According to an e-mail I got from Cathy McRae at the MQC3, the Michigan Quality Community Care Council has been ended. The state has moved the function of this Registry to an organization called MPHI. MPHI has taken over the MQC3’s phone number, which is 800-979-4662. If you should need assistance with finding a Home Help provider, please contact MPHI at that number.
Tag Archives | Medicaid
QMB/SLMB/ALMB
According to information from my October MMAP presentation, here are the income limits for the Medicare Savings programs. The amounts are for 2012, but still can be used as a general reference.
QMB (Qualified Medicare Beneficiary): monthly income limit is $930, assets of $2000 for single, $1260 income, $3000 assets for married. QMB pays for Medicare B premium, A&B co-pays and deductibles
SLMB (Specified Limited Medicare Beneficiary: single monthly income $931 to $1117; assets $6940. Married income $1261-1513, assets $10,410. SLMB pays for Medicare B premium
ALMB (Additional Low Income Medicare Beneficiary): single monthly income $1118-$1256, assets $6940. Married income $1514-1702, assets $10,410. ALMB pays for Mecidare Part B premium
Program of All-Inclusive Care for the Elderly
Attached you will find the link to the National PACE website. There you can look at all of the services provided by PACE plus all of the national PACE sites. PACE already exists in the Detroit area (Center for Senior Independence (CSI), 7800 W. Outer Drive, Detroit, MI 48235) with areas extending out to zip codes in Highland Park, Grosse Pointes, Hamtramck, Lincoln Park, Redford, and Dearborn Heights. In January 2013, the Detroit PACE site will be opening a second center on the eastside at the Rivertown Neighborhood (see SCoop post on Rivertown Neighborhood). UMRC is looking to open a new PACE site which their catchement area will bump up to the current catchement area of CSI in Wayne County and cover the whole downriver community, including Belleville. This is expected to occur within the next year or so. In addition, there is a PACE site currently open in Battle Creek, MI, with their second site set to open in Kalamazoo in early 2013. This is a wonderful opportunity for those seniors committed to aging in place!
The website is: www.npaonline.org
Covenant Dental Week 2012
Free Dental Services for Medicaid recipients provided by Covenant Dental at AIHFS October 1-5, 2012. See attached flier.
Nursing Home Payment
The question was asked, when will a nursing home start “taking” a person’s social security check when they are receiving services at the nursing home … and is there anything that can be done to stop this?
Ann Kraemer states, “I want to reinforce that nursing homes don’t “start taking” resident’s social security. As Brenda notes [below], Medicare & other insurance programs pay for some of the person’s stay in a nursing home. If the resident’s Medicare days run out, (ref Brenda’s reference to the 21-100 days Medicare & related insurance limitations) then the resident has to pay for his/her stay in the nursing home. Residents typically “turn over” their social security checks to the nursing home for a portion of their payment. Keep in mind that nursing homes charge on the average $6-7,000/month so most nursing home residents are looking for ways to pay that tab when their health insurance won’t pay.”
Brenda Carney adds, “For traditional Medicare, Medicare pays 100% of the first 20 days, and then a daily co-payment thereafter for days 21 – 100, as long as they meet the criteria for Medicare Skilled Care. If they have a secondary insurance (besides Medicaid), they may pick-up some to all of the daily co-payment. If their secondary insurance is Medicaid, then at day 21 they start charging the daily co-payment until all but $60 of their social security check is depleted then Medicaid kicks in. If they DO NOT have Medicaid, then the co-payment starts at day 21 and continues until discharge from Medicare. Therefore, it is HIGHLY recommended that they apply for Medicaid should they not have any savings (over $2000) as it could cost them A LOT. Nursing Home Medicaid is different than community Medicaid, so it is worthwhile applying for …
Having said ALL of this, there is a Special Director or Olmstead exception that they can apply for which will possibly waive part to all off the monthly payment to the nursing home out of the Social Security check. Below is a link that explains this application process. The nursing home social worker should be able to assist with this process. They have to provide supports for all NECESSARY bills that they need to maintain their apartment while they are in the nursing home. It does not include Cable TV, etc. I have applied for this on behalf of a resident successfully and partially successfully. Do not anticipate that the entire social security check will be preserved.
