Posts Tagged ‘Difference between Medicare and Medicaid’

Free Caregiver Resource eBook: 8/26/12 Only!

Very important for those who are caregivers or know they will be one day soon.

 On 8/26/12 from 12 AM to 11:59 PM, my “Taking Care of Mom and Dad” eBook will be free on!

You don’t need a Kindle to get it – a PC, Android, or any number of eReaders will do just fine. Amazon has a free download for you to use. Download the reader and then download the eBook!

This book is regularly $6.99. If you have a need or know any followers that need help with caregiving, please share/tweet/google+ or do whatever you need to. I am happy to give this away for one day.

In order to get the eBook, click on the icon to the right or right here: 


How Can I get Paid to Take Care of Mom and Dad?

I get this question at least three times per week, sometimes more. A son or daughter will call and say they need to give up their own current position in order to take care of their parent 24 hours per day. The caller goes on to say they heard that their neighbor’s cousin’s friend was doing it and they wanted to as well. While it CAN be done, there are rules. Also, being paid to take care of your loved one is not going to be the financial panacea that you might think it will be. CMS (Centers for Medicare and Medicaid) does not like for family members to care for family members exclusively for several reasons. Let’s talk about those first:

Reasons CMS Will Not Reimburse:

1. Chances are greater for caregiver exploitation, abuse, and neglect of Consumer (your loved one)
2. Caregiver Burnout increases exponentially.
3. Chances of CMS reimbursement fraud is higher.

Reasons Some States will Allow in Certain Situations:

1. Consumer lives in an extremely rural area. Mileage is not reimbursable under CMS rules so if your family member lives several miles out of town, that’s a really high mileage roundtrip that the Home Health Aid must eat every day. No one will want to do that so family placement as caregiver may be approved.
2. Consumer requires very specialized care that only family member can perform.
3. Occasionally, if the consumer is blind and fearful of strangers, it is possible.
4. Consumer lives in region of the state that is impossible to staff. For instance: In Western Oklahoma there is now an oil boom. Oil pays very well when things are going well. Wal-Mart is having to bus in employees from 60 miles away just to have staff. Home and Community Based Services (HCBS) suffers greatly during this time. This is an instance where a family member MAY be allowed to be a paid caregiver.

Reasons Consumer will not be Considered for Family as Paid Caregiver:

1. Because they are uncomfortable with strangers.
2. Family member has been convicted of felony, but “that’s okay with them”.
3. Because that’s who they would prefer take care of them.
4. Because they paid their taxes and want it this way.
5. Because they are afraid the family member will leave the home and nursing home placement might occur.
6. Because the family member feels it is too hard to hold down an outside job and care for the family member as well.
7. Because the doctor said the family member was best.

Misunderstood Concepts of the Program:

1. Family members often think they will be paid for a full day’s work.
2. Family members often have no idea how low the pay is.
3. Family members think the $$ will be enough to sustain the family financially.
4. Family members think they will only have to take care of their loved one and that’s it.
5. Family members think they can work through the local Social Service Agency instead of their local Provider Agency.

So, you see it is NOT the easiest thing in the world to become a paid caregiver if you are the family member and if you are financially responsible for the consumer, you will not be considered at all. An instance of this would be a wife wishing to be paid in order to care for a husband. Also, even if you are eligible to care for the loved one, you will only be paid for the time the case manager or nurse says is required to keep the loved one out of a nursing home. That may be less than an hour per day.
I hope this has cleared up any questions you may have about a family member as a paid caregiver. If you have any questions, please post them here and I will answer!

Don’t forget to check out my new Kindle eBook on Taking Care of Mom and Dad: A Baby Boomer’s Resource Guide.

New eBook for Caregivers

I am very excited to announce that my newest eBook has been released on Amazon in the Kindle Bookstore. The title is: Taking Care of Mom and Dad: A Baby Boomer’s Resource Guide. I cannot tell you how happy I am to finally have this completed. I worked for a very long time to put together all the information. I used all 20 years working with Seniors in putting together a comprehensive handbook for caregivers thrust into service, not knowing the first thing to do or first place to look for help. This is particularly helpful if you are caregiving from afar.

