Difficulties With Instrumental Activities Of Daily Living
Instrumental activities of daily living include common daily tasks such as housekeeping, preparing meals, doing laundry, managing ones finances, running errands, and attending appointments. Because of cognitive and muscle impairment with Parkinson’s disease, a person may find they are unable to perform their IADLs as the disease progresses and therefore need help.
How Much Will It Cost My Family
Depending on the level and amount of care needed and where you live, long-term care costs can vary greatly. It is surprising for many to learn that most health insurance, including Medicare, does not cover long-term care. However, it can be covered by Medicaid, long-term care insurance, or veterans benefits.
Organizations and county and state agencies sometimes offer limited in-home aide or respite programs or vouchers. However, most long-term care services, including facility- based and in-home care, are paid for privately. It can be financially feasible for some and cost-prohibitive for others. Financial advisors and elder law attorneys can also help you better understand what you can afford and explore asset protection options.
Parkinsons Disease And Medicare Coverage
Medicare is made up of multiple parts. Each part covers different services and treatments that youll need to manage Parkinsons.
Original Medicare is composed of Part A and Part B. Part A covers a portion of your inpatient hospitalization costs. Part B provides coverage of outpatient medical needs including those for diagnosis, treatment, and prevention.
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How Do I Get Approved For Disability Due To Parkinsons Disease
The symptoms of Parkinsons can vary drastically in nature, severity, and frequency. Due to the somewhat unpredictable clinical presentation of Parkinsons, just being diagnosed is not usually enough to receive long term disability benefits. Instead, the insurance company will look to see how your particular symptoms impact your ability to work.
The insurance company will assess your Parkinsons by considering your:
- Motor functioning
- Treatment.
Six Other Important Policy Provisions
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What Is Parkinsons Disease
Parkinson’s disease is a disease of the brain that affects the muscles of the body. The cause of the disease is unknown and there is no cure. Parkinsons disease progression means that symptoms get worse over time. It often begins as a subtle hand tremor or it may begin with increased muscle stiffness or slower than normal movement.
As an individual becomes weaker and unable to care for themselves, family caregivers often help with care needs so the person may remain independent as long as possible. However, rigid muscles that prevent the individual from mobilizing safely or a serious fall may result in the need for long-term care.
What Are The Costs Associated With Long Term Care Insurance
If you or a loved one has a chronic illness or is concerned about the costs associated with aging, now is a good time to consider long term care insurance. For more information on long term care insurance, please visit longtermcare.gov.
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Gathering Evidence And Writing The Appeal
Properly handling an LTD appeal is much more complicated than just completing some paperwork. Although a doctors note proclaiming your inability to remain in the workforce helps your case, it may not be enough for the insurance company to approve your LTD claim. At CCK, we take a comprehensive approach in managing your appeal. We gather all evidence that you will need in court and submit it with your appeal in order to provide the strongest evidence record possible. This evidence might include:
- Test results
- Reports from your treating physicians
- Expert opinions
- Witness statements from you, your family, friends, or co-workers
Preparing a strong and complete evidence record to file with your LTD appeal is especially important with ERISA-governed LTD appeals this is because in ERISA cases, the administrative appeal stage is the final opportunity a claimant has to submit substantive evidence into the record. One major source of adversity that ERISA LTD claimants face is the lack of flexibility in submitting new evidence to the administrative record in court. We gather all evidence and write the appeal using this information. In our appeal, we thoughtfully explain why you meet your policys definition of disability and other conditions for coverage. Our arguments are based on, and supported by, evidence.
How Can You Effectively Work With An Agent Broker Or Financial Planner
When working with your long-term care insurance agent, broker or financial planner, the most important thing to remember is not to be afraid to ask questions. In particular, be sure to discuss the following:
- Ask him or her to assist you with comparisons. Compare the policy illustrations, outlines of coverage and disclosures from several companies.
- Make sure you understand the difference between Medicare and MassHealth , including the limitations of each.
- Know how any change in policy features affects the premiums. In particular, understand how the different inflation options work and which one is right for you based on your age, health and financial needs.
- Understand the important differences in policy benefits and prices. Remember that price is always relative comparing similar plans is not always an easy task.
- Customize your coverage based on your specific needs. One insurance plan does not fit all situations.
A well-trained and experienced long-term care insurance specialist should ask you questions about your finances, health, family health history, support network and expectations regarding your financial security. Ultimately, the time taken at the outset to understand your needs will help ensure that you get what you need and avoid buying too much coverage.
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What Are The Responsibilities Of Agents Selling Long
Long-term care insurance can be sold directly by insurance companies by mail or phone solicitation, by agents and brokers who represent one or more insurer, by some estate-planning lawyers or through an employer or other group setting. Most people who buy long-term care insurance do so through an agent. A responsible, well-trained agent can be an important source of information about the policies that you are considering.
