Berkshire Senior Online

By Nancy Stoll, SHINE Coordinator

Long-term care is a "variety" of services that help people with health or personal needs and activities of daily living over a period of time. Studies show that most elders prefer to stay at home and receive long-term care services "in the community" rather than in a nursing home or in a "long-term care facility."

Community Services available in Berkshire County include:

- Adult day care

- Meal programs (Meals-on-Wheels)

- Senior centers

- Friendly visitor programs

- Help with shopping and transportation

- Help with legal questions, bill paying, or other financial matters

- Home care

- Subsidized senior housing

- Board and care homes

- Assisted living facilities

A number of these programs or services are available free of charge or for a nominal fee. Others require personal resources or long-term care insurance. Some life insurance companies allow use of life insurance benefits to pay for long-term care. Check with your insurance carrier.

Generally, Medicare does not pay for long-term care. Medicare provides a home health benefit for skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury.

Home Care

Depending on your needs, you may be able to get help with your personal activities (for example, help with laundry, bathing, dressing, cooking, and cleaning) at home from family members, friends, or volunteers. This is commonly referred to as "custodial care."

Elder Services administers a variety of programs for people 60 and over who meet income eligibility requirements and who have various levels of need for care. In addition to State Home Care Services, the Community Choices Program provides daily at-home services to elders who are at imminent risk of nursing home placement, but who prefer to stay at home.

For more information, contact Elder Services’ Information and Referral Department at 499-0524 or 1-800-544-5242.

Medicaid/MassHealth

Medicaid (or MassHealth, as it is called in Massachusetts) will pay for homemaker, personal care, and other services that are not paid for by Medicare. If you meet the eligibility requirements of low income and few savings or other assets, MassHealth has programs that pay some or all of Medicare’s premiums, deductibles and coinsurance, as well as for prescription medication, adult day health care, medical transportation and more.

Elders who are 65 or older with a permanent or long-lasting disability that keeps them from being able to perform activities of daily living like bathing, grooming, eating, dressing, toileting, taking medications, etc., without the physical assistance of another person may qualify for the Personal Care Attendant (PCA) program. By getting PCA services through MassHealth, some people can live at home instead of having to live in a long-term care facility.

Long-Term Care Insurance

This is private insurance that can help pay for many types of long-term care, including both skilled and non-skilled care. Some long-term care insurance policies will cover home health care in addition to a range of services like care in an adult day care center, assisted living and medical equipment.

Prescription Advantage Update

There will be no open enrollment for Prescription Advantage as of February 1, 2003. Anyone who submitted an application prior to February 1 will be considered for enrollment in the plan. All current members will remain in the plan and will receive a renewal form over the next few months. It is important to complete and return the renewal form promptly to avoid the risk of having your membership discontinued.

For help with completing a Membership Renewal Form or for help with lowering costs of prescription medications, call SHINE at 800-544-5242 or 499-0524.

Remember to ask for your 10% senior citizen discount at the pharmacy!

Medigap Open Enrollment ends March 31!

A representative from Blue Cross/Blue Shield Medex Supplement Insurance Plan will be available to discuss open enrollment on March 4 at 1p.m. at the Ralph Froio Senior Center, 330 North Street, Pittsfield, and March 12 at 10a.m. at the Lee Council on Aging, Railroad Street, Lee. Or call SHINE for help with enrollment in a Supplemental Insurance Plan.

Supplement 2 is the only plan which offers prescription drug coverage.

For more information call SHINE at 499-0524 or 1-800-544-5242; request a copy of two publications, "Medicare and Home Health Care" and "Choosing Long-Term Care."