Quality Home Health Care

Understanding The Four Parts of Medicare

In the United States, Medicare is a federally-funded social health insurance program for people over the age of 65 who have worked and paid into the system, persons under age 65 who have disabilities and people suffering from the final stage of chronic kidney disease and Amyotrophic lateral sclerosis. Elderly careTo be eligible for this insurance, you must be a US citizen or a permanent US resident lawfully residing in the US. Medicare is financed by a portion of the payroll taxes paid by employees and their employers as well as from monthly premiums deducted from social security checks. In essence, Medicare consists of four main parts: A, B, C and D. Here is a detailed look at each of those parts:

Medicare Part A: Hospital Coverage

Medicare Part A (hospital insurance) helps you pay for:

• Inpatient hospital care: This includes semi-private rooms, meals, and tests for up to 90 days in an inpatient facility, 60 lifetime reserve days in a general hospital, and a maximum of 190 days in a Medicare-certified psychiatric hospital.

• Skilled nursing facility (SNF) care: Medicare covers convalescence in a skilled nursing facility provided the following three conditions are met:

1. The patient must have completed a three-day inpatient hospital stay, including 3 midnights prior to seeking SNF care.

2. The nursing home must be for something diagnosed during the stay, the care availed in the facility must be skilled. Long-term care, non-skilled care, daily living and custodial activities are not covered. The expenses covered by part A include: meals, semi-private room, skilled nursing care, medications, medical supplies and equipment, and transportation for those needing skilled nursing services seven days a week, or physical, occupational or speech therapy services five days a week.

3. The maximum allowable stay period for a nursing facility is 100 days. During this period, Medicare pays for the first 20 days in full. However, for the remaining 80 days, the patient has to foot a portion of the bill (copayment).

• Hospice care: This is for the terminally ill patients or those patients with about six months to live. This package covers doctor services, nursing care, medical equipment, and medical supplies including pain relief and symptom control medications.

Home health services such as skilled nursing care and medical social services. Additionally, it also includes home use medical devices and related medical supplies.

Medicare Part B: Medical Insurance/Physician Coverage

Part B helps to pay for care from doctors and other health providers that are medically necessary to diagnose, treat or manage your health condition. It covers, but is not limited to, many of the following services:
• Doctors services, including an annual wellness exam.

• Ambulance services if your health condition requires transportation to and from your home to the health facility.

• Rehabilitative services such as outpatient physical therapy and occupational therapy.

• Many preventive care services such as flu and pneumonia shots.

• Laboratory services such as blood tests, urinalysis and other related services.

• X-ray, MRI, CT scan, EKG and some other related diagnostic tests.

• Select diagnostic tests such as colorectal and prostate cancer tests and mammograms.

• Durable medical equipment for use at home such as oxygen, wheelchairs and walkers. Your doctor must certify that you need these and they must be supplied by a Medicare approved vendor.

• Emergency room services .

• Skilled nursing care and health aide services for the homebound on a part-time or intermittent basis.

• Mental health care as an outpatient.

• Certain prescription drugs as well as some physician-administered drugs.

Medicare Part C: Medicare Advantage

Medicare Part C refers to Medicare-approved private health insurance plans for individuals eligible for or enrolled in Original Medicare (Part A and Part B). It is worth noting that, when you join the Medicare Advantage Plan, you would still need to continue paying your Part B premium. Medicare Advantage Plans provide all of your Medicare Part A and Medicare part B coverage. These plans offer additional benefits, such as optical, dental, and hearing care and many include prescription drug coverage. Medicare Advantage plans often charge a premium in addition to the Medicare Part B premium. They also generally charge a fixed amount called a copayment whenever you receive a service. You can join any Medicare Advantage plan if you meet the following conditions:

• You have Medicare Parts A and B
• You live in the plan’s service area
• You do not have End-Stage Renal Disease (ESRD).

Medicare Part D: Prescription Drug Coverage

Medicare Part D is essentially private insurance that pays for prescription drugs. This coverage is available to Medicare beneficiaries in one of two ways:

• A Medicare prescription drug plan: This is a stand-alone plan that can be added to your Original Medicare coverage.
• A Medicare Advantage Prescription Drug Plan: This plan offers the same benefits as Original Medicare and includes prescription drug benefits.

Medicare Part D plans generally prescription drugs for a medically acceptable condition. It is worth noting that drugs covered by Part D cannot be covered under Part A or Part B. Additionally, to enjoy Part D coverage, you would need to pay a monthly premium.

Conclusion

Medicare consists of four main parts: A, B, C and D. This article has discussed each of these parts in detail.

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Things to Ask When Choosing A Home Care Company

 

Choosing the company which will be introducing a caregiver or aide into your home, or your parents home is a big decision. Here in South Florida, there are a few hundred to choose from. Not all Home Care Companies are alike. Boca Home Care provides some tips from the great questions our callers and clients ask.

 

In- home complimentary assessment

In- home complimentary assessment

Like any other professional or worker you have into your home, you likely will get their name and number from someone you know. For home care – medical or private duty, a referral from a friend or doctor is a very good starting point.

Using the Internet will bring up pages and pages of companies, see if any match the ones referred to you. Make sure they are LICENSED. Read some TESTIMONIALS. See how long they have been in business – especially in South Florida where companies tend to open and close.

Once you have called a few companies and find that you have a rapport with someone on the phone, ask more questions. Also listen to what they are asking you. They ought to want to know something about you or your aging loved one’s present health condition, any falls, primary physician and what prompted the call NOW.

Important questions to ask when shopping for a Home Care Company.

* Are you licensed, since when?

*Is your company bonded?

