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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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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.
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.
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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.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Medicare does cover hospice care and supplies, in home or in a facility. Medicare will cover a new appliance w/o hospice care every 5 yrs. So if mom needs a wheelchair but not hospice, have her doctor write a prescription for one.
Yes—hospice will cover most of these things. The hospice physician will write the orders for what’s needed, and their team will submit everything to Medicare for approval and coordinate it on your behalf.
Take your time finding the right hospice. They are not all the same, and the difference in care, communication, and heart matters more than you can imagine.
Trust your gut on this—your person will tell you when it feels right.
I second the advice to spend some time finding the right hospice.
When my father went into hospice, I chose the same company for hospice that we had previously used for home health. They were one of the few companies that we could pick from with Dad's Medicare Advantage plan. I did not realize that his Medicare Advantage plan would not be involved in hospice, so we were not limited to the same providers.
I chose a different hospice team for my mother and I am so happy that we did. They are wonderful.
Just to clarify....Medicare covers hospice but most Medicare Advantage program do not. So if you have a Medicare Advantage policy, you may need to switch.
I discontinued my relatives Medicare advantage to Medicare now she is receiving astronomical medical bills. Even transport from hospital on hospice she has a bill saying transportation was not medically needed. Please advice should I have enrolled her in another plan..I truly need sound advice
Hospice and all end of life equipment, supplies and medications are covered by Medicare Part A for everyone. In hospice, my elders were provided with a basic manual wheelchair, a hospital bed, bed tray, a lifted toilet seat with rails, and continence care items. Hospice also covered pain management medications and any of their regular prescriptions used to treat the condition for which hospice is needed. They had a Medicare C plan that continued to cover any outside doctor visits, such as podiatry, dental, and eye doctor, as well as any other prescriptions that they still wanted to continue taking.
If you are not on hospice, durable equipment like the wheelchair will be covered by your Part B (if you chose traditional medicare) or Part C (if you chose Medicare Advantage). That coverage will vary according to your plan.
i have to laugh at number 2. I was already for the fight when my wife was on her way home from the hospital the ambulance was rear ended. No damage to the ambulance or occupants. They did not have the courage to send me a bill.
Hospice coverage can get complicated when Advantage involved.
Hospice gets convoluted for billing when Medicare Advantage Plans are involved….. here’s why: - Original Medicare as created in the 1960’s has Part A benefits to 100% include hospice. The payment to hospice agencies was & still is paid by Medicare by CMS (Centers for Medicare & Medicaid Services). HOWEVER - Medicare Advantage Plans (Part C) which came about by health insurance companies starting underwriting in the 1980’s DO NOT cover hospice. Not to get too too in the weeds on this, but its mainly due to hospice as a benefit is paid by a Federally set capitation rate (fixed $ amount paid per enrollee) SO…… - what has happened is that when someone on an Advantage Plan goes under hospice care, it is NOT PAID by the AP but gets switched back to Original Medicare for them to pay. YET!!!… - only the hospice benefit that’s switched back! You still are on your AP for all other health insurance coverage costs which are not precisely related to and covered under hospice. Only hospice deems back to Original Medicare.
As you can well imagine, billing can get quite crazy complicated. So let’s say you just got diagnosed with terminal cancer but you also have Rheumatoid arthritis (RA) for years and are on Enbrell for your RA. The terminal cancer gets you on hospice not RA. The serious opioid pain meds for your cancer and staff monitoring your pain would be 100% related to hospice eligibility so those bills are paid by Original Medicare hospice benefits. But the Enbrel for your RA is not. The Enbrell would still be paid by however you did your Advantage Plan drug coverage. The medical staff & hospice agency staff that deals with you being on hospice is paid by Original Medicare. But when you go and see your rheumatologist or internal medicine docs for your RA, that’s covered by how your Advantage Plan is structured.
It’s complicated so super easy to have errors made in billings. And easy to misunderstand who’s paying/covering what. Those Advantage Plans imo becomes disadvantage plans if your health care becomes complicated.
Recently put my mom on hospice, she was on an Advantage plan at the time but the hospice company never asked about insurance coverage, just her Medicare number. When we put both in-laws on hospice, they never asked about insurance.
