Need: Home Health agency in MI

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staceygar

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Joined
Jan 25, 2021
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1
Reason
CALS
Diagnosis
10/2018
Country
US
State
IN
City
Indianapolis
Hi, I'm new to this forum and truly hoping someone can help with this issue. My pALS, dad, lives in southeastern Michigan. He is at the point where we need to bring in more care to help (my mom does the majority, I drive in from Indianapolis every 3 - 4 weeks to stay for a week & my sister helps out as well). I have spent almost 18 hours on the phone trying to find a home health agency that can provide the home health aide assistance provided by Medicare that my dad needs (coverage details: HHA who provide personal care service for less than 8 hrs/day and less than 7 days/wk. Max coverage of 35 hrs when combined w/the skilled therapy). This has become my bible (https://ncler.acl.gov/getattachment...re-Home-Health-Ch-Summary.pdf.aspx?lang=en-US).

I'm constantly having to educate these agencies that Medicare does provide personal care services to ALS patients as long as the pALS is receiving PT.... so, I'm looking for a referral for an agency in Michigan that can provide this for my dad. Anyone have a pALS that's currently being cared for w/the home health benefit? Please share! Thanks.
 

lgelb

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Nov 5, 2009
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9,748
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Lost a loved one
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Country
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City
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Unfortunately, we have had this discussion before.The home health benefit is not the same as receiving custodial "personal" care. Despite "the letter of the regulations," the reality is that if someone is not living alone (i.e. has some kind of caregiving in place), has a time-limited program of PT or whatever the "skilled therapy" is, and has ALS, I know of no one here who has received Medicare reimbursement for home health aides without legal action (which has applied to one person I know of, who was trached). The only payor that reliably pays for the latter is Medicaid, not Medicare.
 
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