* What if I don’t like the aide?

* How are the caregivers screened and credentialed?

*Is there a contract to sign?

*Can I meet and interview caregivers? — usually for longer shifts or live ins.

*Do your caregivers carry insurance?

*What are your hours of operation?

*How do you track the aide’s hours of care?

*What happens if the aide cannot make it or needs time off?

*What does the services include? Exclude?

*Is there a minimum of hours per shift or per week?

*How does the management team supervise a client case?

*Do you offer an in-home assessment?

*What is the process to begin care and how long will it take?

 

                                                 

 

All licensed home care companies in the State of Florida must do FBI level II fingerprinting background checks. All aides must be certified as HHAs – Home Health Aides or CNAs. Certified Nurse Assistants. All companies licensed have similar rules and protocols to follow.

If you phone a home care company and they aren’t forthcoming with information or seem unsure, call another. This service is transparent. The good companies know and follow the rules. The better companies go beyond the rules of their license.

 

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Make Your Home Care Experience a Success

 

We at Boca Home Care Services understand what a big step it is to have a caregiver come into the home. They are only “strangers” at first. Once rapport is established a warm interaction and helpful routine can follow. Find some tips to help make your Home Care experience a successful one.

 

Cooking with your Caregiver

Either due to an accident, fall, hospitalization or a chronic, progressive disease, you need an aide to assist you. The idea of a “stranger” coming into your home, into your kitchen and helping with your personal care is hard to imagine. But, you have made the decision to start and now you have a caregiver coming over.

We have found that the best way to set up this new relationship to be a successful and even pleasant one is to have a routine. Use the caregiver’s time with you wisely. It is important to have things each visit for the aide to do. Otherwise, you’ll both be wondering how to pass the time. The aide will go on the phone and you may start having feelings of resentment, and want to call the whole thing off.

Truth is, if you need help, then you need help! We try to increase the chances of success by giving you some tips on how to properly make use of having a caregiver. Firstly, know what the duties of a hired caregiver are – and what they are NOT. A good aide will assist you, as needed with showering, dressing, walking and other “Activities of Daily Living”. They will also keep the bathroom, kitchen and bedroom neat – BUT they are not domestics. It is unrealistic to expect them to do household cleaning beyond ther rooms mentioned. They will also do the shopping, laundry, cooking, and driving. Other tasks include, medication prompts, serve as a companion and can help you with walking and exercises – all while keeping you safe from any falls.

Other tips for Home Care success are:

* Make a list of your important contacts – Family, Physician and a nearby Friend.

* Another list of you prescribed medications – name, dosage, time to take it and whether before or after eating.

* Let the caregive know what your routine is. Do you prefer to shower, then breakfast or the other way around?

* If you don’t know how to get to a doctor’s office or other locale, have someone get clear directions for the caregiver.

* If you are the primary caregiver, after the second day, disappear and go take care or yourself – you are Off Dutty for a few hours.

* Let the aide know what you like to do – favorite TV programs, a senior center, cards, puzzles, computer…

* Go with the aide the first time to the market, or have someone who knows your preferences go so that he or she can learn what products and brands you prefer.

* Let the caregiver know what types of foods you like, how you want them prepared and at what time do you wish to eat.

* Tell the aide of your allergies to  foods or medication. Your pet peeves and what you enjoy.

Remember, when you hire a caregiver from a licensed company, they will be screened, trained and experienced, just not with you in your home. It takes a couple of visits to “click” and once you do – it is magic. If you don’t, let the company know immediately so that a change can be made. Everyone is dofferent so sometimes it takes more than one try.

 

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Introducing Home Care in Dade County – South Florida

Miami Jewish Home Care, LLC

Miami Jewish Home Care, LLC

 

From the team that brings exceptional  Home Care to Broward and Palm Beach counties, the Bensmihens are now serving Dade County.

Joseph and Lisa have over forty years of combined Elder Care and Home Care experience in South Florida. As owners and operators of Boca Home Care Services & Boca Home Care,

Both are pleased to announce the opening of:

Miami Jewish Home Care located at 975 41st Street on

beautiful Miami  Beach. They are committed to bringing exceptional Home Care to Dade County’s aging seniors.

As a Geriatric Care Manager and court appointed Guardian, “JB” approaches Home Care as a Social Worker providing the full gamut of Elder Care services to our clients and their families. Our primary focus is keeping seniors safe and independent in their homes while recuperating from surgery (Hip) or managing a progressive disease (Alzheimer’s Dementia).

Miami Jewish Home Care offers hourly or live-in care, short or long term. Screened, certified and experienced caregivers assist with personal (ADL) care, routine household chores, medication prompts, transportation, companion and respite care. As JB says “The magic comes from making the right Shidduch/match between caregiver and client.

Call today to speak with a Care Manager and create a personal care plan:  877-706-0785.

All LTC insurance accepted.

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Give the Gift of Home Care For Holidays

The Holidays are here, with the joy and stress of the season. It is an opportunity to begin home care for a loved one who may need some personal care assistance.

Home Care is a big decision. It means bringing an essential stranger into your home and help you with personal care and routine daily chores.

Many Seniors who do need a lit in home help are resistant to it. The Holidays may be an ideal time to surprise your loved one with the gift of home care – a few hours a week to get started.

If you believe your aging mother, father or other loved one is unsafe living alone, overwhelmed by being a primary caregiver or at risk for falling as they are unable to do the shopping, cooking, driving etc. then home care may be the answer. The trick is to get started. Boca Home Care Services can answer your questions and a Geriatric Care Manager will go to the home to answer questions and do an assessment to put together a sensible care plan.

 

Happy Holidays!

 

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