Transcript MEDICARE - Indo-American Association Delaware

Social Services- An Overview
The information is purely for guidance and
may not be quoted as an Authority. The
information keeps changing as per State and
Federal policies. Please contact your local State
Service Center for updated information.
Agenda
• Medicare
• Medicaid-Home & Community Based
Services
• State Programs for the Elderly
• Cost Saving Programs
Medicare Plans
PART A
PART B
Hospital Insurance
Medical Insurance
PART C Also known as
PART D is prescription
Medicare advantage plans
drug coverage provided
like HMO or PPO.
by pvt co.s approved by M
Hospital Stay
Doctor’s Visits
Private insurance
Part D too has premium
Skilled Nursing Facility
DME (wheelchair, oxygen)
plans approved by
depending on your plan
Home Health Care
Physical Therapy
Hospice
Preventive Services
Medicare.
and has late enrollment
penalty if you do not
Lower cost alternative
enroll when u r eligible. It
to original Medicare
is 10 % of the national
Part A premium for
Other Outpatient Care
those who do not
There is Late
services like dental,
For eg. For 2011, if you
have Social
enrollment penalty for
vision, hearing etc.
enrolled in 2010 when u
Security benefits is
Part B which is 10% of
approximately $443
the current Part B
premium for each 12
month period you
plan and offers more
average premium.
could’ve enrolled 20 mths
Will cover Part A and
ago, your penalty will be
Part B and may
$6.40/mth or $76.80/year
include Part D
on top of the premium.
were eligible for Part
If you are traveling out
B, but did not enroll in
of ur plan coverage
it.
area, u will still be
covered for
emergency services.
Medicaid Waiver for the Elderly and Disabled
The Medicaid Waiver Program for the Elderly and Disabled provides an alternative
to nursing home care for eligible older persons and adults with physical disabilities.
It includes services to help a person to continue living in his or her home safely.
Services included in this program are:
• Home Health Care
• Adult Day Services
• Case Management
• Personal Emergency Response System
• Respite Care
This is called the Waiver program because for this program your income can
be higher than the Medicaid limit. They provide you nursing care, help with
daily activities and much more. It can be up to 7 days a week and the number
of hours depend on the client’s skilled needs.
http://www.dhss.delaware.gov/dhss/dsaapd/medwaiver.html
Adult Day Services
Adult Day Services provides activities and assistance for people with physical
and/or mental impairments. This service is for people who cannot be left alone for
long periods of time. For example, a person may use adult day services while the
primary caregiver is at work.
For information or enrollment contact:
• Easter Seals Delaware and MD - (302) 324-4444
• Elwyn Delaware - (302) 657-5609
• Gull House - (302) 226-2160
• Laurel Senior Center - (302) 875-2301
• Modern Maturity Center - (302) 734-1200
• Newark Active Day Center - (302) 831-6774
Adult day centers provide care and social activities for
Individuals who do not require 24 hr institutional care, but
cannot live independently.
Alzheimer's Day Treatment
• Alzheimer’s Day Treatment is a program for people with
Alzheimer’s Disease or related dementia. It is a nonresidential, day program. Medical, recreational, and
personal care services are provided.
• This program can be used while you are away at work
during the day or even as a respite which can give some
relief to the caregiver.
For information or enrollment contact:
• Evergreen Center I – Wilmington (302) 995-8448
• Evergreen Center II – Milford
(302) 422-1575
• Medical Transportation
Provides transportation to health care appointments for persons 60
years old and older who live in New Castle County but outside the city
limits of Wilmington if you have no other means of transport.
Contact: WHEELS -395-5660
Generations: 658-6731
Personal Emergency Response System
• A Personal Emergency Response System is a device that allows a person
at high risk (for example an older person who lives alone and has a
health problem) to get immediate help in the event of an emergency.
•
The person who is using the system wears a button that he or she can
push if needed. The button connects electronically to the person's
phone, which is programmed to send a signal to a response center.
