Ohio has publicly funded in-home programs for those who cannot afford private-pay home care.
Included in such funds are senior services levies approved by voters in numerous Ohio counties. These programs are for people who can’t afford to pay for in-home services themselves, but who make too much to meet the low income limits set for Medicaid, the state-federal health insurance for the people with extremely low incomes. Some levies are specifically for seniors; in others, seniors are among the beneficiaries of human services levies.
In West Central Ohio, Champaign, Clark, Greene, Montgomery and Preble have such levies that benefit seniors. Darke, Logan, Miami and Shelby counties do not. You can ask about in-home care services through the local levy or through PASSPORT, the statewide nursing home alternative.
There are diverse ways to pay for in-home services and organizations to help find funds.
For example, long-term care insurance covers long-term care that Medicare and supplemental insurance don’t cover – if your policy includes care at home, so study the small print.
Policies specify kinds of care and conditions you must meet before the insurer will begin to pay for home care. You must have problems with several “activities of daily living” – bathing, eating, dressing, walking, continence, transferring from one place in the house to another.
For unbiased information about long-term care insurance you have or want to buy, first contact the Ohio Senior Health Insurance program (OSHIIP) at (800) 686-1578 or visit www.insurance.ohio.gov
Some medical insurance policies include limited coverage at home for certain conditions. Again, read the fine print.
There are strict rules for home-care paid under Medicare, the federal health program for people over age 65 and certain others, and Medicaid, the state-federal health program for low-income people. Some Ohio programs with home services are on a sliding fee scale; others are free.
A quick source of finding financial aid and services that you qualify for is the National Council on Aging free online program,www.BenefitsCheckup.org.
Another first-step in finding benefits and care is the Eldercare Locator, a national information and referral service sponsored by the Administration on Aging at (800) 677-1116. The Web site is www.eldercare.gov Enter your zip code or city to find your nearest Area Agency on Aging (AAA). Services vary at hundreds of AAAs nationwide, but their shared mission is to help older adults remain independent at home with unbiased information and connection to resources.
In the West Central Ohio/Dayton area, Eldercare Locator will refer you to Area Agency on Aging, PSA2, 40 W. 2nd St., Dayton, Suite 400, Dayton, OH 45402, www.info4seniors.org, (937) 341-3000 or (800) 258-7277. This is a useful central place to start finding resources, information and services for seniors and caregivers in Dayton and the counties of Champaign, Clarke, Darke, Greene, Logan, Miami, Montgomery, Preble and Shelby.
Area Agency on Aging, PSA2 offers a comprehensive range of home and community services aimed at helping seniors maintain quality independence in West Central Ohio.
It also offers a free long-term care home consultation by a nurse or social worker. You can get help finding payment sources. In Clarke, Greene and Montgomery counties, call (937) 223-4357 or (800) 258-7277. In Champaign, Darke, Logan, Miami, Preble and Shelby counties, contact Catholic Social Services of the Miami Valley/PASSPORT at (800) 521-6419
According to Medicare literature, “Medicare covers only a small proportion of the long-term care services you may need if you have a chronic illness or disability. Most importantly, it will not cover ‘personal or custodial’ care or supportive services, such as homemaker or Meals on Wheels. Medicare will pay for home care that is all medically necessary, for limited hours for a limited number of days, and, after deductibles are met, will pay 80 percent of Medicare-approved durable medical equipment – such as a walker or wheelchair. Your Medicare supplemental insurance typically pays for the remaining 20 percent once you’ve met the insurance deductibles.”
Instead, Medicare focuses on acute care rehabilitation. It pays for limited home health care requiring skilled nursing such as intravenous and medication administration and physical, speech and occupational therapies. The recipient must be homebound with a physician-approved care plan.
Medicare-certified home health agencies can’t charge more than they are paid for Medicare-approved services. They’re required to tell you in writing and verbally costs that Medicare won’t cover.
