Caregiver Tip of the Month

More than six million people with Medicare also qualify for Medicaid. This means they now get their prescription drug coverage through their state's Medicaid program. These seniors are referred to as "dual eligibles." Beginning January 1, 2006, dual eligibles will no longer receive their prescription drug coverage through Medicaid. Instead, they will be covered by Medicare's new prescription drug benefit.

Dual eligibles need to switch their coverage from one program to the other. To help them, the federal government has made special arrangements to prevent gaps or interruptions in coverage. Like all people with Medicare, dual eligibles will have an opportunity to learn about their options and select a plan that they believe best meets their needs. But, if they haven't selected and enrolled in a plan by December 31, 2005, they will be enrolled automatically in a plan that the federal government chooses for them. This is called "auto-enrollment." In most cases, the plan the federal government chooses will be based on where the dual eligible already receives the rest of his or her Medicare benefits and on the amount of the dual eligible's premium subsidy.

In October, the federal government's Centers for Medicare & Medicaid Services (CMS) sent a letter to all dual eligibles to let them know which plan they will be auto-enrolled in if they don't choose another plan by December 31st. The letter reminded dual eligibles that if they prefer, they can choose a different plan or decline to receive drug coverage altogether. It also told them how to choose a different plan, in case they wish to do so.

This letter told dual eligibles that even after December 31st, they can switch to a different plan if they want to do so. Even though most people with Medicare will need to wait for enrollment periods to change drug plans, the law allows dual eligibles to change their drug plans as often as once a month.

All dual eligibles throughout the country will have a choice of plans with a premium at or less than the regional average premium. This means they will have a choice of plans: a basic plan with little or no out-of-pocket premium or deductible, and co-pays of $1 to $5 for each prescription. Or, they can choose from one or more plans with better benefits. If they choose a plan with better benefits, they will have to pay a portion of its premium charges.

For more information, visit the Medicaid website for consumers.

Key Dates for Dual Eligibles

December 31, 2005. Last chance for a dual eligible to enroll in a plan before auto-enrollment takes effect.

January 1, 2006. Dual eligibles who have not enrolled in a plan will automatically be covered by the plans into which Medicare auto-enrolled them. However, they may still switch plans if they are not satisfied with the plan in which they were enrolled. They can switch plans as often as once a month.

Our visitors ask ...

Q. I am trying to assist my elderly parents plan for their future, from long distance. They live in Florida, with few surviving friends and no family nearby.

In the event of my father's death, it is anticipated that my mother will have difficulty managing her finances effectively. Is there anything we can do now in anticipation of this situation, to have financial management assistance in place for her? She is of sound mind, so appointing legal guardianship is not a practical consideration at this time. Can you suggest any resources or a strategy to pursue? Their lawyer, stock broker and accountant have not been helpful.

A. First, we suggest that you review our 2-page article, Elder Care 101 - First Steps. It is a primer - a source of both information and comfort - for people who are caregivers today, or who may become caregivers in the future. It discusses many things that should be taken care of when elderly loved ones are still of sound mind and body, in addition to offering tips and pointers to help our loved ones when they begin to have difficulty living independently.

We also suggest that you work with your parents to complete the Personal and Financial Organizers that you'll find in our companion website, Today's Seniors. We've prepared 6 different free personal and financial organizers to make the job easier for someone to manage or settle one's affairs by answering questions such as:

Are your personal and financial records in order? What documents do you need to keep? Where? How long? Are your records easy to find? What if you had a serious accident tomorrow? Could someone you trust step in and temporarily handle your financial affairs, even if it's just to pay your bills? What if you should die tomorrow? Could your spouse or heirs easily find the personal and financial records they'd need to settle your estate? Or, will they find a jumble of unorganized records scattered throughout your house? At your attorney's office? In your safe deposit box?

With regard to advisors, we suggest that you talk with an attorney who specializes in elder law. Check the yellow pages in your local telephone directory, or go to the National Academy of Elder Law Attorneys' web site at www.naela.org. On their home page, you'll find a link in the upper left corner (just below their logo) that will help you locate an elder law attorney.

Finally, depending on the accumulated value of your parents' assets, you may wish to have them make a pre-arrangement with a bank trust officer to manage your mother's financial affairs before the need actually arises. Or, if your parents are of more modest means, you might suggest that they work with a member of the American Association of Daily Money Managers. Professional members assist people who have difficulty managing their personal monetary affairs, from simple bill-paying to more complex financial issues. You can check to see if a member is near your parents by clicking on the Find a DMM link in their website.

Daily Living Solutions

— products for seniors —

As we grow older, it often becomes difficult to use many everyday products because of arthritis and other conditions. If you or a loved one needs a little help – or a lot – we've selected a group of practical and affordable solutions from our affiliated merchants to help overcome those limitations.

