Your independent streak got you this far. ElderONE gets you even further.



Similar documents
Your independent streak got you this far. ElderONE gets you even further.

Managed Long Term Care (MLTC). the end the Guide you will find list managed long term care plans New York State and the areas they serve.

Disability Rights Ohio Frequently Asked Questions about Medicaid: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

Important! You Must Join a Managed Long Term Care Plan

Healthy Michigan MEMBER HANDBOOK

The Ida Kayne Transitional Care Unit

Moving Through Care Settings (Don t Send Me to a Nursing Home)

Florida Medicaid and Implementation of SB 2654

Important Benefi ts for Medicaid Eligible Children: EPSDT EARLY & PERIODIC SCREENING DIAGNOSIS & TREATMENT. Ohio Legal Rights Service

Home Health Care in Florida

What is Home Care? Printed in USA Arcadia Home Care & Staffing

Long Term Care Exam Study Guide

UNIVERSITY OF VIRGINIA HEALTH PLAN 2015 SCHEDULE OF BENEFITS CHOICE HEALTH

How To Get Pace Care Plan

NJ FamilyCare B. Covered by Horizon NJ Health for spontaneous abortions/miscarriages. Abortions & Related Services

100% Percentage at which the Fund will reimburse Fund Administration

Licensed Counselors (LPCC)

Home Care Agencies. Types of home care agencies. Home health agencies

HOSPICE CARE. and the Medicare Hospice Benefit

Welcome to Medicare! Module 1A

CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary

Affordable Housing Opportunities

Understanding Hospice Care. A Guide for Patients and Families

Coverage Basics. Your Guide to Understanding Medicare and Medicaid

Sacramento County Medi-Cal Mental Health Services

National PPO PPO Schedule of Payments (Maryland Small Group)

AARP Medicare Supplement Insurance Plans

PPACA, COMPLIANCE & THE USA MARKET

2016 Medicare Advantage Special Needs Plans (SNP) Full Dual Medicare & Medicaid Maricopa County

THE REHABILITATION CENTER AT DAUGHTERS OF SARAH SHORT TERM STAY AGREEMENT

Terence G. Dougherty, Interim Medicaid Director. All Provider Manuals (Dental Benefits for Certain MassHealth Members)

Health Plan Administration and Stop-Loss Insurance for Small Employer Groups Massachusetts

Introduction to One Care. MassHealth plus Medicare.

at Concord Village Skilled Nursing & Sub-Acute Rehabilitation

Member Fact Sheet Medicare Secondary Payer Small Employer Exception

Ryan White Program Services Definitions

Aetna Savings Plus plan guide

Medicare Benefit Review

Special Needs Plan. Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of True Blue Special Needs Plan (HMO).

The Healthy Michigan Plan Handbook

Health Insurance Overview

Cal MediConnect Plan Guidebook

One step closer to home

Member Rights, Complaints and Appeals/Grievances 5.0

MISSION STATEMENT PHILOSOPHY

DEPARTMENT OF HEALTH & HUMAN SERVICES MEDICAID PROGRAM OVERVIEW

Community Care Services Division

Local Resource Guide for Caregivers

Early Intervention Services in New Jersey Frequently Asked Questions

CHAPTER 3 SCOPE AND STANDARDS OF NURSING PRACTICE AND CNA ROLE

Comprehensive Hospice Care

The Healthy Michigan Plan Handbook

Virginia. A guide for individuals and families. The health insurance benefits you want, at a cost you can afford

CHAPTER 6: CREDENTIALING PROCEDURES

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Current Approved State Plan Language

Harvard Pilgrim s Stride SM. (HMO) Medicare Advantage Plan. Value Rx Plus Annual Notice of Change

Patients Bill of Rights

NJ FamilyCare ABP. Covered by Horizon NJ Health for spontaneous abortions/miscarriages. Abortions & Related Services

Your Guide to Choosing a Kaiser Permanente Medicare Health Plan

APPLICATION TO RENT 1519 Locust Street Chico, CA 95928

CHAPTER 600 PROVIDER QUALIFICATIONS AND PROVIDER REQUIREMENTS 600 CHAPTER OVERVIEW AHCCCS PROVIDER QUALIFICATIONS...

Choosing an Assisted Living Facility: Comparing Apples to Apples!

Member Handbook

Four Schools. One Calling. SAMFORD UNIVERSITY S COLLEGE OF HEALTH SCIENCES

OREGON CASCADES WEST SENIOR & DISABILITY SERVICES

RE: CMS-3819-P; Medicare and Medicaid Programs; Conditions of Participation for Home Health Agencies

JASACare Home Care Services

T H E P A T H W A Y T O I N D E P E N D E N C E

End-of-Life Care: Diversity and Decisions Participant Handout

Medicaid 101. The basics of publicly funded healthcare.

