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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.
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They have seen same Drs for 20+ yrs and see many specialists. They are coming to live with hubby and I. So much to coordinate. Diabetes, parkinson's, lupus, one is recently WC bound and incontinent. Any advice? No assisted living...not an option!
I’d suggest that you clearly understand what type of health insurance they currently have. & ASAP (like this month November) cause right now is the annual switching period of Medicare so moving them into a new one will be easier (as vendors are geared up for this).
Imo you need to do this BEFORE they ever, ever, ever see any physician or get any prescriptions filled in FL.
They have MediCARE but you MUST ascertain if it’s a Medicare Advantage system OR Original (traditional) MediCARE and if it’s Original what kind of gap or supplemental insurance they have to go with their Original. CMS (centers for Medicare & Medicaid) puts out an annual state by state bookLet on this. If you & hubs are 65+, you got one in the mail recently yourselves. If not, your library will have one or you callCMS to get one snail mailed to you. It’s your guidebook to see just what insurer will be the best one to have them sign up for services in your part of FL.
If they are on MediCARE Advantage, that is all in network based on where they lived in TX and with whatever health care system affiliated with Advantage Plan. Once they move, they are out of network & coverage either zero or 10-30% with them or whomever signed off as financially responsible will be billed. Advantage plans are very strict & narrow on coverage. It has to be within their network to make it work. Rarely does it cross multi state lines. If they are Advantage, you have to look at all Plans nearby you to see which “match up” best for the level of care & type of medications they both need.
If they are on a gap plan, I’d contact the current insurer to see if they have a underwriter in FL who does the same gap benefit plan to what they have in TX. If not, I’d suggest that you look to see if FL does a Medicare exchange info program for gap plans; they have navigators who can help your parents figure out selections that might be best for them and which insurers to contact to sign them up for coverage.
They are going to have to do something definitive with their Medicare, UNLESS they are on either VA or are RRRB or MediCARE & FEHIB combo. If they are Railroad or FEHIB, do a post as it’s sticky different, we had both in our families.
I’ve got to ask, have you actually spent like 4-6 weeks 1 on with them 24/7 in TX? Based on what you wrote, their care needs are huge. How old are they? Doing this for parents in 70 & 74 different story than folks 88 & 93.
On the “no AL”, I so doubt that would even be a option for them. Lupus, nonambulatory, Park, diabetes plus I’m sure other issues..... that’s not AL care. AL kinda fully expect them to do for themselves with assistance for a few things, like transitioning out of a shower, or pulling up a back zipper.
Your folks have serious health challenges. Being wheelchair bound in & of itself needs 24/7 oversight. That’s more skilled nursing care, aka a NH. I don’t know your age & your hubs age; or your folks age, and whether or not you & hubs work or have your own active lives but to have your parents move in with you from another state is going to be a full time 24/7 project from now till you find you realistically cannot meet the level of care they both need. It could be within months, unless folks hire & pay for in home healthcare 3-5 days a week. X2!!
Could you, really truly, on your own do a fire drill with them?
Please plan for the eventuality of LTC in a facility for them & find a CELA level of elder law atty to review their old TX legal, do new legal good for FL and review thier financials to see where they are for being able to b eventually eligible for FL Medicaid programs, like for LTC or PACE program. Their situation is complex as it’s couples planning & financials plus change in state of residency. Unless they have serious $ (500k) to do self pay x 2 for years or you & hubs paying all for them. I’m not being snide, but realistic.
Dependent on their supplemental or advantage insurance coverage I would seek out one solid and VERY GOOD Gerontologist. As you are going to be negotiating all of this in some way or another now or eventually it is crucial to get all POA paperwork and all wishes for future plans of what heroics are wanted and what are not, in order. Now it falls to the coordination and recommendations of that Gerontology specialist to decide what other specialists are needed. On another thread today we were discussing the Modern Medicine dilemma in a time when we live so long. I mentioned an acquaintance who is basically being treated as a "cash cow" to pay off any number of specialists in her last days. It can happen. A good gernontologist will be able to hand diabetes; other things are specialties. One the doc/docs are in place it is on them to collect, with your or your parents signature, the paperwork, easily transferred in our times. It will be very helpful if, before the move, your doctors will do letters of introduction re their care of your parents. Such things as medications, staging, and etc. Speak with them now re this planned move. You will have a lot on your plate. Wishing you good luck. You will learn a lot, too; so share it HERE!
