HEALTHCARE WILL BE CHANGING FOR THE UNINSURED,
UNDERINSURED AND UNDERSERVED DUE TO LIMITED STATE FUNDING… By Aurelia McGruder – American Seniors Association-Home Health Agency
What’s New? According to the New York Times… • Florida has the fourth-highest unemployment rate. • Florida has the second highest rate of people without insurance. • Florida turned away millions in grant funding made available under the Affordable Care Act and it is not pursuing grants worth millions more.
Therefore, funds are limited for moving long-term elderly patients back into their homes and for signing up new eligible Medicare recipients.
Since the health insurance exchange program under the Affordable Care Act is no longer an option for Floridians, individuals and small businesses will no longer have the ability to choose from a variety of health plans.
What’s Next? Florida recently approved a new plan called the Medicaid Managed Care (MMC). MMC has two (2) programs as part of this plan - The Florida Long-Term Care Managed Care Program (LTCMCP) and The Florida Managed Medical Assistance Program (MMAP). All eligible Medicaid recipients will be eligible to enroll in these programs. The LTCMCP will begin enrollment July 1, 2012 and end October 1, 2013. The MMAP will begin enrollment January 1, 2013 and end October 1, 2014. Once enrolled and accepted, Medicaid recipients will receive their long-term care from their new managed care plan and Medicaid recipients who qualify will receive all of their health care services minus long-term care from their desired managed care plan. Eligible Medicaid recipient will receive a letter in the mail notifying them if they are required to enroll in the program.
What is
Medicare.gov’s definition of Long-Term Care? Long-term care is a variety of services that include medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with daily activities such as bathing and assistance in the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. It is important to remember that you may need long-term care at any age. You may never need long-term care. This year, about nine million men and women over the age of 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. Most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. What Now? • Florida has failed to create the health insurance exchanges for individuals or small businesses.
• Our economy has changed drastically and people are really feeling the impact! • For many people, the thought of retirement was just around the corner then one day they woke up to find that they are now part of the unemployed, underemployed, uninsured and near homelessness. Do you fit into this category?
• For many families, money was plentiful, now the reality of paying a $50 co-payment for medication is out of reach and a hardship. What will you do when you no longer can afford your medication?
• Is your family struggling with caring for a loved one with little or no help? • How have you dealt with unemployment, underemployment or who helps the uninsured get care?
• Does the uninsured even ask for help and if so, who would they really ask? • Medicare believes that 70 percent of the elderly will be cared for by family and friends. Are you prepared for this change?
Florida Medicaid rates for long-term care have not increased in two decades. Because of the stagnant rates for long term care, home health agencies are barely breaking even with their costs. This discrepancy causes home healthcare agencies to provide substandard care to Medicaid recipients. For many years, the lack of funding in long term care left Medicaid recipients calling agencies to plead for assistance. The end result for many families was providing care to their loved ones or forced many individuals to attempt to take care of themselves.
American Seniors Health Foundation was created to assist seniors and
disadvantaged individuals. We offer a community-wide initiative through faith and community organizations to empower families on how to provide home healthcare services safely at home. These 12 FREE educational in-services (Examples: Fall Prevention, Fire Safety and Elder Abuse) will be administered by registered nurses or licensed practical nurse professionals beginning in October 2011.
For additional information, please call American Seniors at (813) 874-3938
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