My mom is currently on an Advantage plan”Give back” plan because it helps preserve her money for memory care. Hospice care was seamless and done in two days. When she needed a new wheelchair, it was delivered that afternoon. She also received a hospital bed and received all of her incontinence products. She went from one Advantage plan to another, no questions asked.
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.
Take your time finding the right hospice. They are not all the same, and the difference in care, communication, and heart matters more than you can imagine.
Trust your gut on this—your person will tell you when it feels right.
When my father went into hospice, I chose the same company for hospice that we had previously used for home health. They were one of the few companies that we could pick from with Dad's Medicare Advantage plan. I did not realize that his Medicare Advantage plan would not be involved in hospice, so we were not limited to the same providers.
I chose a different hospice team for my mother and I am so happy that we did. They are wonderful.
Hospice and all end of life equipment, supplies and medications are covered by Medicare Part A for everyone. In hospice, my elders were provided with a basic manual wheelchair, a hospital bed, bed tray, a lifted toilet seat with rails, and continence care items. Hospice also covered pain management medications and any of their regular prescriptions used to treat the condition for which hospice is needed. They had a Medicare C plan that continued to cover any outside doctor visits, such as podiatry, dental, and eye doctor, as well as any other prescriptions that they still wanted to continue taking.
If you are not on hospice, durable equipment like the wheelchair will be covered by your Part B (if you chose traditional medicare) or Part C (if you chose Medicare Advantage). That coverage will vary according to your plan.
1. Call the hospice provider first
They should:
Coordinate care
Help determine what should have been covered
Often advocate on billing issues
2. Appeal the ambulance denial
Very important—many get overturned.
Ask provider for:
Medical necessity documentation
File an appeal with Medicare. Instructions are on the rejection letter.
3. Check for current enrollment options
Depending on timing, they may still qualify to:
Re-enroll in a Medicare Advantage plan
Or possibly get a supplement (harder, but worth checking)
4. Contact
State Health Insurance Assistance Program
This is huge:
Free, unbiased Medicare counseling
They’ll review your exact situation and fix gaps.
The big picture
This likely isn’t a “mistake” so much as:
A coverage transition without backup (Medigap)
Combined with how strict Medicare is about what it pays for
And the good news:
Some of these bills can be reduced or overturned
They’re not necessarily stuck with all of it.
I hope this helps.
Hospice gets convoluted for billing when Medicare Advantage Plans are involved….. here’s why:
- Original Medicare as created in the 1960’s has Part A benefits to 100% include hospice. The payment to hospice agencies was & still is paid by Medicare by CMS (Centers for Medicare & Medicaid Services).
HOWEVER
- Medicare Advantage Plans (Part C) which came about by health insurance companies starting underwriting in the 1980’s DO NOT cover hospice. Not to get too too in the weeds on this, but its mainly due to hospice as a benefit is paid by a Federally set capitation rate (fixed $ amount paid per enrollee)
SO……
- what has happened is that when someone on an Advantage Plan goes under hospice care, it is NOT PAID by the AP but gets switched back to Original Medicare for them to pay.
YET!!!…
- only the hospice benefit that’s switched back! You still are on your AP for all other health insurance coverage costs which are not precisely related to and covered under hospice. Only hospice deems back to Original Medicare.
As you can well imagine, billing can get quite crazy complicated. So let’s say you just got diagnosed with terminal cancer but you also have Rheumatoid arthritis (RA) for years and are on Enbrell for your RA. The terminal cancer gets you on hospice not RA. The serious opioid pain meds for your cancer and staff monitoring your pain would be 100% related to hospice eligibility so those bills are paid by Original Medicare hospice benefits. But the Enbrel for your RA is not. The Enbrell would still be paid by however you did your Advantage Plan drug coverage. The medical staff & hospice agency staff that deals with you being on hospice is paid by Original Medicare. But when you go and see your rheumatologist or internal medicine docs for your RA, that’s covered by how your Advantage Plan is structured.
It’s complicated so super easy to have errors made in billings. And easy to misunderstand who’s paying/covering what. Those Advantage Plans imo becomes disadvantage plans if your health care becomes complicated.
My mom is currently on an Advantage plan”Give back” plan because it helps preserve her money for memory care. Hospice care was seamless and done in two days. When she needed a new wheelchair, it was delivered that afternoon. She also received a hospital bed and received all of her incontinence products. She went from one Advantage plan to another, no questions asked.