HELP LINE: Don’t get lost in terminology

ARE WE UP for a little bit of this and that?

OK, here’s a this: You might recall I’ve been warning you periodically that next year Medicare will be issuing new Medicare cards that will have numbers that are not our Social Security numbers.

We like that.

(OK, we would’ve liked that 20 years ago, but I suppose progress is progress.)

Anyway, a sharp reader got an email from “Medicare” regarding said new card, wanting her to update her information before issuing the card.

I said she was sharp: She did not click on the link and she promptly permanently deleted the email.


Ignore scams

Medicare did not and will not do that, so if you get anything like that (or a phone call, or whatever) ignore it.

It’s a scam. The end.

This is a that: I’ve heard from a number of you for a while now about the fact that it’s easy to get lost in the words, phrases and names of things, as if all this “aging stuff” wasn’t complicated enough already.

So, let’s try to clear up a few things:

Terms to remember

• Medicare: This is federal government-run/overseen health insurance.

For most of us, eligibility is based on age, which is 65.

There are some factors that involve the number of years you might have worked and paid Medicare taxes, and some folks access Medicare before age 65 due to disability, but for most of us, most of the time, it’s about age 65.

• Medicaid: This is federal/state health insurance that is based on need plus income and assets.

In other words, it’s primarily based on how much you make and the value of any assets you own.

There are many forms of Medicaid, covering different groups of folks, e.g. young moms, elders in nursing homes or at home, etc. Think low-income.

• Dual-eligible: Folks who are on Medicare and Medicaid.

Think about it: 65 or older plus low-income.

• Long-term care: A phrase that’s been around for a long time, generally referring to someone who is going to need some degree of care for a very long time, often permanently, as opposed to someone who just needs short-term rehab, etc.

This phrase also became synonymous with nursing home care, depending upon the context.

• Long-term services & supports: The updated, currently more popular replacement phrase for long-term care that recognizes the fact that there are a lot of things that go into supporting someone who needs to be supported besides care, such as yardwork, finances, transportation, etc.

You get it.

• In-home care: Remember I said that long-term care has sometimes been synonymous with nursing home care?

Well, this simply overstates the obvious, which is that an awful lot of care can be provided in the home, which is where most of us would prefer to have it provided.

• Homecare agency: This is an organization (nonprofit or for-profit) that recruits, trains, employs, supervises and schedules homecare aides who can come to your home to provide anything from very personal care to shopping, housekeeping, etc.

Also, some agencies have nurses on staff.

These services might be paid for via private pay, VA, long-term care insurance, Medicaid, etc.

Different agencies have different rates, minimums, policies, etc. Shop around.

Home health vs. health home

• Home health: This is an agency that employs medical professionals (RNs, therapists, etc.) who can come to your home to provide medical/skilled nursing services because getting to the professionals is difficult for you, usually on a time-limited basis, usually paid by Medicare, but other payment sources might apply (long-term care insurance, VA, etc.)

Not all home health agencies are Medicare-certified, so be sure to ask that question if you’re expecting Medicare to pay.

• Health home: This is a very specific service for certain Medicaid/dual-eligible folks to help them navigate the labyrinth of health care in America.

I know.

• Full retirement age: This is a Social Security term, meaning the age at which you can collect 100 percent of your Social Security benefit (currently for a lot of us, that age is 66, but there’s a chart on the website that breaks out specifics).

Not required to start

You are not required to start collecting Social Security at that age.

In fact, if you choose to not start collecting and delay it/keep working for another four years, you can increase that benefit to 133 percent.

• Medigap/Medsupp/Medicare supplementals: These all refer to private (meaning, the feds don’t run them) insurance policies you can choose to purchase to pay all or part of the health-care costs that Medicare does not pay, which is usually 80 percent of their approved costs.

These policies are standardized, meaning all “F plans” cover the same things, etc. Again, these are not required, so it’s up to you.

• POA: Power of attorney.

• DPOA: Durable power of attorney.


Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing [email protected].

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