Schedule of Benefits. Plan Information Participating Provider Non-Participating Provider

Hospice Services Provided in a Long Term Care Facility. Companion Regulations for Hospices and Long Term Care Facilities

My Health Insurance Comparison Worksheet

Healthy Michigan MEMBER HANDBOOK

Occupational Therapy Protocol Checklist

MANAGED LONG-TERM CARE AND NURSING HOMES

NJ FamilyCare A. Covered by Horizon NJ Health for spontaneous abortions/miscarriages. Abortions & Related Services

Home Care SERVICES. One experience at a time

Annual Notice of Changes for 2015

There are some specific guidelines provided in the rules and regulations for these lists:

Coventry Health and Life Insurance Company PPO Schedule of Benefits

Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_ CMS Accepted

Health Insurance Premium Assistance Program

Transcription:

585.922.2831 855.457.4636 toll free (TTY 800.662.1220) or visit www.elderone.org Your independent streak got you this far. ElderONE gets you even further. Live at home with comprehensive, personalized care services from a single team. H3331_SB 12.2014 147174 MEDICAL CARE PERSONAL CARE REHABILITATION DAY CENTERS MEDICATIONS TRANSPORTATION

COMPREHENSIVE CARE ElderONE is an affiliate of Rochester Regional Health System that gives elderly men and women an alternative to nursing home placement. Designed for individuals 55 years or older, the program provides highly coordinated services that enables participants to remain in their own home maintaining their independence without compromising their medical care or safety. ElderONE is a Program of All- Inclusive Care for the Elderly (PACE). It offers all of the necessary health, medical and social services needed to ensure that participants can enjoy their independence while maintaining their dignity and quality of life with confidence. ElderONE SERVICES include: Medical care Home health care and personal care Social services Prescription and over-the-counter drugs Nursing services Medical specialists Rehabilitative and supportive services Laboratory, X-Ray, and ambulance services Transportation to program-related medical and social services Acute hospital care and nursing home services Adult day care PERSONALIZED, COMPASSIONATE CARE COMES TO YOU ONE TEAM, PROVIDING COORDINATED CARE

MEDICAL CARE The ElderONE interdisciplinary care team will work with you and your family to assess your needs and develop a complete, personalized care plan. This team consists of a primary care physician*, nurse practitioner, day center manager, nurses, social workers, rehabilitation therapists (physical, occupational and speech), recreation therapists, chaplains, nutritionists, personal care assistants, drivers and most importantly, you. Your treatment plan will be regularly reviewed by the care team, and modified when necessary to ensure that it meets your evolving needs. MEDICAL SERVICES include: Board-certified geriatricians, primary care All prescription medications including over-the-counter Rehabilitative and supportive services Acute hospital care Medical specialty services All durable medical equipment Nursing home services, as needed * In some cases, your current primary care physician can continue to work with you. YOU RE A VITAL MEMBER OF YOUR OWN CARE TEAM

CARE IN YOUR HOME In addition to complete medical and social services, the ElderONE program includes comprehensive home care that enables you to live safely and comfortably in your own residence. Depending on your needs, ElderONE home care services may include: Nursing care Personal care Homemaker/chore services Physical, speech and occupational therapy Social services Home-delivered meals As with your medical care, these comprehensive services will be regularly evaluated by the interdisciplinary team, collaborating with you and your family, to ensure that your individual needs are being met. TRANSPORTATION ElderONE provides transportation services for all participants to medical appointments and the ElderONE PACE Center. All ElderONE drivers are specially licensed by the State of New York, and go through an extensive screening process and rigorous training to ensure that they will provide safe and friendly transportation for all program participants. Transportation Services include: Assisted transportation to and from all necessary medical appointments, including dialysis appointments and all specialist appointments Assisted transportation to and from the ElderONE PACE Center SAFE, CONVENIENT TRANSPORTATION TO APPOINTMENTS

THE ElderONE PACE CENTERS Most care provided in the ElderONE program takes place at an ElderONE PACE Center. The Center provides social opportunities that might not be easily available when you are living alone at home. Examples of PACE Center Services include: Medical clinic Physical, occupational and speech therapy Nutritional services Social work services Exercise and craft programs Cooking, gardening and recreational therapy Chaplain and spiritual groups Hot lunches served daily Attendance at the Center is based on your individual needs; as a member of your own care team, you will help determine which services offered at the Center are appropriate for you. SPEND TIME WITH YOUR PEERS PACE Center Locations Hudson Center 2066 Hudson Avenue Rochester, NY 14617 585.922.2800 North Park Center 355 North Park Drive Rochester, NY 14609 585.922.9920

ELIGIBILITY All ElderONE participants must be 55 years old or older, and fit the following criteria: You must be determined to be in need of nursing home level of care, based on accepted standard guidelines set by New York State. You must be determined to need ElderONE services for more than 120 days. You must be capable of residing safely in the community with ElderONE support services at the time of enrollment. You must be a resident of Monroe County. Upon determination of eligibility, you must complete the ElderONE assessment and enrollment process. ElderONE will not discriminate on the basis of race, ethnicity, national origin, religion, sex, age, sexual orientation, mental or physical disability, or source of payment. PROGRAM COSTS AID ELIGIBILITY STATUS Eligible for only Medicaid Eligible for only Medicare Eligible for Medicaid and Medicare Not eligible for Medicaid or Medicare RESPONSIBILITY FOR PROGRAM PAYMENT Medicaid pays for program (You may also have a share of cost payment) Participant pays only the Medicaid portion plus Part D No premium will be due (It may be determined that you will have a share of cost payment as determined by the local Department of Health Services) Participant pays self-pay rate All services provided to ElderONE participants are provided by ElderONE, an affiliate of Rochester Regional Health System. The participant may be liable for the costs of unauthorized or out-of-pace program agreement services. ElderONE IS GROWING TO HELP MORE PEOPLE