Trained professionals in the response center then respond to help the
person in need.
Call Div of Aging for more info @ 343-4280.
Senior Community Service Employment Program
The Senior Community Service Employment Program provides
paid, part-time work experience for eligible persons. Training
that is available through the program takes place at various
locations and is subsidized/paid for by the program. The
program also provides its participants with supportive
services; training workshops; and, help with finding
employment.
For information contact:
• New Castle Co.Wilmington Senior Center (302) 651-3440
• Kent Co. Modern Maturity Center (302) 734-1200
• Sussex Co. First State Community Action Agency (302) 8567761
Money Management
This program offers money management assistance to help low-income
seniors and adults with physical disabilities who have difficulty budgeting,
paying routine bills and keeping track of financial matters. The program’s
goal is to promote and prolong independent living for individuals who are
at risk of losing their independence due to inability to manage their
financial affairs.
Eligibility:
• Low-income seniors or adults with physical disabilities.
• To be eligible, a single person must have liquid assets of no more than
$35,000 and an income no greater than $23,475 per year ($1,956
per month).
• Couples must have liquid assets of no more than $35,000 and an
income no greater than $33,217 per year ($2,768 per month).
Delaware LifeSpan Respite Care Network
"When you care for a person 24/7, it's so nice to have time to
devote to yourself. It really helps to build you up on the
inside again!"
• Respite care programs provide relief to primary caregivers,
such as family members, who give care to someone in need.
Respite care can be scheduled once a week or can be given as
needed by the caregiver.
• Care can be provided for DE residents who are 60 or older/
with dementia or are disabled in the home or through
temporary placement in a long-term care facility, adult foster
care, or in other community settings.
Low income Home Energy Assistance Program
Help with Home Heating And/Or Cooling Bills
FOR MORE INFORMATION ABOUT LIHEAP AND WHERE TO APPLY
• You can call the National Energy Assistance Referral (NEAR)
project. NEAR is a free service providing information on where
you can apply for LIHEAP. You can speak to someone at NEAR
Monday through Friday, from 7 a.m.- 5 p.m. Call the toll-free
phone number at: 1-866-674-6327
• or send an e-mail to: [email protected]
• Or you can contact your local LIHEAP office at:
www.acf.hhs.gov/programs/ocs/liheap/grantees/states.html
Legal Services
• Delaware Volunteer Legal Services, Inc (DVLS)
DVLS screens and refers low income clients with civil cases to volunteer attorneys.
Types of cases include landlord/tenant, wills, family law, foreclosures, consumer, govt.
benefits, & personal injury defense depending on attorney availability. DVLS cannot
accept fee-generating criminal cases, DUIs , child support or medical or legal
malpractice cases. Call 478-8850 or 1-800-773-0606.
• Legal Services Corp. of Delaware
A federally funded program to provide free legal services to low-income persons.
Types of cases include consumer law, bankruptcy, landlord/tenant concerns,
unemployment compensation. Call: 575-0408
• Delaware Elder Law Program
It provides legal services to seniors in non criminal and non-fee generating cases.
Services include legal counseling and representation in appropriate court cases as well
as drafting of powers of attorney and advance health directives. Assistance is also
provided for problems related to govt. benefits such as Social Security and SSI,
Insurance or home ownership.Call:302-575-0660.
Delaware Apartment Association
Apartment Angels
Apartment Angels THP, Inc. is a Program intended to provide transitional housing
for individuals/families that have been displaced from RENTAL HOUSING.
This Program is intended to help individuals in FINANCIAL
NEED that have a history of being responsible renters, but
became victims of the current economic recession through
no fault of their own (loss of employment OR were
negatively impacted financially by a one-time, life altering
event (such as illness/hospitalization, death in the family,
military service, etc.)
•
•
PROGRAM TERMS AND CONDITIONS: Individuals that participate in the Program
will be placed in an apartment at a community in the State of Delaware.