For details on the Medicare Home Health benefit in original Medicare, visit www.medicare.gov or call (800) 633-4227. Or visit www.ssa.gov or call (800) 772-1213. Other information sources are your local Social Security office or the Ohio Senior Health Insurance Information Program at (800) 686-1578 or visit www.insurance.ohio.gov
If your Medicare insurance is through a Medicare health plan or Medicare Advantage Plan, check your plan for in-home services.
The Qualified Medicare Beneficiary and Special Low-income Medicare Beneficiary programs help low-income seniors pay for some the Medicare Part A and B premiums, co-payments and deductibles.
Medicaid is the state-federal program for medical and long-term care assistance for people of all ages with very low incomes and assets. Medicaid is the main funding source for late-life care nationwide. Medicaid is the payer of last resort.
Most services under Medicaid are free – but there are strict enrollment limits. For seniors, that often means “spending down” assets, savings and income before qualifying. Total asset limits take into consideration a spouse who still lives at home. The government looks back at your financial transactions to see if you’ve deliberately divested yourself of assets to qualify.
For specific requirements, check with the Area Agency on Aging, PSA2 or your county Department of Job and Family Services or the Ohio Consumer Hotline at (800) 324-8680 or visit www.ohio.gov/odjfs
Medicaid covers such things as home health care; homemaker and chore services; care by physicians, podiatrists, optometrists, dentists, chiropractors and psychologists, hospice care, medical transportation, eyeglasses, dentures, hearing aids and prescription drugs.
Medicaid covers in-home and community-based long-term care services through several programs in Ohio, including PASSPORT (in-home care) and the Assisted Living Waiver, if you’re medically and financially eligible.
PASSPORT is Ohio’s nursing home alternative for low-income seniors age 60 or older who are eligible for Medicaid and who need skilled or intermediate health care. The goal is to prevent costly institutionalization by providing needed home services. Seniors can get help with such activities as bathing, dressing, continence, hygiene, eating, walking and moving from one place in the home to another, home-delivered meals and medical equipment. The cost is free or at an affordable level based on your income and assets. For more information, call Area Agency on Aging, PSA2 at (800) 258-7277.
ComCare is a program for seniors whose income is too high to qualify for Medicaid but who still need financial help to stay at home. Seniors in this program wouldn’t be able to live independently without help, and may or may not be impaired enough to enter a nursing home. Seniors in Montgomery County can receive a variety of services, according to need. Services are free or based on a sliding-fee scale due to levy funding. For ComCare information, call Area Agency on Aging, PSA2 at (800) 258-7277.
For other levy-funded programs, contact Champaign County Senior Citizens Center, (937) 653-
6088; Elderly United Senior Services, in Clark County, (937) 323-4948; Greene County Council on Aging, (937) 376-5486; and Preble County Council on Aging, (937) 456-4947. For similar programs in other areas, visit www.aging.ohio.gov
Home-delivered nutrition programs such as Meals on Wheels deliver a daily meal to people 60 and older who can’t fix a meal, attend a group meals center or who are homebound. Meals are free to the disabled senior and his or her spouse, but donations are welcome.
Veterans programs are complex, and the easiest way to find ones you and your family qualify for is to have a guide. Contact the Ohio Department of Veterans Services, whose benefit service officers will assist veterans with finding and submitting benefits paperwork, (888) 387-6446 or www.veteransaffairs.ohio.gov
Eligible military retirees may be covered by TRICARE For Life, an original Medicare wrap-around insurance available to all Medicare-eligible TRICARE beneficiaries, regardless of age, provided they have Medicare Parts A and B. TRICARE has a low-cost prescription benefit.
Beneficiaries also include Medicare-eligible family members and widow/widowers and certain former spouses if they were eligible for TRICARE before age 65.
Respite Care Grant Family caregivers of those with Alzheimer’s disease and other dementias can apply for a grant to get respite care only through local non-profit organizations that are members of the Alzheimer’s Foundation of America. For information and lists of member organizations, visit www.alzfdn.org or call (866) 232-8484. For more information about dementia, call the Alzheimer’s Association – Miami Valley Chapter at (800) 272-3900.