Have you reached a roadblock in finding that perfect assisted living facility? Perhaps you’re looking because you can no longer care for a loved one or maybe you’re considering a facility for yourself; the search for just the right kind of assisted living or even retirement facility is hard enough, but it’s made much harder when trying to wrangle the legalese and wording that come from trying to understand how to pay for these types of communities.
If you’re a resident of New Mexico, you may be familiar or have just discovered that the average cost of assisted living is between $2,200 to $3,500 a month, usually based on the type of assisted living that you may decide on. This price is determined by the facility and usually include certain features, like nursing care, activities, and even a dementia/Alzheimer’s care facility, but with these added features, the cost of a community can easily rise, which put many family in a quandary as to how they are able to pay for the expenses.
The CoLTS Program
Luckily, residents of the state are provided with the Coordination of Long Term Services or CoLTS, a program that manages health care and long term services for certain Medicaid recipients. The program has several different managed care organizations that help to manage all doctor visits, hospital services, prescriptions, and more that are usually covered by Medicaid, with patients being able to choose between two groups of managed services – Evercare and AMERIGROUP.
The program is considered a waiver, which can help provide the extra features for patients that they may not be able to get with a chosen assisted living facility. CoLTS-C is able to serve those patients who are aged, blind, or disabled, providing them caregiver services within the home, deliver adult day health, respite care, emergency response, and of course, assisted living. More about the program can be found here.
Eligibility for CoTLS is based on those individuals who are receiving personal care option services, on the home and community based waiver (what was formerly known as the D&E wavier), receiving Medicaid and Medicare, and in a nursing home. Speaking with a CoLTS service coordinator can help determine if you or your loved one is eligible for the program and how it can help with expenses that may not be provided by an assisted living.
New Mexico MEDBANK
Due to the impact of the economic downturn within the United States, many Americans are unable to afford or pay for medications and while the percent of those who are uninsured continue to decline, however the percentage of adults who are 65 years and older is still at 2.2%, with the whole of the American public at 15.9%.
Though the numbers look smaller on paper, there is still the issue of those who need medicine in order to control certain illnesses or diseases, not including medications for regular illnesses such as colds and the flu. Again, there is a program that can help those that are uninsured receive medications – the MEDBANK (pdf). This program is available for any resident of New Mexico who doesn’t have prescription drug coverage or have used all benefits through drug company assistance.
The MEDBANK is partnered with several different companies that have offered prescription coverage for those that are low or middle income, need their medication that treats a chronic illness, and are not eligible for other types of assistance; the cost is free or there may be a small co-pay during visit. Along with these features, the MEDBANK also offers emergency drug assistance vouchers, in the case that patients are unable to wait for prescription assistance program approval.
Many of those who search for assisted living for their loved one or themselves have been proud members of our military, however many of them don’t take advantage or even know about assistance that is providedfor those who have served for our country.
Any veteran who is receiving a VA pension or is a survivor and receiving a VA death pension may be eligible for an aid and attendance benefit. These benefits can sometimes add up to $700 a month ($500 for those on death pension), which can sometimes be an essential point when it comes to paying for assisted living. Eligibility for these benefits includes a veteran or survivor who requires regular daily living assistance, including bathing, feeding, getting in or out of bed, using a prosthetic device; they are bedridden; they are a patient in a nursing home; or they are blind.
Applying for VA aid and attendance or the similar housebound benefits requires contacting a VA regional office where the veteran or survivor lives; if you don’t know where an office is near you, you can check theUS Department of Veterans Affairs for locations, as well as getting more information. When you apply for the benefits, you will need a report from the primary care doctor that describes the veteran’s or survivor’s condition and the need for the benefits, a VA health system ID number (only if the vet or survivor is using VA medical care), and a report from any home care agency, aide, or physical therapist that regularly assists the individual with their daily activities.
Where Do I Start?
This may seem like a lot of information, especially in lieu of the initial search and research it takes to looking for and finding an assisted living community. The first place to start is to identify whether or not an assisted living facility is something you or your loved one needs; this may be a difficult decision in itself, but the overall consideration is how this may help or hinder the individual you’re thinking of. Assisted living facilities aren’t nursing homes and many of them take the approach of providing environments that remind many residents of being within their own homes and having the freedom they used to have when they were younger.
The next step is to see what types of assistance or aid you or your loved one is able to receive should a move to an assisted living facility. It’s important to know and remember that Medicaid sometimes does not cover assisted living! Be sure to check all of the available help and assistance to see where they can help cover or offset the costs, which also helps in the critical decision of choosing a facility.
Because there are many assisted living facilities within the state of New Mexico, being able to look inside a community without needing to visit can make the difference between looking at one hundred facilities and checking out five facilities. Many assisted living communities have virtual tours that can be viewed on a computer or tablet, that go over the design, environment, and sometimes even residents of the community.
Copyright � 2014 By Regina Woodard
Article by Regina Woodard exclusively for Assisted Living Directory
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