Contact toll free @ 1-800-223-9074 for details
Project Life Saver
Bringing loved ones safe home
New Castle County Police Department
Project Lifesaver helps provide rapid response to save lives and reduce potential for
serious injury for adults and children who wander due to Alzheimer’s, Autism, Down
Syndrome, dementia and other related disorders. A preprogrammed personal radio
transmitter is placed on an individual who may wander away from the safety of their
homes.
How does it work?
• An application is completed by the primary caregiver and submitted to the NCC
Police program coordinator. Once approved, a police officer will install the unit and
train the caregiver. The mobile tracking system and search procedure will be
initiated to augment the existing search methods currently utilized by the police.
What is the cost?
• There is an initial equipment fee of $300 for the transmitter and a year’s supply of
batteries. After the original payment, there is a yearly fee of $75 to maintain the
unit.
More info contact NCC Police - Community Services Unit - 302-395-8050
Emergency Medical Services, Vial of Life
• Eligibility: All New Castle County residents
Fees: None
• Intake Process: Call @ 302- 395-8184; Packet is mailed or delivered.
• The Vial of Life program is offered to those residents that suffer from
medical disease and take medications on a daily basis.
• A form is provided on which the participant can list their medical history,
medications taken on a daily basis, and any medication allergies.
• Other information can include the family doctor, cardiologist, or other
specialist and the hospital of choice.
• The form is placed in a small medication sized container labeled Vial of
Life and is stored in the refrigerator. A magnetic card is provided to
attach to the outside of the refrigerator to indicate that the vial is inside.
• Although the vial does not require refrigeration, this location has been
chosen as it is a nearly universal appliance within the home.
• Emergency responders can access the vial for critical information when
the patient cannot speak for themselves.
Senior RollCall Lifeline, NCC Police
• Service is available to individuals over 55,
disabled individuals, and individuals with unique
medical needs.
• Fees: None
• To enroll Call Senior RollCall Lifeline
@ 302- 395-8159
• Senior Rollcall Life Line is reliable, daily telephone
reassurance for seniors in New Castle County.
Senior RollCall checks on subscribers’ safety daily
through a computerized telephone system.
Senior Centers in Delaware -Social Services
• Eligibility: Ages 50 years and older or disabled
• Fees: Nominal membership fee
Call toll free # for info @ 1-800-223-9074
• Social services include money management, blood pressure
screening, legal aid and information and referral.
• Center also provides a variety of recreational, enrichment
and wellness programs including handcrafts, painting,
dance exercise, games, trips, choral group and senior
players group.
• Provides transportation to doctor’s appointments for frail
members and to and from the center.
• The Centers also sponsors support groups for stroke
survivors and for individuals with Alzheimers disease,
arthritis, fibromyalgia, or diabetes.
Community Services - New Castle County
• Eligibility: Senior citizens and physically disabled adults unable to arrange
for services; financial eligibility varies
• Fees: None
• To register Contact Community Services @ (800) 223-9074
• The Community Services program develops care plans for the evaluation
and treatment of senior citizens and adults with physical disabilities who
are unable to arrange services on their own behalf.
• Community Services assesses needs and coordinates the delivery of
services for Homemaker Services, Adult Foster Care, Attendant Services,
Personal Care, housekeeping, Emergency Response System, Assisted
Living, home delivered meals, general case management and the Elderly
and Disabled Medicaid Waiver Program.
• Community Services also administers the Home Modification Program.
This program provides limited financial assistance to help modify homes
so that eligible adults age 60 and over or disabled adults may live
independently.
YWCA, Home-ownership Education
•
•
•
Eligibility: Low to moderate income families moving towards home ownership
Fees: None
Intake Process: Call 302-224-4060
• Helps low-income families with a program of intensive oneto-one counseling to ready themselves for home-ownership.
• Provides free counseling on Reverse Mortgages for senior
citizens.
