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Q&A: Medicare supplements, rent rebates and transportation among top issues

The Centre County Office of Aging provided the following list of frequent questions people ask and the answers the office provides.

Q: What insurance do I need to have besides Medicare?

A: Medicare is not designed to be a full coverage program. Most people need to get a drug plan (Part D) and you should consider a Medicare supplement or a Medicare Advantage plan to cover additional costs.

Medicare supplement plans work with Medicare. Medicare Advantage plans are contracts that are primary insurance such as an HMO, Preferred Provider Organization or a Private Fee For Service Plan. The best plan for you is based on your individual situation.

You can call Apprise at 800-783-7067 to discuss the options.

Q: How do I get home delivered meals?

A: Home delivered meals are designed for people who are not able to prepare a meal, are homebound and have no one to prepare a meal for them. Meals are delivered three or more days a week, with a cold meal provided for the other weekdays. A caseworker or the program director completes a home visit and a short assessment to determine eligibility. In the State College Area School District, call 237-8135; all others, call Centre County Office of Aging at 355-6716.

Q: My mother’s doctor said she needs around-the-clock care. Do you provide that?

A: There is no public funding for 24-hour in-home care. Many home care agencies are available to provide 24-hour service, although it is paid for by the customer. There are various options to consider when someone is said to need 24-hour care.

An assessment can determine whether a person needs constant monitoring or help throughout the day. There are programs through the Office of Aging and the Department of Public Welfare that may help to cover some of the time needed. An assessment and a financial application are required. For more information, call the Office of Aging.

Q: Can I get help with my property taxes?

A: The Property Tax and Rent Rebate Program is designed to assist taxpayers with adjusted incomes below $35,000 with property taxes. This is provided through the Pennsylvania Lottery. To receive a rebate, the taxes must have been paid for the prior year.

Typically the maximum rebate is $650. In certain situations where the property tax exceeds 15 percent of income (up to $30,000), there may be a supplemental payment.

Q: My mother needs to go to a nursing home. Will Medicare pay for that?

A: Medicare does not typically pay for nursing home care, although rehabilitative care in nursing homes is often paid for by Medicare. Most nursing home care is paid for by private funds such as pension income, savings, Social Security and by Medical Assistance. Medical Assistance has very specific eligibility guidelines and rules about transferring property or financial resources. It is best to consult an attorney experienced in Medical Assistance planning before making any changes to your mother’s financial portfolio.

Q: How do I know what kind of care my father needs? He is getting more confused and is not eating right or taking his medications.

A: If you have noticed a decline in your father’s ability to manage on his own, a visit to his doctor is in order to rule out any acute illness that could be causing problems. Following that, an assessment can be completed by the Office of Aging to determine a level of care. This will help to direct you and your father to facilities or services that are most appropriate for his needs and preserve his resources by paying for care that is necessary, but not excessive.

Q: What is the difference between a nursing home and assisted living?

A: Nursing homes or nursing facilities are licensed by the Department of Health. Residents of nursing facilities have “an illness, injury, disability or medical condition diagnosed by a physician and the individual requires care and services … that are either skilled nursing or rehabilitation services as specified by Medicare or health-related care and services which are needed and provided on a regular basis in the context of a planned program of health care and management.”

Assisted living is a relatively new licensure category in Pennsylvania and is licensed by the Department of Public Welfare. The requirements for physical space and kitchen access are different from personal care. The residents are functionally very similar, however, in assisted living, a person can remain even if he or she needs a higher level of care with appropriate care planning. There are no assisted living facilities in Centre County.

Facilities that are often called assisted living are actually licensed as personal care homes by the Department of Public Welfare.

A personal care home is “a premise in which food, shelter and personal assistance or supervision are provided for a period exceeding 24 hours, for four or more adults who are not relatives of the operator, who do not require the services in or of a licensed long-term care facility, but who do require assistance or supervision in activities of daily living or instrumental activities of daily living.” The public funding for nursing homes is through the Medical Assistance program, Medicare, long-term care insurance and private funds. Public funding for personal care homes is through a limited personal care home supplement or private funds and long-term care insurance.

Qualified veterans/dependents may also receive funding in both personal care and assisted living. Private funds are the primary source of payment for assisted living.

Q: Do you provide housecleaning services?

A: Due to funding limitations, the Office of Aging does not pay for housecleaning services. However, there are many excellent home-care agencies in the community that provide the service for private, paying customers.

The Office of Aging can send you a list of agencies.

Q: How can I get transportation to the doctor’s office?

A: We are fortunate in Centre County to have CATA bus service, CATARide service, and the Centre County Office of Transportation. The Pennsylvania Lottery helps to underwrite some of the costs for transportation. If you are 65 or older, you should contact the CATA office at 238-2282 to receive an ID card to use CATARide or the free bus service. For areas of Centre County not served by CATA, riders ages 60 and older should call the county Office of Transportation at 355-6807.

Q: My mother is falling in the house. What services are available for her?

A: As mentioned earlier, it is a good idea to have your mother visit her family doctor to rule out any undiagnosed health conditions that may be contributing to her falls. Consider an assessment and discussion of safety at home and possibly a personal emergency response system to allow her to call for help in the event of a fall. It is difficult to make a judgment on next steps without more information from her doctor.

If she is alert, she will have some opinions on her needs. It may be an appropriate time to discuss personal care homes with her.

— J.R. Reed, acting director, Centre County Office of Aging

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