This is not a book that tells you how to deal with emotional issues, it is a book that is practical and comprehensive explaining different federal programs and how they work with a state. I show you the correct agency to contact through phone, address, or email who can give you state-specific information. While most of this CAN be found, you must be well-versed in Aging Service vernacular and acronyms which often change from state to state and program to program. It also clearly explains requirements in most elder-driven social programs as well as components that each state is required to offer.

If you have the correct reader, all sites (including the table of contents ) are clickable – they have been checked and re-checked to assure no dead links. You do not have to have a Kindle in order to read the eBook – I do not have one – you can download the Amazon reader for personal computers, blackberry, android, iPads, iPhone, MAC, and Windows phone 7.

Maybe you do not need this information, but if you know someone who does, please pass it along to them. The information presented in the eBook may be used by anyone in any of the states or territories within the U.S.

Will my Medicaid Transfer When I Move?

I often get calls from a family member inquiring about how to transfer their loved one’s Medicaid (or MediCal) from one state to another.  The federal government, in their infinite wisdom, decided to name the federal and the state health care programs nearly identical; Medicare and Medicaid respectively.  So the first order of business is to determine exactly which program the family member is talking about.

Medicare cards are all red, white, and blue.  They are connected to Social Security and a premium must be paid each month in order to maintain the benefit.  Medicare is a nationwide program funded solely through federal taxes.  Medicaid is a state and federal partnership that often, in the case of seniors, is used in conjunction with Medicare.  Medicaid cards are as many different color combos as there are states and territories.  Each state, in order to receive federal matching funds, must agree to offer certain specific core services but then there is a menu of other items the state may offer. There is no rhyme or reason as to what each state my offer.

Another difference in Medicaid state-to-state is that the income level may be different as well as resource requirements.  They also may differ in where you may apply with some being only at the local social services office while others have kiosks set up in various public areas for your convenience.  Yet another difference is that some states offer something called a Spend Down while others do not.  A Spend Down is the amount between the client’s income and the maximum amount allowable to receive the benefit.

When you or your senior loved one may be moving here are some points to remember:

  1. You may not transfer Medicaid from one state to another.
  2. You must actually have made the move and declare the new state your home prior to applying for Medicaid in your new state.
  3. Don’t forget to close your Medicaid case in the state you moved from AFTER you have made the move.
  4. Income and Resource limits may be higher or lower in the state you move to.
  5. Some states offer a Spend Down while others do not.
  6. Do not expect the same program in your new state and if it is or if it is better, you will have a pleasant surprise.
  7. Look for my new eBook soon to be available exclusively through Amazon.  It goes into detail about adult Medicaid issues.  The title is “Taking Care of Mom and Dad”, the same as the site here is called.
  8. If you have any questions, please comment on this post and ask away!

Difference Between Medicaid and Medicare

Ever wish you had a quick way to tell the difference between Medicaid and Medicare?

Maybe the following will help.

*Medicare is a federally funded entitlement program for those 65 years-old and certain other disabled people.
* Medicare does not require your income to meet certain low-income standards.

^Medicaid is a federally funded social program that is also an entitlement.
^ Medicaid is funded by both state and federal tax dollars; there are certain income, age and status requirements that must be met in order to be eligible.

*Medicare covers the same services throughout the United States depending on your coverage (A,B, &/or D).

^Medicaid’s benefit package is determined by each state, choosing from the broad array of services designated by the federal government’s Centers for Medicare & Medicaid Services (CMS). This means that what you receive in one state will not necessarily be covered in another state. The following services are mandatory in every state:
• Outpatient hospital services;
• Inpatient hospital services;
• Physician services and medical and surgical
services of a dentist;
• Nursing facility services and home health services
for those aged 21 or older;
• Family planning services and supplies;
• Rural health clinic and federally qualified health;
center (FQHC) services;
• Laboratory and x-ray services;
• Nurse practitioner services;
• Nurse-midwife services; and
• Early and periodic screening for children under age 21.

Hope this helps you when trying to understand the difference between the two. It can help you when you are trying to navigate the health care system with your mom and dad.

If you have any questions, please leave them in the comments section, under this article and I will be happy to answer!

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