on Medicare AND Medicaid) is to be in a MCO. Both for individual and facility. Facility gets a set amount of $ per enrollee. As it’s Medicaid, each state is going to do this uniquely (like TX has STAR Plus). 2 big players in this - Molina & HealthSpring. MCO system basically uses the playbook that CHIP (kids Medicaid) has done for decades & with pretty good cost containment & level of care done.
Remember switch out of Advantage must be done ASAP!
If the person can't afford care in an AL or MC then Medicaid can be applied for. Generally, Medicaid only pays for LTC in a nursing home. You will have to check your State to see if they have waivers for ALs or MC.
They will not pay for facilities. Unless it is rehabilitation after a 3 night hospital admission.
It is health insurance not long term care insurance. I know it gets confusing when it is medically necessary for placement, but room and board is never covered by regular insurance. All of the medical treatment required will still be covered.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Medicare Advantage Disenrollment Period (1/1 - 2/14/2020)
Why? well.... Please realize that IF you are on an “advantage plan”, you have basically made the decision to exit original / traditional MediCARE & moved your health insurance coverage to a much more narrow system that is designed to have you use & actually go to providers, facilities etc. that are “in network” for the specific Advantage Plan you signed up for. MC won’t likely be in network, ever.
To get the most out of an Advantage Plan -imo - you have got to use MDs, clinics, labs, hospitals etc. that are “in network”. All have signed off negotiated rates with Plan. That is part of the way that Advantage Plan are able to appear cheaper. Often much much cheaper than a Original Medicare & a “gap / supplemental” would be.
To get low or no-cost, you have to HAVE TO stay “in network”
Out of network may cost you anywhere from 20%-80% of whatever rack rate the provider or facility bills you & the out of network terms of the agreement on the Advantage Plan you picked.
And for institutional care - NH or MC - that’s almost always going to be out of network. If your elder is in NH, their not likely to be able to do an appointment with old ophthalmologist and get themselves over to that doctors office at the medical center downtown. Once in MC or NH, they are now under the care of the MD who is medical director of NH and get all their care done at NH (or MC) unless seriously ill and then they get hospitalized. Unless there’s something extraordinary, once in MC or NH, it’s going to be all routine care... like flu shots, taking temps, BP/pulse reading, medication management AND all orders for care and drugs come from the MD / medical director of the MC or NH.
So what to do??..... I’d suggest you ask the MC to have a care plan meeting ASAP. You need to find out what gap insurance the MC and the medical director participate in (if any). Then do the MADP paperwork to get back into original MediCARE then get a gap policy Lr do LTC Medicaid application.
THIS iS IMPORTANT- between 1/1 and 2/14 is MADP, MediCARE Advantage Disenrollment Period. You can get out of that Advantage Plan & back into original MediCARE with no problems. But you gotta do this ASAP. And the MC can tell you at the care plan meeting what gap or supplemental plan works best or if your elder needs to go to a MCO (managed care organization) & which one or perhaps go onto Medicaid.
Advantage plans really tout about being zero or low cost premiums or have some sort of “silver sneakers” gym membership or other “free” stuff. But imho they really only work if you are healthy (so you can actually get to whatever clinic, lab, PT they own), don’t really travel (so always able to go into their hospital) and have 2 -3 big hospital / clinic systems with speciality care units that compete against each other to get Medicare age enrollees and your not needing long term care.
A current trend by states for Medicaid for “duals” (both on Medicare AND Medicaid) is to be in a MCO. Both for individual and facility. Facility gets a set amount of $ per enrollee. As it’s Medicaid, each state is going to do this uniquely (like TX has STAR Plus). 2 big players in this - Molina & HealthSpring. MCO system basically uses the playbook that CHIP (kids Medicaid) has done for decades & with pretty good cost containment & level of care done.
Remember switch out of Advantage must be done ASAP!
It is health insurance not long term care insurance. I know it gets confusing when it is medically necessary for placement, but room and board is never covered by regular insurance. All of the medical treatment required will still be covered.