Medicare Coverage Of Skilled Nursing Care Facilities
In order to receive care in a nursing home under Medicare:
- You must have had a three-day hospital stay prior to admission into the skilled nursing facility.
- You must be admitted into the skilled nursing facility within 30 days of discharge from the hospital.
- You must enter the skilled nursing facility for treatment of the same condition that you were hospitalized for.
- You must require daily skilled care.
- The condition must be one that can be improved.
- The facility must be Medicare-certified.
- Your doctor must write a care plan. The care plan must be carried out by the skilled nursing facility.
Financial Resources For Wisconsinites
Living with PD can put significant strain on a familys finances. To help ease this burden, APDA Wisconsin proudly offers a Patient Aid Scholarship program to offset costs associated with care.
To be eligible for the program, the applicant must be a Wisconsin resident and have a physicians verification of their Parkinsons disease diagnosis. Applicants must sign a statement of financial need.
A limited number of scholarships are available each year. Scholarships are awarded on a first-come, first-served basis, beginning in January of each calendar year. In order to serve those with the most need, we ask that applicants have a household income of less than approximately $50,000 per year.
Parkinsons Disease Treatments Covered
Parkinsons disease can come with a wide range of motor and nonmotor symptoms. The symptoms of this condition can be different for different people.
Since it is a progressive disease, symptoms can change over time. Medicare covers a range of different treatments, medications, and services that you may need to manage Parkinsons disease throughout your life.
How Can I Help Myself
Making sure that all your financial and legal documents are up to date and well organised is probably the most important thing you can do. But there are a number of other practical steps that may be helpful:
- Sign up for electronic banking if you have online access as this can save you the inconvenience of going to the bank.
- As your handwriting and possibly your signature may alter over time make sure you give your bank a copy of your new Parkinsons signature. If writing becomes difficult see if you can use Chip and PIN cards so you need only enter numbers on a keypad.
- Securely store an up to date list of all your PIN numbers and passwords. You can buy password manager programmes that securely store passwords on your computer. Avoid obvious passwords like 1234 or your date of birth and use different passwords for different sites. Try and include a mix of upper and lower case letters in a password, as well as numbers and symbols.
Filing For Social Security Disability With A Parkinsons Disease Diagnosis
The SSA has a complied list guidelines of conditions that qualify for disability benefits. Under it’s listing in the “Blue Book,” Parkinsons Disease is a condition that can qualify a person for Social Security Disability benefits provided that certain diagnostic criteria are met and documented which include:
- bradykinesia, or tremor in two extremities causing ongoing problems with movement
- gait, or ability to stand
There is no single test that can provide a definitive diagnosis of Parkinsons Disease. Diagnosis is based upon an evaluation of the symptoms present, as well as a neurological examination.
Also, the presence of at least two of what are considered to be the cardinal symptoms of Parkinsons can be considered to be strongly indicative of the presence of the condition.
Additionally, tremors of the hands that occur while the hand is at rest, symptoms that begin on one side of the body, and/or a positive response to levodopa are also telltale diagnostic tools.
It can be assumed that these symptoms could be used as the basis for a Social Security Disability case on their own should they become serious enough to inhibit ones ability to work. If the disease has progressed to this point, however, the patient has likely already qualified based on physical/motor symptoms.
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Legal And Financial Documentation
It is not uncommon for one partner to manage family finances and often, for a number of reasons, this information may not be fully shared. This can be problematic if the person who takes care of finance is ill. So it is useful to write down the most important information and jointly review it on a regular basis. If you have a particular system for keeping information then write this down so that others can navigate their way around in the event of unexpected hospitalisation or illness, or if you are no longer able to continue taking care of this.
A good starting point when organising your affairs is an assets list: a comprehensive list which includes details of any bank accounts, insurance policies, stocks and bonds, as well as valuable possessions such as jewellery or antiques. The list can be either typed or hand-written. Details should be updated annually and kept in an easy-to-find location such as a desk drawer or filing cabinet. You may also want to keep a copy with your Will or in a safe deposit box.
It is a good idea to buy a file or clearly mark and file several envelopes containing copies of important legal and financial documents. Originals can be stored in a safe place such as a fireproof box, safe or with your bank, but make sure that you write down and tell someone where these are stored. You may also want to give a set of photocopied documents to a family member or good friend.
Symptoms Of Parkinsons Disease
Parkinson’s disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.