Yes, yes, yes! and I’d try to get a gerontology group affiliated with a teaching hospital system / Health Science Center. Otherwise it’s going to be madness for their health charts.
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.
Imo you need to do this BEFORE they ever, ever, ever see any physician or get any prescriptions filled in FL.
They have MediCARE but you MUST ascertain if it’s a Medicare Advantage system OR Original (traditional) MediCARE and if it’s Original what kind of gap or supplemental insurance they have to go with their Original. CMS (centers for Medicare & Medicaid) puts out an annual state by state bookLet on this. If you & hubs are 65+, you got one in the mail recently yourselves. If not, your library will have one or you callCMS to get one snail mailed to you. It’s your guidebook to see just what insurer will be the best one to have them sign up for services in your part of FL.
If they are on MediCARE Advantage, that is all in network based on where they lived in TX and with whatever health care system affiliated with Advantage Plan. Once they move, they are out of network & coverage either zero or 10-30% with them or whomever signed off as financially responsible will be billed. Advantage plans are very strict & narrow on coverage. It has to be within their network to make it work. Rarely does it cross multi state lines. If they are Advantage, you have to look at all Plans nearby you to see which “match up” best for the level of care & type of medications they both need.
If they are on a gap plan, I’d contact the current insurer to see if they have a underwriter in FL who does the same gap benefit plan to what they have in TX. If not, I’d suggest that you look to see if FL does a Medicare exchange info program for gap plans; they have navigators who can help your parents figure out selections that might be best for them and which insurers to contact to sign them up for coverage.
They are going to have to do something definitive with their Medicare, UNLESS they are on either VA or are RRRB or MediCARE & FEHIB combo. If they are Railroad or FEHIB, do a post as it’s sticky different, we had both in our families.
I’ve got to ask, have you actually spent like 4-6 weeks 1 on with them 24/7 in TX? Based on what you wrote, their care needs are huge. How old are they? Doing this for parents in 70 & 74 different story than folks 88 & 93.
On the “no AL”, I so doubt that would even be a option for them. Lupus, nonambulatory, Park, diabetes plus I’m sure other issues..... that’s not AL care. AL kinda fully expect them to do for themselves with assistance for a few things, like transitioning out of a shower, or pulling up a back zipper.
Your folks have serious health challenges. Being wheelchair bound in & of itself needs 24/7 oversight. That’s more skilled nursing care, aka a NH. I don’t know your age & your hubs age; or your folks age, and whether or not you & hubs work or have your own active lives but to have your parents move in with you from another state is going to be a full time 24/7 project from now till you find you realistically cannot meet the level of care they both need. It could be within months, unless folks hire & pay for in home healthcare 3-5 days a week. X2!!
Could you, really truly, on your own do a fire drill with them?
Please plan for the eventuality of LTC in a facility for them & find a CELA level of elder law atty to review their old TX legal, do new legal good for FL and review thier financials to see where they are for being able to b eventually eligible for FL Medicaid programs, like for LTC or PACE program. Their situation is complex as it’s couples planning & financials plus change in state of residency. Unless they have serious $ (500k) to do self pay x 2 for years or you & hubs paying all for them. I’m not being snide, but realistic.
Now it falls to the coordination and recommendations of that Gerontology specialist to decide what other specialists are needed. On another thread today we were discussing the Modern Medicine dilemma in a time when we live so long. I mentioned an acquaintance who is basically being treated as a "cash cow" to pay off any number of specialists in her last days. It can happen. A good gernontologist will be able to hand diabetes; other things are specialties.
One the doc/docs are in place it is on them to collect, with your or your parents signature, the paperwork, easily transferred in our times.
It will be very helpful if, before the move, your doctors will do letters of introduction re their care of your parents. Such things as medications, staging, and etc. Speak with them now re this planned move.
You will have a lot on your plate. Wishing you good luck. You will learn a lot, too; so share it HERE!