1. What exactly is long-term care?

1. Bathing- Washing oneself with a sponge bath; in either a tub or shower, including the task of getting into or out of the tub or shower with or without equipment or adaptive devices.

2. Dressing – Putting on or taking off all items of clothing and any necessary braces, fasteners, or artificial limbs.

3. Toileting – Getting to and from the toilet, getting on and off the toilet, and performing associated general hygiene.

4. Transferring – Moving in and out of bed, chair, or wheelchair with or without equipment such as canes, quad canes, walkers, crutches or grab bars or other support devices including mechanical or motorized devices.

5. Continence – The ability to maintain control of bowel or bladder function; or whenever unable to maintain control of bowel or bladder function, the ability to perform associated personal hygiene (including caring for catheter or colostomy bag.)

6. Eating – Feeding oneself by getting food into the body from a receptacle (such as a plate, cup or table) or by feeding tube or intravenously.

Yes. Medicaid will pay for long-term care, but Medicaid is welfare. Unlike Medicare, which is administered by the federal government, Medicaid is administered by state government. In Iowa, the Iowa Department of Human Services (DHS) is the state agency responsible for Medicaid. Medicare beneficiaries should visit their local DHS office, one in each county, to pick up free literature to review the Iowa Medicaid program. To give you an idea of what is considered welfare in Iowa, in order to qualify for Medicaid and have the government pay for your long-term care services, the Medicare beneficiary can have resources of no more than $2,000 (includes cash, other liquid assets, cash value life insurance, stocks, bonds, real estate, etc.) and an income of no more than $564 per month. If the Medicare beneficiary exceeds either of these two limits, the person will not be eligible for Medicaid benefits.

Your family, friends, or relatives; home health care agency; a nursing home.

Services provided by friends, family, or relatives or a home health agency are delivered in your own home where you are 100% independent. Services delivered in a nursing home renders the Medicare beneficiary 100% dependent. Between the independence of your own home and complete dependence on the nursing home, are several alternative living arrangements for Medicare beneficiaries such as independent living units, continuing care retirement communities, residential care facilities, adult group homes, assisted living facilities, etc. These out of home living arrangements provide varying degrees of health care support services. Medicare beneficiaries are encouraged to carefully read the contract and understand clearly what services the living unit provides and which services the Medicare beneficiary is responsible for.

Yes. The HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) “federalized” long-term care insurance and brought federal government regulation and oversight to long-term care insurance policies. HIPAA dictated to long-term care insurance companies that to sell a tax-qualified policy, the policy must have a claims trigger of an inability to perform 2 of the 6 activities of daily living (ADLs) or cognitive impairment requiring substantial supervision and medically certified care needed at least 90 days then the insurance premiums are deductible as a medical expense. Every insurance company in Iowa that sells a tax-qualified plan must have a claims trigger in compliance with HIPAA.

Yes. The Iowa Association for Home Care has a long-standing relationship with Mr. Shane O'Malley, Financial Consultant with Wells Fargo Investments, LLC. Mr. O'Malley has been a guest speaker at many of the IAHC quarterly meetings, has coordinated numerous benefit speeches at many member agencies and has greatly helped coordinate payment on old insurance policies for many of our current clients. He has a thorough knowledge of the long-term care delivery system, including Medicare and Medicaid, and understands the desire of Medicare beneficiaries to remain in their own homes as long as possible. Mr. O'Malley only offers products which help make this desire a reality should health conditions warrant home care services. He may be contacted by telephone at (515) 245-3422. Please inform him you are calling as a result of viewing the Iowa Association for Home Care website in order to qualify for any and all premium discounts offered.