People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
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How Do People Receive Medicaid Benefits
Medicaid eligibility requirements depend on financial need, low income, and low assets. In determining Medicaid eligibility, officials do not review rent, car payments, or food costs. They only review medical expenses. Medical expenses include:
- Care from hospitals, doctors, clinics, nurses, dentists, podiatrists, and chiropractors
- Transportation to get medical care
The four eligibility tests required to receive Medicaid include:
- Categorical. You must be age 65, blind, or disabled.
- Non-Financial. You must be a U.S. citizen and a state resident. You also must have a social security number.
- Financial. Your total gross income, personal assets, and property will be evaluated and must meet a certain standard. This amount varies from state to state.
- Procedural. You must complete and sign an application and have a personal interview with a Medicaid official.
Each eligible Medicaid recipient receives a monthly medical identification card. The card is valid for one month only.
Relief For People Living With Parkinsons In Vermont
The APDA Vermont Chapter offers a patient aid scholarship program designed to provide financial support to people with Parkinson disease and their families. Approved applicants will be eligible to be granted up to $500 once per calendar year . Funds are limited and will be awarded on a first-come basis. This Patient Aid Scholarship Program is intended for individuals with PD in need of financial assistance for programs, services and/or activities, such as:
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Surgery And Deep Brain Stimulation
Deep brain stimulation is a treatment for Parkinsonâs disease that uses an implantable pacemaker-like device to deliver electrical pulses to parts of the brain involved in movement. The DBS system consists of leads precisely inserted into a specific brain target, the neurostimulator implanted in the chest, and extension wires that connect the leads to the neurostimulator. Though implantation of the system requires a neurosurgical procedure, the treatment itself consists of long-term electrical stimulation. Advantages of DBS include its ability to reduce the high doses of medications , its adjustability , and its reversibility DBS was approved by the Food and Drug Administration as a treatment for PD in 2002 and according to Medtronic , more than 80,000 patients have undergone DBS surgery worldwide.
Typical candidates are those who have motor fluctuations or periods of âoffâ time with troublesome symptoms alternating with periods of âonâ time with good symptom control, and also with possible periods of excessive movement .
Not all patients with Parkinsonâs disease are good candidates for treatment with DBS. Approximately 10â20% of patients considered for possible treatment with DBS include those:
Assistance And Treatment For Parkinsons Disease
Parkinsons disease can be controlled through the use of medication, which needs to be adjusted as the disease progresses. Physical exercise and professional therapy can also help assuage some of the worst effects on daily activities. In addition to healthcare professionals, there are organizations and programs available that can educate and support patients and their caregivers.
- Parkinson Society CanadaThis national organization partners with regional groups and 240 chapters and support groups to provide support, education, and advocacy for Canadians with the disease. It also helps fund research in the diagnosis, prevention, and treatment.
- Canadian Disability Tax CreditThose with Parkinsons disease may qualify for a Canadian disability tax credit. The disability tax credit is intended to help with extra expenses caused by the condition and to help sufferers lead a more normal, productive life.
- PhysiciansSince there is no cure, ongoing professional medical care is necessary. Parkinsons patients frequently need their medications adjusted or changed as the disease alters over time. Some patients also may benefit from surgery.
- Physical, Speech, and Occupational TherapySeveral different therapies can improve the quality of life for Parkinsons patients. Physical therapy helps with mobility and flexibility. Occupational therapy improves the performance of daily chores. Speech therapy aids in voice control.
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Complex Parkinson’s Disease And Palliative Care
Complex Parkinson’s disease is defined as the stage when treatment is unable to consistently control symptoms, or the person has developed uncontrollable jerky movements .
These problems can still be helped by adjustment or addition of some of the medications used to treat Parkinson’s disease, under the supervision of a doctor with a specialist interest in Parkinson’s disease.
As Parkinson’s disease progresses, you’ll be invited to discuss the care you want with your healthcare team as you near the end of your life. This is known as palliative care.
When there’s no cure for an illness, palliative care tries to alleviate symptoms, and is also aimed at making the end of a person’s life as comfortable as possible.
This is done by attempting to relieve pain and other distressing symptoms, while providing psychological, social and spiritual support for you and your family.
Palliative care can be provided at home or in a hospice, residential home or hospital.
You may want to consider talking to your family and care team in advance about where you’d like to be treated and what care you wish to receive.
Medicare Coverage Of Home Care
In order to receive home care under Medicare:
- You must be home-bound.
- Your doctor must certify a plan of care.
- Care must be needed on an intermittent basis.
- Care cannot exceed 35-hours per week or eight hours per day.
