/PRNewswire/ -- According to the National Alliance for Caregiving, more than 65 million people in the United States serve as informal caregivers, typically for family members, which equates to more than one out of every four people serving as unpaid caregivers.
A caregiver is someone who provides assistance to another person who is ill, disabled or needs help with daily activities. It's a role that can be physically and emotionally draining. The health care system doesn't make it any easier. Fortunately, there are a few tips caregivers can follow to better manage their loved one's health care, particularly when it comes to people with Medicare, according to Krista Bowers, senior vice president of senior products at Blue Cross and Blue Shield of Georgia's parent company.
"At Blue Cross and Blue Shield of Georgia (BCBSGA), we hear regularly from caregivers who are learning how to navigate the system on behalf of their parents, grandparents and others," said Monye Connolly, President, BCBSGA. "There are some themes that are common among them."
Gathering Information
The first step in helping to manage care for a loved one is gathering as much information as possible about their health and health benefits. Some items caregivers might want to gather include the following:
-- Medicare card (if eligible)
-- Health plan membership card
-- A list of doctors, including specialists
-- A list of medicines and dosages
-- Information about the person's medical conditions both treated and
untreated.
This is basically creating a "personal health record." A loved one might be reluctant to share this information at first. Experts recommend that caregivers remain patient. They can explain that the information is needed to advocate on their behalf with their doctors, hospitals and insurance companies.
Getting Permission
Most people have heard of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is an important law for protecting patient privacy. However, it can be an obstacle for caregivers.
"People are sometimes surprised to learn that companies like Blue Cross and Blue Shield of Georgia cannot readily disclose a person's health information, even to their own spouse or child," said Connolly. "That's why it's so critical for caregivers to file the proper paperwork with their loved one's health benefits provider."
Caregivers can access a loved one's health information in a number of ways. One way is with a "durable power of attorney," which can be established with the assistance of an attorney. Another way is with an "Authorization to Disclose Personal Health Information," which is available from a health benefits company. With the disclosure form, the member can authorize someone else to see their health care information, while specifying just how much information that person can see. Beneficiaries also can designate someone to participate on their behalf in Medicare appeals and grievances by filling out an "Appointment of Representative" form.
These forms are returned to the health benefits company where they are kept on file. When they are on file, designees can serve as the member's representative on health benefits, including determinations, exceptions, and appeals and grievances. Anybody can serve as a designee, including a family member or friend. However, the member can revoke these designations, in writing, whenever they see fit.
Enrolling in a Chronic Disease Program
Some Medicare beneficiaries suffer from chronic diseases, such as cancer, stroke, multiple sclerosis, dementia, diabetes, end stage renal disease or Alzheimer's disease. In fact, according to the Centers for Disease Control and Prevention, eight out of 10 Americans age 65 or older are living with some chronic illness. Those enrolled in a Medicare plan may have access to free programs to help them manage their diseases. Many times, these programs are administered by nurses or other licensed personnel. The goal is to help prevent acute episodes through better disease management. Many plans even follow-up with members after their hospitalization.
"These programs are above and beyond those offered by Original Medicare," Bowers explained. "It's important for caregivers to know about them and encourage their loved ones to participate. They may want to get a copy of a member's explanation of coverage from their insurer to find out what's available."
Knowing Your Rights
Once the disclosure/authorization paperwork has been filed, caregivers can speak to a customer care agent on a beneficiary's behalf as well as access the beneficiary's information online, including claims history, provider network and drug formularies.
If a beneficiary ever disagrees with any Medicare decision, including a denial, they have the right to appeal it. For more information about appeals, visit http://www.medicare.gov/ to get a free copy of "Your Rights and Protections."
Investigating 'Extra Help'
As a caregiver, it's also important to know about "extra help" that is available to low-income people with a Medicare prescription drug plan through the Social Security office. This "extra help" includes assistance with monthly prescription drug premiums, annual deductibles and prescription copayments. For information about eligibility for this program, go to www.socialsecurity.gov/extrahelp.
Even if your loved one doesn't qualify for extra help from Social Security, there are a myriad of other resources that might be available to them at the state and community levels. The Web site www.benefitscheckuprx.org has compiled information about these resources in one convenient online location. The site, which counts Blue Cross and Blue Shield of Georgia among its sponsors, tracks more than 1,550 benefit programs throughout all 50 states and the District of Columbia. It has identified more than $7.6 billion in benefits for those in need since being launched in 2001.
Caring for Yourself
The final tip for caregivers, and perhaps the most important, is for them to take care of themselves, including getting enough sleep, going for a walk, taking an occasional day off and maintaining a sense of humor. After all, caregivers can't possibly take care of anyone else until they first take care of themselves.
