What is ALTCS?

MEDICAID/ARIZONA LONG TERM CARE SYSTEM

            Since 1982, Arizona has participated in the Medicaid program through the operation of the Arizona Health Care Cost Containment System ("AHCCCS") under a federal waiver allowing payment of federal Medicaid dollars into our homegrown version of a managed care program.  In 1987, the state legislature added long term care services to the AHCCCS program by establishing the Arizona Long Term Care System ("ALTCS") for Medicaid-eligible persons who are elderly (over age 65), or physically or developmentally disabled.  As a result, ALTCS is a separate division of AHCCCS, operating under Medicaid long term care rules.  Although the names are different, it is correct to say that ALTCS is Medicaid. 

            Benefits available under the ALTCS program range from home care services and assisted living to care rendered in an adult foster care home or skilled nursing facility.  Because ALTCS is a needs-based program, a person must be both medically and financially "needy" before long term care services are rendered.  

Why having a Trust is better than a Will

A Revocable Trust dictates how your want your property to be handled while you are alive as well as distributed after your death.  If a person dies without a Trust, there could be a probate to determine how to distribute your estate.  This can become a lengthy and costly process.  Having a Last Will and Testament in place can help the courts determine how to make distributions, but it does not avoid the probate process.  The probate process validates the Last Will and Testament if one exists, however this process allows public access to the deceased’s estate and it opens up the estate’s distributions for public viewing.   That is why you should not only create a Will but a Trust as well.  If set up properly, the Revocable Trust will not go through the probate process, this is because the owner of the property (the Revocable Trust) did not pass away, just the person in the role of the Trustor or Grantor (you).  The successor Trustee will be able to step in and handle the affairs of the Trust, including the distribution of the assets.

Most families like to use Trusts to minimize inheritance taxes that can be associated with the transfer of assets from parents to children or grandchildren.  A Trust also allows parents to remain in control of their assets and decide on the distributions amounts and place age restrictions on the beneficiaries as to when they receive the assets.  It can also ensure providing for family members who are disabled.  Some Trusts can be created for the purpose of protecting assets and build lasting framework for the family’s wealth.  The key to a successful Revocable Living Trust is to create one that best suits the family’s needs and one that will function properly over time and ensure to fulfill the wishes of the Trustor.  For more information on creating your Revocable Trust, call the Dana Law Firm.

Ask the Expert series focuses on family pets - Your West Valley News: Elmirage

Ask the Expert series focuses on family pets - Your West Valley News: Elmirage

Home health care

I met with the owner of the Phoenix Non-Medical Home Care agency and found that:

 

All ComForcare employees are given complete criminal, driving, and sex offender checks. Candidates are drug tested prior to hire and randomly throughout employment. In addition, all employees take a skills and ethics exam and are personally interviewed by executive staff. ComForcare also carries general liability and worker's compensation insurance.

If you know of someone in need of services, please call 623.934.2722

 

It is one of the most important factors in making decisions for your loved one.

 

 

Senior Fraud and Abuse

Medicare Fraud

This information is provided via the Area Agency on Aging Region One located in Maricopa County.  Call the 24-hour Senior HELP Line for more 602.264.4357 or 1.888.264.2258.

Every 3 months, a Medicare summary notice is mailed to you.  It is not a bill.  It is a list of the claims billed to Medicare on your account.

Look for any possible mistakes:

The Medicare Number.  Are the last four digits yours?
The Date.  Did you have a medical service that day? Note: a test might have been done on a different day than when you had it.
The type of Service.  Is this what you had done?
The Provider Name.  Is this who provided the service or medical supply? May have a different name if seen by a specialist or what you call the doctor or hospital.
The Address.  Is this where you received the service?  The address shown will be where the bill comes from.

Call your doctor, hospital, or supplier right away if you have questions.  Ask them to explain payments.

How can mistakes happen?  Your Medicare claim is submitted twice or the wrong code is entered, indicating you had a more expensive test.

How can "fraud" happen?  A criminal uses your Medicare number to file fake Medicare claims.  If your wallet or mail is stolen or if someone phones or visits you pretending to be from Medicare and you give them your Medicare number.

A dishonest health care provider bills Medicare for more services than you received.

What you can do.

Understand what Medicare covers, read your Medicare Summary Notice or ask Area Agency on Aging to send you a SMP (Senior Medicare Patrol) Personal Health Care Journal to write down all your medical visits.  Compare that to your Medicare Summary Notice or Explanation of Benefits.

Only give your Medicare number to trusted sources.  Guard it like your Social Security, credit card and bank account numbers.  Do not carry in your wallet.

Please take care of yourself and your identity.

Questions about Medicaid (ALTCS/Arizona Long Term Care)

I recently met with a family and they had some very good questions not normally asked.

1)  How long is the ALTCS approval for?

Answer: as long as the client continues to meet the financial & medical criteria.

2)  Does ALTCS take all of the client's money?

Answer:  No & yes, it depends on where the client is going to reside will determine the cost of care

3)  What happens if client lives in a community that accepts ALTCS but does not like it, can she/he move?

Answer:  Yes, as long as the other community is an ALTCS approved home, case manager approves the home and the new home accepts the client.

4)  Is it true that Dementia/Alzheimer's patients automatically qualify for ALTCS?

Answer:  No, it helps to have a diagnosis (ALTCS uses scoring system) but it does not automatically qualify a person.  They still have to meet or exceed a combination of functional & medical factors as established by the Preadmission Screening process completed by ALTCS.  The applicant must need long term care at a level of care comparable to that provided in a nursing facility.

Importance of making pre-arrangements

Most people get offended when you ask if they have made any type of arrangement for a funeral or cremation.  Most say they do not want to think about it or they will let the family take care of it.

I wish they would understand the undue stress that they are leaving their loved and the financial hardship they could possible have.

People don't come to a funeral because someone died...
They come because someone lived!

Celebrate your life and let the ones you love know instead of having them guess.

Medicare Fraud