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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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I’m spending a small fortune on his medical bills and medication. I have a cousin who said everything should be free at this age. I’m very new to this. Ty
It would be really hard to explain what is involved with Medical insurance here. What you first need to do is determine what type of coverage your Dad has.
Traditional Medicare with a supplemental and a separate prescription plan. (Does he have dental and vision?)
Medicare advantage which covers parts A&B and prescriptions but is contracted out by Medicare. (May cover dental and vision)
You need to understand what staying in network means. Copays and deductables. Maybe Dad needs more coverage than he now has. Maybe he could qualify for Medicaid as his supplement.
Dad should be getting yearly benefit books from UH explaining what they cover. Once you can get all his cards together and that booklet (don't worry if u can't find it), call your Office of Aging and make an appt to sit down with someone who can look at what Dad has now and maybe find him better Insurance coverage.
Be aware though, when you have employers insurance, if you drop it you usually cannot pick it up again. With my DHs employer, we have 3 policies we can choose from. Medicare Advantage (PPO*), Traditional BC/BS (PPO*) and an HMO (must use their doctors)
*PPOs are where networks are involved. You stay within their network providers you save money, use a provider not in their network, you pay more out of pocket.
This all can be very complex. Talk to Office of Aging before you talk with anyone else. Those insurance brokers (I guess thats what they r called) work on commission so do not have the clients best interest.
Thanks for this thumbnail explanation; this insurance is so complicated, more than it needs to be, imho. And beware those 'brokers' as you said, they paint a pretty picture, perky people often, so you get sucked in; it happened to me, briefly, but luckily I was able to get back on regular Medicare right way due to my age. Whew! Part of my confusion is never having had health insurance from a job most of my life, so the terminology and processes were 'Greek' to me. And becoming Disabled before regular retirement age meant tapping my SS earlier than one would like, a lower amount from the getgo. This forum is a great place to become better educated by folks 'in the trenches'...thanks again!
Is dad on Medicare? Medicaid? Why are YOU spending a fortune on HIS medications and Medical expenses? Hate to break it to you but most things in life are not "free". Someone somewhere along the line pays for things. Is dad a Veteran? If so the VA can cover most of his Medical Expenses and Medications. And if he is a Veteran they may pay for a lot more, and he may qualify for a few benefits or a LOT. Check with your local Veterans Assistance Commission. Or contact the VA in your area.
If dad has straight Medicare and no supplemental insurance, he pays for Parts B and D and there are copays. And there is a deductible to be satisfied each year.
If he has a supplement, he pays for that, but there may still be co-insurance charges.
If he has a Medicare Advantage plan, he may pay less for coverage, but the coverage may need to be only with in-network providers and institutions.
You should not be spending YOUR money on dad's medical care. That should come out of dad's funds.
First, YOU should not be paying anything for his medical needs. If his income is low enough, he should be on Medicaid and Medicare, and his medication and co pays would be covered. My father earned about $1850 a month from Social Security which was low enough for him to qualify for Medicaid and reduced costs for medications. His copayments were very low. You need to bring him to social services and see what he qualifies for based on his income.
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.
Without it his costs will be SUBSTANTIAL in age.
Traditional Medicare with a supplemental and a separate prescription plan. (Does he have dental and vision?)
Medicare advantage which covers parts A&B and prescriptions but is contracted out by Medicare. (May cover dental and vision)
You need to understand what staying in network means. Copays and deductables. Maybe Dad needs more coverage than he now has. Maybe he could qualify for Medicaid as his supplement.
Dad should be getting yearly benefit books from UH explaining what they cover. Once you can get all his cards together and that booklet (don't worry if u can't find it), call your Office of Aging and make an appt to sit down with someone who can look at what Dad has now and maybe find him better Insurance coverage.
Be aware though, when you have employers insurance, if you drop it you usually cannot pick it up again. With my DHs employer, we have 3 policies we can choose from. Medicare Advantage (PPO*), Traditional BC/BS (PPO*) and an HMO (must use their doctors)
*PPOs are where networks are involved. You stay within their network providers you save money, use a provider not in their network, you pay more out of pocket.
This all can be very complex. Talk to Office of Aging before you talk with anyone else. Those insurance brokers (I guess thats what they r called) work on commission so do not have the clients best interest.
Why are YOU spending a fortune on HIS medications and Medical expenses?
Hate to break it to you but most things in life are not "free". Someone somewhere along the line pays for things.
Is dad a Veteran? If so the VA can cover most of his Medical Expenses and Medications.
And if he is a Veteran they may pay for a lot more, and he may qualify for a few benefits or a LOT.
Check with your local Veterans Assistance Commission.
Or contact the VA in your area.
If dad has straight Medicare and no supplemental insurance, he pays for Parts B and D and there are copays. And there is a deductible to be satisfied each year.
If he has a supplement, he pays for that, but there may still be co-insurance charges.
If he has a Medicare Advantage plan, he may pay less for coverage, but the coverage may need to be only with in-network providers and institutions.
You should not be spending YOUR money on dad's medical care. That should come out of dad's funds.
"Does your cousin know what s/he's talking about?"
Many younger/inexperienced/not from the US folks think that Medical care for the elderly is free in the U.S. It's not
So, if your cousin has no experience having Medicare himself or dealing with an Elder who does, s/he may simply be making an assumption.