- Physical or speech therapy must be provided on a “necessary and reasonable” basis. There are restrictions on the number of days or hours per week of these therapies.
- If you qualify for home health care, you are entitled to a home health aide to provide some personal care.
Department Of Veterans Affairs
Through the VA Health Care program and their pensions, the VA offers veterans multiple avenues of assistance with medical equipment, assistive technology and home modification. The avenue best pursued depends on whether or not the individual with Parkinsons Disease was exposed to herbicides during their military service. For those individuals not exposed, they are most likely to receive assistance from the Aid and Attendance pension benefit, VD-HCBS or the HISA Grant. For those veterans with PD who were exposed, VA Health Care will cover the cost of much assistive technology and medical equipment.Another option for veterans comes not from the VA but from a non-profit organization with a veteran-specific program called Heroes at Home. This program is intended to assist in making home modifications and typically provides free labor for modifications but does not cover the cost of materials.
Financial Support For Carers
Everyones financial situation is different. If you are a carer of a person with Parkinsons and have concerns about money, you may be entitled to claim Government benefits that could reduce the financial stress. To determine if you are eligible for Government payments, contact Centrelink on 132 717 or visit their website.
Some of the Government benefits available to carers are:
- Carer Payment Provides financial support to people who are unable to work in substantial paid employment because they provide full time daily care to someone with a severe disability or medical condition, or to someone who is frail aged.
- Carer AllowanceA supplementary payment for parents or carers providing additional daily care to an adult or dependent child with a disability or medical condition, or to someone who is frail aged. Carer Allowance is free of the income and assets test, is not taxable and can be paid in addition to wages, Carer Payment or any other Centrelink payment.
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Caregiving For People Living With Parkinsons
Caring for a loved one with PD can be a challenging job, especially as the disease progresses. Former caregivers of a loved one with PD suggest doing the following : Get prepared, Take care of yourself, Get help , Work to maintain a good relationship with your loved one, and Encourage the person with PD for whom you care, to stay active.
Preparing for caregiving starts with education. Reading this fact sheet is a good start. More resources are available to you in theResources section of this fact sheet. Early Parkinsonâs disease usually requires more emotional support and less hands-on care. It is a good time for family members/caregivers to educate themselves about the disease.
Consider Your Medical Coverage Options
Employee Insurance. If you are insured, either through your employer or a retirement policy, read all of the policies pertaining to chronic illness. If you are unsure about the language or terminology, contact the personnel department or your financial planner.
It is important that your insurance agree to provide for a referral to a specialist in Parkinson’s disease in the event that you should need one now or in the future. Not every neurologist is a specialist in Parkinson’s disease. To be a specialist, neurologists undergo further training in movement disorders.
Private Insurance. If you are unemployed and you do not have coverage, you should look for the highest level of coverage that you can afford.
Medicare. If you are 65 or over, you will qualify for Medicare. You can supplement this insurance with a “Medigap” policy available through a private insurer. Note also that many states have prescription assistance/reimbursement programs for low-income senior citizens.
If you are disabled but too young to qualify for Social Security, you may be eligible to receive a form of Medicare for the disabled.
Medicaid. If you cannot get insurance and your income is low, you may qualify for Medicaid, a government “safety net” program that pays for medical costs that exceed a person’s ability to pay.
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Facts About Parkinsons Disease
Parkinsons disease is considered by most to be a disease affecting mostly seniors, with onset averaging at around age 60. However, nearly 10 percent of the diagnoses of Parkinsons occur in people under the age of 40, and 20 percent are under age 50. While many of the symptoms will be the same, regardless of the age of onset, there are some differences with younger sufferers:
- Dementia and Balance ProblemsThese are less likely among those with an earlier onset.
- MedicationsThose with earlier onset are typically are more sensitive to the medication benefits used to treat Parkinsons.
- Physical ComplaintsCramping or abnormal posture is more prevalent.
- Work LifeOn average, those with earlier onset are able to function at work longer than those who acquire the disease later in life.
How Available And/or Useful Is The Information On The Motability Scheme
23. The Motability website is easy to navigate and offers functionality to live chat if there are questions. They have accessible ways to get in touch by phone, minicom and textphone with queries. Also, Motability also offer sign language interpretation. It is positive that they offer these options to ensure they meet the diverse needs of the client base, as not everyone is online.
24. We believe that the Motability scheme is referred to in the award letter, if someone has been successful. But wonder if any further information is provided as people may miss this useful information in the award letter.
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