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Do you mean Medicaid? That's a different program from Medicare. Also, when did your father get those services? What year was it?
Usually, a doctor will recommend skilled nursing or rehab at home for other reasons.
Once you have your loved one diagnosed with a serious health condition, they may qualify for hospice care and Medicare will pay for it. Hopefully, we will start to see improvements in the future for Dementia care.
Regular Medicare (one has Part A, B and D) does not pay for "aides" such as folks to come help with things such as cleaning, food prep, dressing, bathing (Activities of Daily Living.) If a person was in the hospital (inpatient for surgery for example) and discharged home, Medicare may cover a visiting nurse, PT or OT for a limited number of visits. But this is "health or medical" in nature. These aides may come 2 or three times a week for perhaps 45 mins. This is NOT fully day, weekly help at all.
If one has Medicare Part C (or NOT regular Medicare, but a Medicare Advantage plan) there may be some that office some short term assistance, but again generally this is not a full day/weekly on going type of aide.
If one has a long term care insurance policy purchased separately, that policy may cover actual aides to come into the home on a daily weekly basis. But that totally depends on the terms of the policy purchased. Most folks do not have a separate long term care insurance policy as the premiums are high.
Some may have access to Medicare PACE, a specialized program but I am doubtful this is for someone in the later stages of dementia.
Each state law is different in terms of how Assistive Living (AL) and Memory Care (MC)facilities are licensed and regulated that are NOT Medicare and Medicaid qualified; that is NOT regulated/licensed by the US gov. But most of these are totally private pay, albeit some non-profit/religious ones may have other arrangements for folks with limited resources.
Medicaid is typically the program that can (once one has spent down and qualifies) will cover skilled nursing homes or facilities (SNFs). This is generally the "insurer" of last resort. Medicaid has home health aides that "IN THEORY" could come to one's home to help, but there is a HUGE backlog to get an aide given the HUGE demand for help. In our state, I was told the "wait list" for a Medicaid covered aide was FIVE YEARS! OMG
If one has resources, hiring aides from an agency is the way to go until it becomes unsafe for the person with dementia to remain at home. Having 24/7 at home aides is generally cost prohibitive so at some point SNFs (nursing homes w/memory care units and Medicaid) often is the only option.
A relative who had resources (good for her) paid $9K weekly for 24/7 aides so she could stay in her huge upper East Side condo in New York City. There were three shifts of aides. It was her money and she spent it until her passing. Most folks cannot obviously do that.
Your relative got ripped off if she was paying 9 grand a week for live-in homecare even in New York. She got scammed.
People with limited resources who are so invalid with dementia that they need round-the-clock care and supervision should really be put into LTC in memory care facility.
I see this all the time. Families who don't understand when their loved one's condition is beyond what homecare should try to provide and they need residential placement.
Then wat follows is the negotiation attempts on lowering the price of the homecare services.
I'll tell a family straight when a person is so advanced in dementia that they have to be supervised like a toddler 24/7 my recommendation is to put them into residential care. I don't even take on cases where a potential client needs 24-hour supervision.
Everything for us is out of pocket. I have someone come in for 2 days a week for only 5 hrs a day and that for me is a blessing but very expensive. It gives me a chance to leave the home so I can run errands and a little me time. My Mom is home bound and doesn't leave the house. Very challenging
depends on what insurance you are talking about. There must be thousands of insurances plans/programs etc.
‘’Does Medicare pay for ANY home “health” aid services for dementia?
Yes, not because it’s dementia. It could be for other disease as well.
home “health” vs home “care”….home health is covered in some instances by Medicare but home “care” is private pay unless a person qualifies due to their medical and financial situations and could receive mediCAID which is state specific and not mediCARE.
I did both for 25 years. Home/health aide and homecare CNA. Medicare will pay for some hours a week if person's doctor orders it. That's usually temporary though. Of course there are exceptions to every rule. Things have changed very much over the last few years.
If a doctor determines someone needs hygiene assistance becaus they have mobility issues for example,, or it's medically necessary for them to have homecare services AND they have dementia, Medicare will pay for some hours as in a few hours a couple times a week.
Medicare will pay for up to two weeks respite stay in a care facility for a person with dementia though. Medicare offers this for family care slaves who need a break and have to be on duty 24/7-365 for a family member with dementia.
The rules for Medicaid and what they're willing to pay for are changing too.
If your loved one has assets, you may have to start using some if they need elder-sitting services.
I am glad you posted this for Nicholas.
Hospice care is paid for by Medicare and the services they offer is very similar to Home Health care paid for by Medicare.
The aide comes because you have Hospice. An aide also comes when a person has Home Health services through original Medicare.
Often a person may have Home Health Care and then switch to Hospice as their health declines.
Some companies have a Home Health group and a Hospice Group.
HOME HEALTH SERVICES and HOME HEALTH CARE
please see this article Aging Care has posted. It includes a chart and an assessment tool if needed. It can be found under Resources, Care Topics…
https://www.agingcare.com/articles/difference-between-home-health-and-non-medical-home-care-services-
‘Home Care vs. Home Health Care: What’s the Difference?”
Kayla Carney
Cheri
Did want to mention they will not cover transportation and it is a process to get and they cover 250 hours to knowledge.
You can contact some Home Health companies in your area to see which one offers the most services with Medicare and get doctor to do an order to the one that could help you the most. It's not going to be hours at the house every day - it will be more like bathing, physical therapy, etc.
If income is low, you could get a medically necessary letter/verification from the doctor and use it to apply for Medicaid to see what programs Medicaid has in your area.