http://www.mplp.org/Issues/mplpissue.2010-05-05.9554801510
As for food stamps and SSI, while you are in a nursing home, these items are items that can be cut. However, it does not consistently happen, depending on how long the individual is in the nursing home and the speediness at which the billing office at the nursing home submits and the State changes the resident’s status as Nursing Home in the State computer. There is no work around that I know of … and cannot be applied for until after they are discharged from the nursing home. There is a code in the State Medicaid system that needs to have them reflected as being community living for them to be eligible for Food Stamps and SSI. Conversely, it can take a while when the person is OUT of the nursing home to resume these services as it depends on the speed of the billing office at the nursing home to submit and DHS to change the State database.”
Medicaid Long Term Services and Supports 101: A Webinar for advocates on emerging challenges and opportunities
In response to SC interest in finding ways to advocate for better Medicaid coverage.
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Solving the transportation puzzle
Finding non-emergency medical transportation for clients is like trying to solve a Rubik’s cube. Certain elements need to come together just right – or your client may be out of luck. Providing the right resources can be especially tough if you don’t know how to navigate the system. Elements to consider while researching options include: The exact location of the destination, date, time, and duration of the appointment, and whether the client will be under anesthesia during the visit. All of these factors will determine the resource given to a client. Other questions to consider may not be as obvious. In a recent e-mail correspondence, Sara Mary Wallace, mobility specialist at Area Agency on Aging 1-B provided the following tips:
I know how frustrating finding transportation can be. The goal of the program I work for, myride2, is to be a one-call, one-click mobility management service dedicated to helping seniors and adults with disabilities remain mobile for life. Our website and call center are designed for users to easily connect to transportation resources and information. Even though it is literally our job to find folks transportation, it can be challenging at times. Here are some tips that might help:
1.) If someone lives in Oakland or Macomb Counties, they can call us! myride2 Mobility Specialists are available from 8:00 a.m. to 4:00 p.m., Monday through Friday, to help individuals find which types of transportation options would work best for them. People can call us toll-free at 1-855-myride2 (697-4332). They can also visit our website at www.myride2.com and search for providers who serve their zip code.
2.) If you are needing non-emergency, medical transportation keep in mind that these companies need to be licensed properly by the State of Michigan. They are required to have a Certificate as an Authorized Limousine Carrier. (Yes, a “limo license.”) If you follow this link: http://mdotwas1.mdot.state.mi.us/public/licensedcarriers/carriers.cfm?type=L, it will take you to the Michigan Department of Transportation (MDOT) website. It shows you all of the providers that currently have the certificate. You can choose a report by County (so it will pull up all current carriers in whatever county you want), or you can look at the entire list for the State of Michigan (which alphabetizes them by the city they are located in, so it’s fairly easy to see what’s available in a certain city).
a. Keep in mind that this list has actual limo companies on it as well, but you can often tell by the name which are limo companies and which are non-emergency medical transportation carriers.
3.) If a person has Medicaid, one of the benefits of full Medicaid is transportation to and from medical appointments. If a person lives in Oakland, Wayne or Macomb counties they can call the transportation provider LogistiCare at 1-866-569-1902. They will need to provide their active Medicaid ID number, but should then be able to get transportation to any medical appointments they have, anywhere in the State. If someone lives in another county, they would need to call their DHS office and as to speak to the Transportation Coordinator.
4.) Look for resources or non-profit groups that focus on a particular group of people. If your client is a Veteran, see if the local Veterans office has any volunteers. If someone is getting cancer treatments, contact the American Cancer Society. If you are trying to help a person with a visual impairment, see if the local LIONS club might help. Also many senior centers provide some type of transportation within the city they serve.
5.) Don’t rule out home help agencies. These agencies generally charge approximately $20/hour and require a minimum number of hours. However, if you client has an insured vehicle, the home help worker can often drive the client’s car, and there is no mileage fee. If a minimum is 3 hours, the trip would cost about $60.00 and you have a person staying with your client the whole time. Often transportation provider’s roundtrip fees are more expensive, and they client is picked-up and dropped off.
Sara Mary Wallace can be reached directly at 248-262-1289 or at swallace@aaa1b.com

