----- Original Message -----
Sent: Saturday, September 25, 2004 7:43
PM
Subject: Re: [QUAD-L] Medicare?
Hi Lori,
It's that way we me too. Not only that but at 51 I'm too young to
be sold a Medi-Gap policy. Can't say I disagree there, though.
Glad to hear your wound is healing so well. I tore my toe awhile
back and it's almost healed too. I'm seeing my doctors Oct., 7th for my
annuals, so I'm glad I'll have it healed by then. I wonder which tests
Medicare have dropped this year? Need to get those doctors to
bill Medicare right or they'll get kicked back out.
I am on the waiting list for the CBA, but that's about two years
long. That's the Texas Waiver Program. I still haven't found a
Medicare Prescription Card worth $30, so I'll get the free one and see what
it'll save me, and wait until after the election to see how the new
Medicare Reform Act will work. :)
Federal Register: August 3, 2004
(Volume 69, Number 148)]
[Proposed
Rules]
[Page 46865-46977]
From the Federal Register Online via GPO Access
[wais.access.gpo.gov]
[DOCID:fr03au04-20]
[[Page
46865]]
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Part
III
Department of Health and Human
Services
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Centers
for Medicare & Medicaid
Services
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42
CFR Parts 417 and 422
Medicare Program; Establishment of the Medicare
Advantage Program;
Proposed Rule
[[Page
46866]]
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DEPARTMENT
OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 417 and 422
[CMS-4069-P]
RIN
0938-AN06
Medicare Program; Establishment of the Medicare Advantage
Program
AGENCY: Centers for Medicare & Medicaid Services (CMS),
HHS.
ACTION: Proposed
rule.
-----------------------------------------------------------------------
SUMMARY:
This proposed rule would implement provisions of the Social
Security Act
(the Act) establishing and regulating the Medicare
Advantage (MA) program.
The MA program was enacted in Title II of The
Medicare Prescription Drug,
Improvement, and Modernization Act of 2003
(MMA) (Pub. L. 108-173) on
December 8, 2003. The MA program replaces
the Medicare+Choice (M+C)
program established under Part C of title
XVIII of the Act, while !
retaining most key features of the M+C program.
The MA
program attempts to broadly reform and expand the
availability of private
health plan options to Medicare beneficiaries.
See the ``Executive
Summary'' in the SUPPLEMENTARY INFORMATION section
for an outline of the
key features of the MA program.
http://a257.g.akamaitech.net/7/257/2422/06jun20041800/edocket.access.gpo.gov/2004/04-17228.htmWell,
that sounds like fun. Try to keep your skin smooth once your wound
heals.
With Love,
CtrlAltDel aka Dave
C4/5 Complete - 28 Years Post
Texas,
USA
Lori Michaelson <[EMAIL PROTECTED]> wrote:
Since 1999 Medicare doesn't cover diddly squat when it comes to
aides. I used to get AM & PM visits before Medicare changed their
payment system to agencies.
Under MediCARE aides can do NO domestic
work. Only personal care.
Sad truth what the government
did. Sad but true.
I'm in the catch-22 life. Too much
income for Medicaid and waivers ... too little to pay for many hours I'd
like for cleaning, etc.
I've been battling for my rights under
Medicare but the agencies don't make a profit on quads or long term care
patients who need aides. My battle the last 4 yrs has gotten me
little.
For example ... call a local Medicare approved agency anf
tell them you're a quad with Medicare insurance /(even tho you aren't yet)
and ask them what they can give you re: aides. They all answer
verbatim "W! e don't have the staff or resources (resources meaning money)
to cover you."
Or call their bluff to see if they are indeed lying.
In essence, "first" call saying you're private pay and I'll bet they'll give
you what you want to hear. Then wait a week or two and call again
saying you're a quad on Medicare. You'll get a different
answer!
Lori
At Friday 9/24/2004 06:37 PM, you wrote:
I get
Medicare in a year and I was wondering how and if they cover live-in
aides?
I think they may only cover agency home care workers? Or has
anyone been able to just get a check to use the way you want to? I have a
weekday live-in, but hoped Medicare would cover a weekend person.
I
need help in the mornings and nights, but through the day I don't really
need much help.
Plus, would Medicare (NOT Medicaide) pay for house
cleaning, shoping, etc.? Or do the agency Home Health Care workers do that
as part of their help?
Thx,
Greg
