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This is an important question and a gap in the current bill. It doesn't specify which parts of Medicaid has to take cuts in the future. So if Medicaid only has 10 dollars to dole out, who is determining that it goes to Unemployed Lazy Joe or Grandma? As far as I can tell, it's first come first serve as soon as you get qualified. I think some structure around that would at least make some people here feel a lot better about it.
If they cut medicaid states will probably be contemplating the same kind of cuts that Oklahoma is considering:
"Some of the programs and benefits being considered are pharmacy, behavioral health, durable medical equipment, the breast and cervical cancer treatment program, the waiver-funded Medically Fragile program and Program of All-inclusive Care for the Elderly, private duty nursing services, adult organ transplants, dialysis, hospice services, physical and occupational therapy, and speech, hearing and language disorder services."Premiums under the Senate Better Care Reconciliation Act | The Henry J. Kaiser Family Foundation
yep, you read it right..they are considering eliminating dialysis for medicaid patients
Same place the money to fund the trillion dollar tax cuts to the rich come from, but why doesn't that bother you?
Cutting previous tax hikes isn't money being funded.
So you want to increase taxes on those who have applied themselves to generate income, already pay the most taxes and most likely create income for others to pay for an increase in social services.
Did you even read your own link? Medicare begins covering dialysis on the fourth month of treatment. Who's paying for month 0-4? They only pay at the beginning IF you're imminently about to get a kidney transplant (hope you have someone willing to give you one as soon as you need it) or you are all trained and ready to do self-dialysis. Self-dialysis should be easy right? Well, you better have the up front money to do some plumbing or electrical reworking on your home and buy the supplies needed to accommodate it and have a loved one who can help you do it each time you need it.
Yes, conditions apply (like every other program out there) with Medicare coverage of ESRD patients, and specific conditions apply to qualify for coverage in the first four months, so if a patient is not willing or able to learn home dialysis, has not yet received or is not on the top of the list for a kdney transplant in that time, he will have to wait for Medicare coverage, but he will qualify for Medicare, most likely, after that time.
In the meantime, and in addition to the Medicare, there are many resources available to help a patient with ESRD on dialysis, not only financially, but socially, and also to help the patient maintain his health, to make adaptations to his home and lifestyle to accomodate home dialysis, peritoneal home dialysis if the patient wishes and is able to go that route (it's always the patient's choice, assuming he is able to do it).
Additionally, each dialysis center employs personnel specifically tasked with ensuring that each patient has and is able to access the resources available to him to meet his needs and maintains his health as he can. These include a dietician, at least one master's degree level social worker, nurses, and a medical director (these are all mandated by the federal government), and each patient is evaluated regularly to make sure he does have what he needs. One of the goals of a dialysis center, and anyone else involved in end stage renal disease, is for patients to have kidney transplants if they are able to, and they''re encouraged to this goal.
I think Medicaid will try to shift more people who need help but not skilled nurses to home health care. It's way cheaper, the patient usually gets better care, it allows family members to be paid caregivers so they aren't going broke caring for families.
I work as a live in caregiver through the Medicaid program. I earn about 6.5k per month. The agency gets about $750. So for about 7k/month, the patient gets 24 hr semi skilled care. She's completely bed bound with vascular dementia. She'd have a million bedsores in a nh bc cnas have a lot of clients per shift and she wouldn't be moved enough. She also has to be fed, cnas don't have an hour to feed one person.
Even if you have a nurse coming 1-3x a week, the cost is still less for Medicaid.
Eta I live in New York City metro so my wages are probably higher than other areas.
I think Medicaid will try to shift more people who need help but not skilled nurses to home health care. It's way cheaper, the patient usually gets better care, it allows family members to be paid caregivers so they aren't going broke caring for families.
I work as a live in caregiver through the Medicaid program. I earn about 6.5k per month. The agency gets about $750. So for about 7k/month, the patient gets 24 hr semi skilled care. She's completely bed bound with vascular dementia. She'd have a million bedsores in a nh bc cnas have a lot of clients per shift and she wouldn't be moved enough. She also has to be fed, cnas don't have an hour to feed one person.
Even if you have a nurse coming 1-3x a week, the cost is still less for Medicaid.
Eta I live in New York City metro so my wages are probably higher than other areas.
Except some states, like Missouri and Kansas, are cutting home health care. That is what is keeping many people out of nursing homes. They say it will save money. It costs $31,000 a year for home health care in Missouri but put the same person in a nursing home, the cost goes to $85,000 a year. Their math is not too good.
I think Medicaid will try to shift more people who need help but not skilled nurses to home health care. It's way cheaper, the patient usually gets better care, it allows family members to be paid caregivers so they aren't going broke caring for families.
I work as a live in caregiver through the Medicaid program. I earn about 6.5k per month. The agency gets about $750. So for about 7k/month, the patient gets 24 hr semi skilled care. She's completely bed bound with vascular dementia. She'd have a million bedsores in a nh bc cnas have a lot of clients per shift and she wouldn't be moved enough. She also has to be fed, cnas don't have an hour to feed one person.
Even if you have a nurse coming 1-3x a week, the cost is still less for Medicaid.
Eta I live in New York City metro so my wages are probably higher than other areas.
It's the NHTD program in NY state? They have a TBI program, too. Both are great programs. I worked in an agency for a year in NY state that trained the PCA's for the programs.
It's the NHTD program in NY state? They have a TBI program, too. Both are great programs. I worked in an agency for a year in NY state that trained the PCA's for the programs.
If you are getting the workers through an agency then you will get a PCA or HHA. I work through the consumer directed waiver. It's called CDPAP in NYS. The consumer or their POA (in my case since she's not competent) hires you and is your boss. I'm technically an employee of the agency but they only act as a compliance and fiscal intermediary. They cut my checks, make sure my shots are up to date and visit every 6 months to check on things. The CDPAP allows family members and friends to care for the person. The only limitations are the spouse,POA or parent of a minor can't be paid. If I'm reading the Medicaid payment schedule correctly, the agency gets about $760/month off of this particular case. However, I'm a 24/7 live in so if she had more caregivers, they would get more money. Not sure if them paying less in employment taxes and other things offsets it. I do know that when I started, their CDPAP department was only one lady and now there's 4, so I guess more people are using it. I also see them constantly advertising for PCA training and hiring.
Yes, conditions apply (like every other program out there) with Medicare coverage of ESRD patients, and specific conditions apply to qualify for coverage in the first four months, so if a patient is not willing or able to learn home dialysis, has not yet received or is not on the top of the list for a kdney transplant in that time, he will have to wait for Medicare coverage, but he will qualify for Medicare, most likely, after that time.
In the meantime, and in addition to the Medicare, there are many resources available to help a patient with ESRD on dialysis, not only financially, but socially, and also to help the patient maintain his health, to make adaptations to his home and lifestyle to accomodate home dialysis, peritoneal home dialysis if the patient wishes and is able to go that route (it's always the patient's choice, assuming he is able to do it).
Additionally, each dialysis center employs personnel specifically tasked with ensuring that each patient has and is able to access the resources available to him to meet his needs and maintains his health as he can. These include a dietician, at least one master's degree level social worker, nurses, and a medical director (these are all mandated by the federal government), and each patient is evaluated regularly to make sure he does have what he needs. One of the goals of a dialysis center, and anyone else involved in end stage renal disease, is for patients to have kidney transplants if they are able to, and they''re encouraged to this goal.
That is a huge joke...why don't you call all of those resources and find out how much help is available? If there was an option to medicaid for dialysis seniors would not be spending down their assets to qualify for it.
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