Dealing With Senior Health Care

Dealing with senior health care of an elderly family member, spouse, partner or friend can be a trying experience. You may have your grandparent to look after or perhaps it is your mother or father who has fallen ill, no matter who the person is, the fact is that you are the one responsible for looking out for their best interests. You are the advocate for your loved one and you need to be sure that all of their medical needs as well as personal needs are met. It is important to learn about the resources that you have available to you right in your community. You do not have to do all of this alone as there are resources and support groups to help you when it comes to elder care.

There can be many reasons that your loved one is in need of senior health care such as: they suffered a broken hip where rehabilitation is a necessity, they are suffering with dementia or Alzheimer’s and are in need of constant care or maybe the effects of aging is limiting their ability to do things on their own. No matter what the cause is for the need of elder care, the fact is that you need to be cautious when it comes to senior health care. You really need to be aware of how they are caring for the person you are responsible for. If you put yourself in the senior’s shoes, it is easy to know what to look for. Are they feeding him or her right? Are they spending time with your loved one? Is your loved one’s needs being met?

Overseeing one’s senior health care is not an easy job but with the right resources and knowledge you can make sure that your loved one is getting the best care possible. There are many things to consider when choosing a facility that will be caring for an elderly loved one. The first thing to consider is the type of care that your loved one will need. Do they need long term elder care, short term elder care or do they just need some extra help to get back on their feet after being in the hospital? Once you know the type of care they need, you can look into facilities or home health care to meet your loved one’s needs.

Another thing to consider when making the choice for senior health care is what type of condition they have. In some cases the condition will pass and in other cases, it is a lifelong condition that will require frequent admissions to the hospital. This will help you in determining if you need to partner with senior health care providers that can give you the flexibility you need when it comes to your loved one. There is a great deal to remember when you are looking after an elderly loved one and you do not want to miss anything that is necessary for their well being. Most likely you are working with a limited budget so finding quality senior health care can be difficult, you have to make the most out of what you got.

It often becomes necessary to lean on other resources to help you in this matter. There are plenty of free resources as well as ones that are covered on various types of medical insurance including Medicare that can help keep you focused on what needs to be done. They can walk you through what you need to do, what you will need and how to stay on top of things so that you can provide your loved one with the best possible care in a timely manner. It can be very helpful for you to make a checklist of all things that need to be managed where senior health care is concerned this way nothing will be missed.

Since each care plan is based on the specific needs of the individual, you will need to have a complete copy of your loved ones medical history to include their current and past medications, test results that they have had done and their doctors information. You should also keep up to date on their financial resources and a resource list that details the patient’s personality so the potential caregivers will know what to expect from the patient. This can help to make a better bond between the patient and any caregivers that may be working with your loved one.

In addition to your checklist, you should make a list of providers and various facilities in your area so you know where you can take your loved one when they need care. You should also educate yourself with their medications and possible drug interactions. Talk with the doctor to get a list of medications that the patient is on and what they used to be on. Learn about the side effects and drug interactions so you can oversee their medications and how they are being administered once they are in the facility. If your loved one is staying at home, it is very crucial to be on top of their medications so that they do not miss a dose of a crucial medication or so that they do not over medicate themselves.

There is a great deal to remember when keeping up with senior health care but once you get all of the necessary information you need, have a check list of what your responsibilities are and a resource list of who you can turn to for help, you will find that everything will fall into place. You will have a better understanding of what you need to do and that will make staying on top of all of much easier. Remember that you are the advocate for your loved one and in some cases you will be the one taking care of all of their needs and all that goes with senior health care. Remember that you have a resource list in place to help you with this so you will not get overwhelmed or run down when you use the resources as needed.

How Are You Affected by Health Care Reform? – Part 1

Health Care reform… “What does it do for me?” “Is it going to be free?” “Will there be waiting lines at doctor offices?” “What about rationing?” These are all legitimate questions and will be addressed over the next few weeks.

