Getting help through Medicare programs

debriesea

The last few weeks I’ve been feeling emotionally fragile but hanging in there until last Thursday after my DH’s annual wellness exam. The Dr gave him the MMSE (mini-mental status exam) and DH scored 3 out of 30. I was surprised at how hard that hit me. But on a positive note, the Dr has put me in contact with Home Health, which is paid for by Medicare where I will receive a wide variety of services, including 4hrs a week respite which may increase if necessary and grief counseling, even light house keeping! . The social worker came out today to get to know me and explain all they do. 2 days ago the Home Health nurse came out to evaluate DH. Both will be back in 2 weeks.
In addition to Home Health, on Thursday my son got me signed up with Medicare’s GUIDE program, which can be used simultaneously with the Home Health. This also is along the same lines as the Home Health. I am allotted 96 hours a year (averaging 4 hrs a week) of respite care! They are sending me a tablet which I will use for Telehealth appointments, and comes with Alz educational info and videos, including Tepa Snow and others. GUIDE also provides me with what I call “My person”. Someone I can call or text anytime with whatever I need to talk about or need help with. She will be coming over next Monday to meet me.
I had no idea that all these services were available and want to share this information with all of you. I am feeling overwhelmed but in good way now. So much help coming my way. I realize states may have different programs to offered, if any. I’m in the state of Idaho.
Thank you to all here, my Alz family, who are always available to help, educate and hug. I’ve been on this site almost everyday for 3 years. This is by far the best place for caregivers to be. Big hugs to you all.

​fesk

Thank you for sharing this information. I am so glad you are getting support. I've heard of Guide but was not aware of any home health program available to people with Alzheimer's. Can you provide more information about that?

Chance Rider

@debriesea Thank you for sharing such positive news that you’ve found support while on this terrible journey.

After one appointment with my husband’s VA care team his doctor had a VA social worker call me. She explained what resources I have available, including weekly respite care and 30 day placement every year. I haven’t needed the resources yet but just knowing the support is that was a huge relief.

Thanks again for sharing. 💜

Goodlife2025

@debriesea thank you for this information. We are on the 2 year wait (with 16 months to go) until DW can qualify for Medicare while receiving SS Disability. We will not be able to afford MC so I have been holding out hope that some of the programs you mentioned will be available to us (Colorado). A real glimmer of light this morning thank you.

starwood

I’m happy you were able to access resources quickly. My DH was involved with GUIDE when it was first started, and I didn’t feel like they provided much for us. Their assessment determined he was in much better condition than he actually was, and their help amounted to a few referrals for legal help and transportation. I was hoping that their re-assessment would make him eligible for respite and in-home care, both of which were desperately needed, but we didn’t get that far. I was desperate for help and had him assessed for hospice. When he entered hospice, they said we were no longer eligible for GUIDE. Best wishes on your new journey.

SDianeL

do you have regular Medicare or a Medicare Advantage plan?

debriesea

Starwood, We are just starting the process now for GUIDE. They sent me a tablet on which we will have a Telehealth session next Thursday. I was also contacted by someone who will be my “go to” person as needed for whatever. She will be here next Monday. I’ll be cautious about getting my hopes up for this program after hearing your story.

SDaniel, We have Medicare Part A & B which is required for GUIDE.

Fesk, I’m just stating the process of what home health can offer. In Idaho they are called, “Home Helpers”.

I’m not sure how much of this is paid for by Medicare but I was under the impression that it all was.
I’ll keep you all posted as I continue on this portion of my journey.

Victoriaredux

https://alzconnected.org/discussion/comment/271082#Comment_271082

@Goodlife2025 did you look at

https://hcpf.colorado.gov/keepcocovered .

A google search of "colorado medicaid while waiting for medicare" produced a few options but there are work and income limits. An elder law attorney can help see if a type of trust etc. can help here. A consult isn't inexpensive but worth it to get specific for you options.

​fesk

https://alzconnected.org/discussion/comment/271173#Comment_271173

Thank you very much. Home Helpers appears to be a home health aide agency. It's my understanding Medicare will not cover this, but your situation may be different or perhaps something with Medicare may have changed. I will definitely look into it again.

Yes, please keep us posted on how it all goes.

SDianeL

Yes, the Guiding an Improved Dementia Experience (GUIDE) program is paid for by Medicare and is provided at no additional cost to eligible beneficiaries. It is a Centers for Medicare & Medicaid Services (CMS) initiative launched to provide comprehensive dementia care, caregiver support, and up to $2,500 annually in respite services. 


4Key Details About GUIDE Program Coverage:

• Eligibility: You must have a diagnosis of dementia, be enrolled in Original Medicare (Parts A and B), and not be in a Medicare Advantage plan.
• Cost: There is no cost-sharing or premium for participants for the services provided under the GUIDE Model.
• Benefits: Covers care coordination, caregiver education, and respite care (for caregivers to take a break).
• Duration: The model is an eight-year, nationwide initiative running from 2024 through 2032. 

debriesea

UPDATE: We had our Telehealth appointment yesterday with Medicare’s GUIDE program. We qualified! I’m now waiting to hear from them on what will be available for us. When I get more info I will share it as a new thread.
I was told that this program is just now getting off the ground as of mid 2025. It’s been in works since 2023. I highly recommend checking into it.

​fesk

Thank you for the update. I hope this proves very helpful to you. Please keep us posted.