Where are the home health aides?
My in laws with dementia, have a Medicare advantage plan that with a doctors order they will qualify for up to 35 hours of in home care with a home health aide, the doctor sent the order to several agencies on a very long list provided by United Health Care/ Medicaid, but we had no response, come to find out the agencies in our area do not accept Medicare for that service, not in 100 miles of my location! So now what do I do? Does anyone have any suggestions? Where do I locate Home Health Aides that can be paid by Medicare not Medicaid, near SW Missouri?
If I sound Stressed, it's because I am, on the phone for all day calling every agency on their List... they do qualify for PT and OT hours a day a couple days a week... But I need to return to work PT and a paid aide 35 hours a week would be a life saver.
Sorry but dealing with Medicare is ridiculous...
That said, I've never heard of Medicare paying for in home health aides for 35 hours a week. Medicaid yes. So perhaps the doctor is confusing Medicare services with Medicaid services, writing an order for something Medicare does not cover.
Good luck to you
If Medicare were the answer I would suggest you change insurance.
You do need to find an insurance that has providers in your area. You have found at least one doctor and some pt.
Any insurance you see advertising, on tv or in the mail, is a private company, not original Medicare. They use original Medicare as an example of what they claim to offer. And in some areas an advantage plan actually will offer similar services. The trick is what areas and which plan, what level providers, hospital, home health, etc and if those providers will stay with them. They all claim to offer everything Medicare part A&B offers. Plus they will also say they have Vision or dental or a ride to the moon etc. They may list it but often don’t have providers who will actually provide it. You need to understand the providers are private business as well and can’t be forced to take the advantage care business. I’m sure they would if they got paid enough. But you and I can’t sort that out. We just need to understand what we are signing on for when we accept the seemingly “free” services an advantage plan leads with. Sorry for the rant but it is so disheartening when trying to deal with insurance. Especially when a person actually needs coverage.
Let me rush to tell you that original Medicare doesn’t provide 35 hours of care either. But they do offer a weekly nurse who will tend wounds, set up meds, do blood work, bring in an aide to help with baths and the PT and OT You would find them helpful. I did. But they don’t provide hours of care such as you are looking for so you can return to work.
Community Medicaid offers up to several hours a week but it isn’t dependable or enough hours from what I’ve heard. Your folks need 24/7 care and the only place you are going to get it from a provider is in a NH or private pay.
Get them on Medicaid and into a NH. Find your Area Agency on Aging for help making sure they qualify. There is one for every county. Being in a NH is not without a need for over site. Anyone with a loved one in facility care will tell you that. But, at least you can return to work and you will know they have someone with them 24/7 who is providing the basics.
Go to….
Health.Mo.Gov
and explore the options for seniors.
OK, this is a question now for United Health Care Advantage plan.
You have the insurance and are paying for the insurance and this is covered. They are apparently not covering well enough for agencies to cover them, and the problem here is often that agencies pump up the cost so much because honestly you are paying the agency AND THE AID.l
You are going to need to get the skivvy from your insurance plan.
We would, I betcha, have the same problem anywhere. This happens when the insurance covers things, but not well enough to make an agency, a nurse, and yes--sadly--even a doctor interested in the patient. So to say they won't treat a patient with low paying insurance.
Often, in illness, when a person is seeking care, but is on SSDI or on Medicaid the doctors just say they aren't accepting new patients or they don't take such patients.
Call your insurance. Tell them your experience. Ask them where to go next.
So sorry you're going through this and can imagine you're quite desperate.
UHC is a Medicare advantage plan. You describe a list provided by “UHC/Medicaid”. But Medicaid has nothing to do with the current situation, so a list that includes Medicaid-accepting facilities would indeed not be helpful. (unless your father also qualifies for Medicaid – but then I think you wouldn’t have this problem.).
UHC is, presumably, contracted with some home health services (and also presumably, not all – that’s how advantage plans commonly work). They should know who they are contracted with. Can you go back to them and ask for a list of home health agencies they are contracted with? That should narrow it to places that your insurance will pay for.
Sorry if you’ve already done this, but I can’t understand why a list provided by UHC would include places they would not pay for.
https://www.medicare.gov/care-compare/?redirect=true&providerType=HomeHealth
Maybe contacting your county's department for the aging, or social services.
or
Maybe the below, perhaps they can help or suggest.
https://www.alz.org/greatermissouri/about_us
Most agencies are expensive and require a 4-hour per visit minimum. Their rates are also going up because home health aides know their worth and many have gone private or moved agencies for better pay. That means that those who remain available for rock-bottom prices through agencies on that list you were given are few and far between. There's also a waiting list.
Geaton's suggestion of going on Nextdoor is your best bet if you want to get someone in fast. Also check your local newspaper for situation wanted ads.
See All Answers