According to the Alzheimer's Association, research shows that caregivers face an increased risk of developing depression. It's natural to grieve about a loved one's disease. However, if sadness persists to the extent that it prevents decision making, interrupts daily living, and discourages participation in normal activities, then it may be time to get some help. Primary care physicians may offer help, including referrals to other resources. Caregivers with access to Employee Assistance Programs (EAP) can find them useful.
"Caregivers need to know that there's no shame in asking for help," said Connolly.
For more information about care giving and Medicare, including helpful forms, please visit www.medicare.gov/caregivers.
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Showing posts with label caregivers. Show all posts
Showing posts with label caregivers. Show all posts
Friday, July 23, 2010
Thursday, June 03, 2010
HHS Announces Availability of $60 Million in Affordable Care Act Grants to Help People Navigate their Health and Long-term Care Options
HHS Secretary Kathleen Sebelius announced the availability of $60 million in Affordable Care Act grants to states and communities to help individuals and their caregivers better understand and navigate their health and long-term care options.
Through this opportunity made possible by the Affordable Care Act HHS' Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) will work collaboratively to award funds for an integrated approach that focuses on the unique needs of seniors, disabled Americans and their caregivers as they seek health care and long-term care.
"The Affordable Care Act seeks to lower health care costs, improve the quality of health care and perhaps most importantly give people more control over their own care. These new grants, authorized under the new law, will help seniors, individuals with disabilities and their families get better quality care and more control. We've also streamlined the process for states and people who rely on these funds," said Secretary Sebelius.
"We know how difficult it can be for caregivers and patients to try and deal with a sudden illness or chronic disease while at the same time trying to navigate through a complex health care system to figure out where you can get help. These new funds that we have bundled together will help promote better opportunities for coordination of health and long-term supports," said Sebelius.
The purpose of this new grant program authorized by the Affordable Care Act is to create streamlined, coordinated statewide systems of information, counseling, and access that will help people find consumer-friendly answers they seek to meet their health and long-term care needs. AoA and CMS will administer the funding through separate announcements, but will coordinate implementation and monitoring through a single process.
Some specific areas of focus will include assisting individuals who are under-served and hard to reach with information about their Medicare and Medicaid benefits, helping older adults and individuals with disabilities live at home or in settings of their choosing with the right supports, assisting people transition from hospital or nursing home stays back into the community, and strengthening linkages between the medical and social service systems.
"When it comes to long-term health care, each patient has a unique mix of complex medical and social needs that must be considered when seeking care," said Marilyn Tavenner, acting CMS administrator. "Our health care system can offer many options to meeting those needs from traditional nursing home care to home and community-based services. Making patients and their families aware of these options will help them make inherently difficult decisions about long-term care. This integrated program will help families make informed choices and make sure patients have more control over their own care."
AoA and CMS have provided grants to states for several years to develop person-centered systems of information, counseling and access to make it easier for individuals to learn about and access their health and long-term services and support options. This grant program through the Affordable Care Act strengthens and enhances the ability of states to truly integrate the medical and social services care models.
"AoA's national network of community-based organizations has long served as the central place for individuals and families seeking information and help to address health and long term care challenges. This collaborative opportunity between AoA and CMS will further strengthen the network's capacity to help people in a more coordinated and comprehensive way in the communities where they live," said Kathy Greenlee, assistant secretary for aging.
Funds will be available to states, area agencies on aging (aaa's), State Health Insurance Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs). Through the grant program, states and local aging and disability programs will receive funds to:
* provide outreach and assistance to Medicare beneficiaries on their Medicare benefits including prevention;
* use additional funds through a competitive process to provide Options Counseling on health and long-term care through ADRCs;
* use additional funds through a competitive process to strengthen the ADRCs role in Money follows the Person program and support state Medicaid agencies as they transition individuals from nursing homes to community-based care; and
* coordinate and continue to embed tested Care Transition models that integrate the medical and social service systems to help older individuals and those with disabilities remain in their own homes and communities after a hospital, rehabilitation or skilled nursing facility visit.
"CMS and AoA share a long-standing goal of expanding access to community-based care for the elderly and individuals with disabilities. The Affordable Care Act provides significant resources for state Medicaid agencies and providers to balance the nation's long-term care systems and assure that individuals have a choice of where and how they receive their services," said Cindy Mann, director of CMS's Center for Medicaid, CHIP, and Survey and Certification.
The announcement combines funding opportunities from several provisions in the Affordable Care Act signed into law by President Obama on March 23, 2010, including the Role of Public Programs (Title II, Sections 2403 - Money Follows the Person and 2405 - Funding for Aging and Disability Resource Centers) and Improving the Quality and Efficiency of Health Care (Title III. Section 3306 - Funding for Outreach and Assistance for Low-Income Programs).