• Reverse Mortgages are programs to help seniors, who own
their own homes and need added income, to take advantage
of the equity they have built up without having to leave
their residence.
CARE Delaware- Caregiver Information
• Eligibility: Family members, friends, adults who help take care of older
persons 60 and older or older relatives 60+ caring for children
• Fees: Some programs are free, some offer sliding scale fees
• Intake Process: call or email the Delaware Aging and Disability Resource
Center @ (800) 223-9074 or 302-391-3505
• CARE Delaware: Caregiver Assistance-Respite-Education is a program
offered by the State.
• One of the services offered within this program is called Caregiver
Information, Needs Assessment, Care Planning. In this program
experienced employees within DSAAPD will assess caregivers’ needs,
assist caregivers in gaining access to services and care planning, and
conduct outreach in the community.
Cost Saving Programs
•
CHAP (Community Healthcare Access Program)
Delaware’s Community Healthcare Access Program is an insurance-assistance program that helps
low income Delaware residents without insurance get the medical care they need. CHAP will help
link you to doctors and other health resources. Call 1(800) 996-9969 & option 3.
If eligible for CHAP all the tests will be 100% discounted and when approved for CHAP, finance
office will go back one year from the date of CHAP or CCHS Charity eligibility.
• Screening for Life
Screening for Life provides payment for cancer screening tests (breast, cervical, prostate and
colorectal). You must be 18 or older and meet income guidelines. Call 1-800- 464-4357.
• Low-Cost Prescriptions
Some medicines can cost as little as $4 for a month’s supply at stores like Wal-Mart, Costco and
Target if you buy the generic brand of that drug. Ask your pharmacy about their generic program
or access it at needymeds.com, rxhope.com etc.
• Emergency Medical Diabetes Fund
This program provides “emergency” assistance to persons with diabetes with or without
Insurance to cover the cost of medicines, testing supplies and other diabetes related items
up to $400.00 per person per year. Call the Delaware Diabetes Coalition at 302-744-9267.
Prescription Saving Cards
(1) Pfizers Share Card Program is for people 65 or over who are enrolled in
Medicare, have no prescription drug coverage and have a yearly gross income
of less than $18,000; $24,000 gross income for couples. $15.00 per
prescription for 30 day supply. Call 1-800-717-6005. (Available @ Walmart)
(2) http://www.unarxcard.com/index.php to get drug pricing and local
pharmacy information. Not much of a discount on the brand name RXs but
some of the generic drugs are quite reasonable. You can Shop/Compare to
show all of the pharmacies close to your zip code, which is pretty useful.
(3) The Together RX Access Savings Card, call 1-800-250-2839 for eligibility.
This card gives savings of 25-40% on many meds - ADHD, Asthma, Diabetes,
etc…the card allows for savings right at the pharmacy counter.
(4) New Castle County also has a Free Prescription Discount Card. This is a
free card that can be used for discounts on meds NOT covered by insurance s.
Its an average of 20% discount on medications. No Enrollment form, no fee,
one card, immediate use. Call 1-877-321-2652 more information.
Delaware Healthy Children Program
If you can’t afford medical insurance for your child & you don’t qualify for Medicaid
The Plan covers:
Doctor’s visits and regular checkups, hospital care, lab and x-ray services, specialists,
prescription drugs, eye exams & glasses, speech and hearing therapy, dental benefits,
behavioral health services, drug and alcohol services, and more.
It’s Affordable!
The monthly cost for this health coverage is just $10, $15, or $25, depending on your
family’s income. And, the cost is the same no matter how many children are in your
family. There are no deductibles and no co-pays. Call 1-800-996-9969 for more info.
Mental Health Services for Children
Private insurance and Medicaid providers can be located by calling the number on the
Insurance card. Division of Child Mental Health Services serves uninsured children
and provides a range of mental health and substance abuse treatment programs
statewide beyond outpatient services, including a 24-hour crisis service.
