Friday, April 29, 2016

Medicaid in Washington State: Application Tips

Fifteen years ago Medicaid applications were a snap. You picked up a paper application at a DSHS office.  Or at an assisted living community or nursing home. You filled it out based on your aging parent's information, submitted it to the same office with documentation, and waited....

Not so today. My friend Gary is applying on behalf of his mother for COPES, the assisted living version of Medicaid.  It's similar to the nursing home Medicaid program but provided in a lesser care setting. Gary went on line, googling a number of phrases that might work:  applying for Medicaid in Washington State, Medicaid application, on-line Medicaid application, etc.

No dice. Gary called me.  After a few minutes of frustration, googling in vain, I suggested that he go to the DSHS office to get one.  "I'll have to take a couple of hours of work to do that," he said.  True.  We both agreed there had to be a better solution.

Ta da!  Two online documents, "Questions and Answers on Medicaid for Nursing Home Residents" and "Questions and Answers on the COPES Program," both published by Columbia Legal Services, have the Medicaid application process on their front page. 

Apply online for both programs at   The page is general, not specific to Medicaid.  Complete the profile, answering the questions as if you were your parent.

Or obtain a paper application online for both programs at Washington Apple Health Application for Long-Term Care/Aged,Blind, Disabled Coverage.  I'm not sure why long-term care coverage is named Apple Health.  But it is.

And you can still obtain a paper application at a DSHS office.

Good luck!

Tuesday, April 19, 2016

To Move, or Not to Move: A Multifaceted Quesion

You and your aging parent have started talking about the possibility of moving from home.  But when is a good time?

Here are some choices:

1.  Don't move at all.  Approximately 92% of today's seniors say they never want to leave their home.   They have their stuff, their schedule, their neighborhood.  Home care works well for many, if their needs can be scheduled, such as a shower at 10 am and meal preparation beginning at 11:30 am.  Home care costs roughly $30 an hour for a four-hour shift. As care needs rise,  so do the costs  (home care in the Seattle area runs about $325 for a 24-hour shift.)  At some point, usually 6-8 hours of care a day, staying at home becomes more expensive than moving to assisted living or an adult family home.  For some people, the cost is worth the comfort and the security of one on one care.  If an elder has dementia, however, home care may not be safe unless there is a caregiver in the home all day or possibly 24/7.
2.  Move earlier while in good health.  A certain segment of the senior population moves to a simpler lifestyle in a retirement community while they can still enjoy the activities, trips and socialization, knowing that help is available as their needs change.
3.  Move for the sake of a caregiver spouse.  Caregiving causes stress to soar.  Often a caregiving spouse blossoms when the couple moves to a retirement community or when the ill spouse is placed in care. The caregiver spouse can now get away for activities and fellowship with others.  Their domestic duties are fewer now, as are their responsibilities for their spouse's care. The well spouse drops the caregiver role, allowing him or her to focus on the relationship.
4.  Move following a medical emergency, such as a hospitalization, or because a physician says 24-hour care is needed. 

There's no magical time, but circumstances and key people in one's life will help them tell whether the time is right.

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