These grants also complement President Obama's "Year of Community Living Initiative," which focuses on better serving those individuals with disabilities who need ongoing services and support programs in the community such as those provided by AoA, CMS and other HHS agencies.
The deadline for applications is: Monday, July 30, 2010. Grants will be awarded in September 2010. For more information about this grant opportunity, please visit http://www.aoa.gov/AoARoot/Grants/Funding/index.aspx or www.grants.gov.
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Through this opportunity made possible by the Affordable Care Act HHS' Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) will work collaboratively to award funds for an integrated approach that focuses on the unique needs of seniors, disabled Americans and their caregivers as they seek health care and long-term care.
"The Affordable Care Act seeks to lower health care costs, improve the quality of health care and perhaps most importantly give people more control over their own care. These new grants, authorized under the new law, will help seniors, individuals with disabilities and their families get better quality care and more control. We've also streamlined the process for states and people who rely on these funds," said Secretary Sebelius.
"We know how difficult it can be for caregivers and patients to try and deal with a sudden illness or chronic disease while at the same time trying to navigate through a complex health care system to figure out where you can get help. These new funds that we have bundled together will help promote better opportunities for coordination of health and long-term supports," said Sebelius.
The purpose of this new grant program authorized by the Affordable Care Act is to create streamlined, coordinated statewide systems of information, counseling, and access that will help people find consumer-friendly answers they seek to meet their health and long-term care needs. AoA and CMS will administer the funding through separate announcements, but will coordinate implementation and monitoring through a single process.
Some specific areas of focus will include assisting individuals who are under-served and hard to reach with information about their Medicare and Medicaid benefits, helping older adults and individuals with disabilities live at home or in settings of their choosing with the right supports, assisting people transition from hospital or nursing home stays back into the community, and strengthening linkages between the medical and social service systems.
"When it comes to long-term health care, each patient has a unique mix of complex medical and social needs that must be considered when seeking care," said Marilyn Tavenner, acting CMS administrator. "Our health care system can offer many options to meeting those needs from traditional nursing home care to home and community-based services. Making patients and their families aware of these options will help them make inherently difficult decisions about long-term care. This integrated program will help families make informed choices and make sure patients have more control over their own care."
AoA and CMS have provided grants to states for several years to develop person-centered systems of information, counseling and access to make it easier for individuals to learn about and access their health and long-term services and support options. This grant program through the Affordable Care Act strengthens and enhances the ability of states to truly integrate the medical and social services care models.
"AoA's national network of community-based organizations has long served as the central place for individuals and families seeking information and help to address health and long term care challenges. This collaborative opportunity between AoA and CMS will further strengthen the network's capacity to help people in a more coordinated and comprehensive way in the communities where they live," said Kathy Greenlee, assistant secretary for aging.
Funds will be available to states, area agencies on aging (aaa's), State Health Insurance Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs). Through the grant program, states and local aging and disability programs will receive funds to:
* provide outreach and assistance to Medicare beneficiaries on their Medicare benefits including prevention;
* use additional funds through a competitive process to provide Options Counseling on health and long-term care through ADRCs;
* use additional funds through a competitive process to strengthen the ADRCs role in Money follows the Person program and support state Medicaid agencies as they transition individuals from nursing homes to community-based care; and
* coordinate and continue to embed tested Care Transition models that integrate the medical and social service systems to help older individuals and those with disabilities remain in their own homes and communities after a hospital, rehabilitation or skilled nursing facility visit.
"CMS and AoA share a long-standing goal of expanding access to community-based care for the elderly and individuals with disabilities. The Affordable Care Act provides significant resources for state Medicaid agencies and providers to balance the nation's long-term care systems and assure that individuals have a choice of where and how they receive their services," said Cindy Mann, director of CMS's Center for Medicaid, CHIP, and Survey and Certification.
The announcement combines funding opportunities from several provisions in the Affordable Care Act signed into law by President Obama on March 23, 2010, including the Role of Public Programs (Title II, Sections 2403 - Money Follows the Person and 2405 - Funding for Aging and Disability Resource Centers) and Improving the Quality and Efficiency of Health Care (Title III. Section 3306 - Funding for Outreach and Assistance for Low-Income Programs).
These grants also complement President Obama's "Year of Community Living Initiative," which focuses on better serving those individuals with disabilities who need ongoing services and support programs in the community such as those provided by AoA, CMS and other HHS agencies.
The deadline for applications is: Monday, July 30, 2010. Grants will be awarded in September 2010. For more information about this grant opportunity, please visit http://www.aoa.gov/AoARoot/Grants/Funding/index.aspx or www.grants.gov.
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