Efforts to change the delivery system of health care in the U. S. goes back over 100 years. However, the most well known attempt at reform was as recent as 1994 during the Clinton administration. The overriding goal of reform debate has been to get all Americans insured and relieve the system of treating patients who had no insurance.

Providers then would shift the cost (I.e. cost shifting) to those who could afford to pay out of pocket or who had insurance. Consequently, the well to do and insured Americans saw their costs of health care rise disproportionately over time along with the premiums for health insurance.

Since the failure of the 1994 attempt at reform, the health care system introduced “Managed Care” plans. These plans offered discounts in premiums to steer insureds into certain blocks of providers. These plans had a number of different looks, but the most common in the West Texas area was PPO plans.

Managed Care plans helped alleviate the cost shifting stress for a while, but failed to bring more uninsured folks into the system. Eventually, as the number of uninsureds rose, premiums were forced higher and higher until today where it is not unusual for a family premium to be more than a house payment.

Most estimates say 47 million Americans are without health insurance today. The original goal of reform debate when it was seriously renewed in 2008, was to force that 47 million people into the cost sharing arena.

By March 23, 2010, the result of reform provided only modest incentives for those 47 million to participate in cost sharing system. Rather, the result ended up as insurance reform.

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA). On March 30, 2010, the President signed into the law the Health Care and Education Reconciliation Act of 2010 (HCERA), adding certain amendments to PPACA. Combined the two laws comprise health care reform.

The end result of reform will not reduce costs. The primary focus intended to get those 47 million Americans in the system as participating financial contributors by forcing them to purchase health insurance or open the health insurance markets up to insure those with pre-existing health conditions.

The incentives to get more people into the system include:

-tax credits for businesses who offer and help pay for insurance
-penalties to individuals and families who do not buy insurance
-elimination of pre-existing health condition exclusions by health insurance carriers
-premium subsidy payments to individuals and families who could not afford insurance
-expansion of Medicaid

These mandates along with a host of other mandates will be phased in over the next seven years, with the majority required by January 1, 2014. It is on this date that subsidies, penalties, and adult pre-existing condition limitations begin. Other prominent provisions begin on that date as well:

-State run “Health Insurance Exchanges” must be operating
-Policies may no longer include limitations on annual benefits
-Wellness programs begin
-Group plans will not be able to extend waiting periods for insurance eligibility beyond 90 days
-Employers must begin to “certify” coverage.

Other mandates require insurance companies to install important provisions by September 23, 2010:

-Dependent children, whether married or unmarried, student or non-student may remain as dependents until age 26
-Group health plans may not set lifetime maximum benefit amounts on “Essential Health Benefits”. The Dept of Health and Human Services will be determining what “Essential Health Benefits” are by September 23
-Children under age 19 who have a pre-existing condition must be “guaranteed issue”
-Insurance companies may not rescind health insurance policies except in limited cases of fraud or misrepresentation by an applicant
-A $250 payment will be made to Medicare Part D (prescription drug plan) beneficiaries as the first installment toward closing the “donut hole” by 2020.

Health plans in effect on March 23, 2010, or collectively bargained plans will be exempt from certain requirements and will retain the “grandfathered” status until, as yet undefined, policy changes are made. The grandfathered plans must still abide by dependent children to age 26 and benefit limitation rules. However they will be exempt from other more significant requirements that will be addressed in later columns.

Grandfathered health plan premiums will likely be less adversely affected than post-grandfathered plans which will have to conform to many mandates. Most experts believe health insurance on January 1, 2014, could be well over 75% higher than a similar policy today.

Very small group plans may give way to individual plans of insurance because the structure of health care reform blurs the line of distinctions between the two.

In the meantime prior to September 23, 2010, insurance companies will distribute updates to small group plan sponsors the following items:

-Children can remain on parents’ coverage until age 26
-elimination of lifetime benefit caps
-35% tax credit for offering and paying all or a portion of group health plan

The next article will focus on group insurance reforms with more detail about the effects on small
businesses.