Whether you are looking for yourself, or to help an elderly senior continue living in their own home, you'll find a wide variety of supplies and accessories – raised toilet seats, safety rails, incontinence supplies, large-handle eating utensils, pain relief, diabetic supplies, pill splitters and crushers, big-button telephones, canes, walkers, rollators, wheelchairs – and much more.

Everything is sorted into convenient categories in our Solutions for Seniors section.

Our visitors ask ...

Q. My mother lives near Hartford, Connecticut. She is 75 and not a strong driver. She is caring for my Dad who is 83 and has early Alzheimer's.

I live in California, and cannot be there personally. We are desperate to find resources that could help her with driving my Dad as needed; maybe coming to the house to help her out once in a while; even talking to him, to persuade him to accept his limitations; and to make sure they know about any government programs available to help them.

A. First, call the Eldercare Locator. Developed by the U.S. Administration on Aging, the Eldercare Locator is a free public service. It helps people find local support services to help them live independently and safely in their homes and communities for as long as possible. Look for the resources you need by following the easy directions on their website. Or, call their toll-free telephone number 1-800-677-1116, between 9AM and 8PM weekdays, Eastern Time.

Second, consider hiring a Geriatric Care Manager. This professional is trained in geriatrics, social work, nursing or counseling. He or she will conduct a thorough assessment to identify needs and develop an appropriate plan of care for your father. While your mother may not need these services yet, a care manager can also screen and supervise professional caregivers; coordinate medical care; pay bills; and act as a liaison with your family. Depending on your needs, a care manager can also screen and supervise other qualified people to help with housekeeping, laundry, shopping, maintenance and repairs; review applicable financial and legal issues; offer referrals to geriatric specialists; and assist with a change of living arrangements, if that is most appropriate.

To find a care manager near your parents, look at the website of the National Association of Geriatric Care Managers. Their Web site includes a locator to help you find a nearby care manager; click on "Find a Care Manager" in their left-hand menu.

Third, millions of older adults are eligible for federal and state benefits, but are not receiving them, including assistance to pay their Part B premiums for Medicare benefits. This is unfortunate because these programs can help with housing, meals, transportation, health care, prescription drug costs, legal services and utility bills, just to name a few.

Benefits CheckUp is a service of the National Council on Aging, a non-profit organization. It helps older adults quickly and easily find out which benefits they qualify for, and how to get them (many are available regardless of income). It is free and completely confidential. It does not require your name, address, phone number, Social Security number, or any other information that could be used to identify you.

Simply complete the online questionnaire. In a few minutes, you'll have a list of programs for which you or your loved one most likely qualifies, including phone numbers and addresses. It also includes step-by-step instructions on how to apply for the benefits. To visit Benefits CheckUp, click on http://www.benefitscheckup.org/.

Fourth, it would help both you and your mother to read our 2-page article, Elder Care 101 - First Steps. It is intended as a primer – a source of both information and comfort. Each caregiving situation is unique, of course. Whatever the circumstances, the article will help you and your mother get started. Then on other pages in our website, we've included a number of checklists to help you both with more detailed guidance – and to help you feel more confident that you haven't forgotten something important. Finally, we've included links to a number of excellent specialty websites to help make it easier for you to find the information you need – and to save you time.

Our visitors ask ...

Q. My elderly mother lives alone, about 4 hours away from me by car. She is recovering from shoulder prosthesis surgery at her home, is in a body brace, and is unable to drive to the grocery store nor lift any packages. She has nearly run out of food in her house. I am trying to locate either a food service that will deliver prepared meals to her door, or an online grocery store from which I can order food and have it delivered to her home. Are you aware of anyone who does this sort of thing in her area? If not, do you know of any elder-care organizations in her area that I can contact for information?

A. Meals on Wheels may be an option for your mother. Local agencies provide low cost, hot, nourishing meals to elderly and disabled persons, allowing frail, homebound people to remain in their own homes. To find a local program near you or your loved one, click on Meals on Wheels; once at their website, click on Finding a Local Program by City and State. You'll find the names, addresses and phone numbers of over 3,200 local Meals on Wheels programs.

You may also wish to call the Eldercare Locator. Developed by the U.S. Administration on Aging, the Eldercare Locator is a free public service. It helps older people and their caregivers find local support services to help them live independently and safely in their homes and communities for as long as possible. Look for the resources you need by following the easy directions on their website. Or, call their toll-free telephone number 1-800-677-1116, between 9AM and 8PM weekdays, Eastern Time.

Recommended Reading and Videos

Many excellent books and videos can help guide you through the caregiving process. For our recommendations, including a brief description of each one, click here.

The material on this site is for informational purposes only, and is intended as a supplement, not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. More