rosi614 Asked September 2015
Can my parents apply for Medicaid on Healthcare.gov?
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Need advise, new to all of this. My is 86 and mom is 84 dad had a strike and mom suffers from epilepsy and beginning stage of dementia. My question is can They apply for Medicaid thru the obamacare website? They do have Medicare. I am so new to all of this just don't know where to start, we live in Illinois. Thanks
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Your parents HAVae health insurance as they are enrolled in Medicare. ACA isnt geared for them. Most on medicare have a secondary policy to cover or pay for the 20% Medicare copay & or cover Part D gaps. Your parents got a book - based on your state - that provides information on secondary policy & drug coverage available in their state. There are specific enrollment periods to do this. Most on Medicare get all sorts of mailings from secondary /gap coverage companies during the open enrollment period.
CMS - centers for Medicare & Medicaid (the .gov sites) provide overall information on both programs as the federal government funds both. Medicare is totally federal & portable...so they can use it in Illinois but also when on vacation in Florida. Medicaid is joint federal & state but Medicaid is administered by each state uniquely but within overall federal guidelines. Your parents will ultimately need to apply to the State of Illinois Medicaid program with whatever Illinois requires for documentation. What programs are covered by Medicaid vary by state & will be limited to coverage in llinois.
What are you hoping that the government will pay for & provide for your folks?
BUT Medicaid paying for AL is not dedicated funding. AL is not covered in most states Medicaid programs at all. For those that do, AL is a waiver program. Because of this many facilities limit how they accept the waiver if they accept it all. Like only a set # of beds available for waiver & a waiting list for those few beds. Most common qualifier is that they need to private pay for 2 -3 years at the AL before the waiver is accepted.
What is also happening is that many states are gearing back from individual waivers and instead moving to PACE. If there is a PACE center where your parents are, they likely will need to enroll at a PACE center first & if PACE cannot provide the level of care needed then they could get a waiver or will be recommended to be in skilled nursing care in a NH or onto hospice.
Did anyone mention hospice? That is a totally Medicare benefit. If dad could qualify for hospice, they could get in home care 2-4 times a week for a couple of hours. Family will need to do care all the rest of the time or hire home health.But for some families, hospice can be a godsend if there is enough family to balance out caregiving or have the funds for home health.
Home Health Care-Sponsored by Medicare provides In home support and medical care, based on qualifiers called Activities of Daily Living (ADLs) Check Google
Palliative/Hospice- Sponsored by Medicare is an additional team of home and medical care professionals. The palliative part acts as a supplemental group to help with the emotional and medical challenges of care giving.
The Hospice portion engages when the illness progresses beyond the cure stage. It provides near end comfort and emotional support for the care givers and care receivers.
Both medical teams work together at the same time to provide all the necessary support you will require. If your condition improves the Hospice team will vacate and the Palliative and Home Health Team will remain.
It is important to know the patients condition is monitored and evaluated during the illness period and the Home Health portion will be withdrawn, if your care receivers condition worsens.
The teams are limited in terms of time "on the job" and you will need to hire outside help, but the bright spot is you and your care receiver will cherish the feeling of hope and calm this process provides during the stressful and emotional care giving period. .