In NCC, call 302-633-5128 or 1-800-969-4357.
Community Resources for Mental Health
No Insurance:
• Community Mental Health 778-6900
• Mobile Crisis 577-2484 800-652-2929
• Catholic Charities 656-0651 (sliding scale)
Medicare :
• Community Mental Health 778-6900
• Catholic Charities 656-0651
• Meadowwood 328-3330 (for IOP, Partial and level of care assessment)
• Rockford Center 24 hour assessment center 996-5480 or 866-847-4357
Medicaid:
• Connections 984-3380
• Catholic Charities 656-0651
• Meadowwood 328-3330 (for IOP, Partial and level of care assessment)
• Rockford Center 24 hour assessment center 996-5480 or 866-847-4357
Outpatient Psychiatry Practices:
• Allied Behavioral Health (Newark) 832-1282 –also does Dual Diagnosis counseling
• Christiana Counseling 995-1680
• Harmonious Minds 633-6001
Commercial insurance: Call the behavior health number on the back of their insurance
card and suggest that they talk with a “live” care manager.
Drug and Alcohol
No Insurance:
• Brandywine Counseling 472-0381
• Kirkwood Detox: 691-0140
Medicaid:
• Brandywine Counseling 472-0381
• PACE 999-9812
• Open Door 731-1504
• Meadowwood 328-3330 (assessment for level of care)
Medicare:
• Open Door 731-1504
2-1-1 Connects Delawareans with Health and Human Service Providers
• The 2-1-1 service links callers to service providers who can assist with
such issues as rent assistance, food banks, affordable housing, health
resources, mental health resources, child care, after-school programs,
care for senior citizens, financial assistance, legal assistance, job training
programs, and much more.
•
2-1-1 is available 8:00am - 8:00pm, Monday - Friday.
IMPORTANT: The 2-1-1 number is NOT a replacement for 9-1-1.
Remember to use 9-1-1 for life and death emergencies.
•
• United Way of Delaware
625 North Orange Street
Wilmington, Delaware 19801
302-573-3776
Delaware Aging and Disability Resource Center (ADRC)
1-800-223-9074
[email protected]
The ADRC is a one-stop access point for information and services for older persons
and adults with physical disabilities throughout the State.
Options Counseling: Help with understanding options and deciding which services best
meet your needs
Service Enrollment Support: Help with getting the services and supports that match
your needs and preferences
Caregiver Information and Support / Brain Injury and Coma Information – Money
Management Program - Senior Medicare Patrol Program - Support for Grandparents
Raising Children – Training Opportunities for Professionals
Download a copy of the Guide to Services for Older Delawareans and Persons with
Disabilities? Obtain a living will? - Find out about assisted living facilities and nursing
homes in Delaware? Find out about Medicare Part D (for Prescription Drugs)? - Get
help if I don't understand my health insurance?
Services for uninsured
Uninsured needing medications can use ST CLARE VAN:(302-575-8266) to
get free samples of medications for diabetic, cardiac and chronic diseases).
• Connections -free clinic for psych meds. Call 302-984-3380
• Horizon House Echo Center Outpt Psych –Call 302-266-3246
Resources for Eye glasses and Dental Services
• http://www.neweyesfortheneedy.org/forms (Eye glasses for uninsured)
• http://www.zennioptical.com/ (very affordable- can order by phone)
• DE Hope Dental Clinic- www. Delawarehelpline.org ph# 735-7551
(non emergency- extraction, restoration, filling, pain relief 18-65yrs).
• Wilmington Hosp Dental Dept- www.christianacare.org ph# 428-4850
($40 for routine services, for non routine – discounted fees).
• Pierre Toussiant Dental Office- www.ministryofcaring.org ph# 652-8947
($84 for initial visit- call for apptmt for 19 to 65 years old)
Henrietta Johnson Medical Center: http:/hjmc.org/dentistry/html-655-6187
Based on income level - $50 min payment- Ages 3 and up.
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