Even though insurers are required to train their agents, not all agents who are licensed to sell long-term care insurance are equally well-trained and experienced. Ask about the training and experience of any agent with whom you are thinking of working. Insurers usually pay agents commissions for each policy they sell. The amount of these commissions varies depending on the insurer and the type of policy. An agent might represent only one insurer or might receive a higher commission for selling one policy rather than another. Ask your agent to identify the insurers he or she represents and to explain his or her commission arrangements. This will help you understand whether the agent has an incentive to sell you a particular policy.
Massachusetts requires persons who sell long-term care insurance to:
Massachusetts law prohibits persons who sell long-term care insurance from:
What Are Some Common Coverage Limitations That Could Apply To My Long Term Disability Claim
Most disability insurance will exclude or limit coverage for certain conditions. The applicability and impact of a limitation on your claim requires careful analysis of the policy language, facts of your case, and the applicable law. Still, the following information may help you identify whether you have a potential coverage limitation issue.
Pre-existing condition limitation: A pre-existing condition limitation can exclude coverage for disabilities caused by conditions that you had, or for which you received treatment, before you were covered under the policy.
Mental illness limitation: Commonly, benefits for mental illness such as depression or anxiety are limited to 12 or 24 months. This can be of particular concern for those with Parkinsons disease because there can be significant emotional symptoms caused by the disease and side effects of medications. It is important that you identify and document the physical impairments from Parkinsons disease that impact your ability to work.
Appropriate care and treatment: Most policies will not pay benefits unless you are receiving appropriate care and treatment for your Parkinsons disease. That does not mean that you must engage in all possible therapies. However, you should be under the care of a treatment team, including a neurologist. You and your care providers should agree on a course of therapy and stick to it unless it is appropriate to modify it. Failure to do so can result in a benefit denial.
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Types Of Insurance And The Levels Of Coverage Available May Depend On Your Geographic Location
Because many of the industrys rules and regulations differ by state and most plans include limitations and restrictions, it become obvious why this subject is so complex. Understanding which options are availableand when you become eligible for eachwill help you select the best plan for your needs.
Insurance issues are only one of the many issues surrounding early onset Parkinsons disease that you may have questions about, including:
Cold Intolerance And Parkinson’s
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What Should We Look For In A Nursing Home Facility
The following checklist will help you and your family to evaluate different nursing homes. Review the checklist before your visit to the facility. Be sure to take this checklist with you.
Nursing Home Checklist
FIRST: Ask for a list of references of people who have used their facility and are willing to speak to prospective residents. Your physician may have experience with a particular facility.
Facility
- Does the nursing home provide the level of care needed, such as skilled or intermediate care?
- Does the nursing home meet local and/or state licensing requirements?
- Does the nursing home’s administrator have an up-to-date license?
- Does the nursing home meet state fire regulations ?
- What are the visiting hours?
- What is the policy on insurance and personal property?
- What is the procedure for responding to a medical emergency?
- Does the nursing home have a Medicare license?
Admission
- Is there a waiting period for admission?
- What are the admission requirements?
Fees and financing
- Have fees increased significantly in the past few years?
- Is the fee structure easy to understand?
- What are the billing, payment, and credit policies?
- Are there different costs for various levels or categories of services?
- Are the billing and accounting procedures understandable?
- Does the nursing home reveal what services are covered in the quoted fee and what services are extra?
- What governmental financing options are accepted ?
- When may a contract be terminated? What is the refund policy?
Staff
Do All People With Parkinsons Wind Up In A Facility Are There Alternatives
Many people with Parkinsons can have their care needs met in their homes, but this varies greatly and depends on many factors. Take time to reflect on what aging in place would mean for you and your partner or family over time. Many people with Parkinsons have increased needs as their symptoms change and progress so, even if you are opting not to move to a long-term care facility, you may need to tap into additional support systems and resources to stay at home safely.
A good starting point would be to have an occupational therapist perform an in-home evaluation to determine if home safety modifications, such as installing a ramp, widening doorways, and adding grab bars, should be made. Think about whether such modifications are feasible in your home space, what those costs could look like, and what other safety measures might enhance your ability to live safely and independently with Parkinsons.
Consider if you would be willing to bring outside care services into the house and understand what options are available.
Besides homecare and home healthcare, adult daycare is another alternative. Adult day centers can be a great addition or alternative to in-home care, as they offer socialization, activity engagement, and monitoring and provide some respite for family care partners.
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Common Reasons For Insurers To Deny Your Long
Insurance companies will use a variety of excuses to deny your LTD claim for Parkinsons disease. They may attempt to dispute the:
- Subjective impact on your life: In the early to mid-stages of PD, it may be complicated to prove the impact that mild to moderate tremors and movement disabilities have on your ability to work. Insurers may deny your claim by saying that your symptoms are subjective and do not qualify.
- Progression of your symptoms: If you were able to work with PD for several years after your diagnosis, insurers may claim you cant prove that your condition has deteriorated to the point where you can no longer work.
- Diagnoses and medical support: There are currently no tests or scans that can definitively diagnose Parkinsons Disease. Without extensive medical records and documentation, insurers may dispute the diagnosis itself.
Faqs About Parkinsons Disease
1. How does a doctor diagnose Parkinsons?
There is no specific test for diagnosing Parkinson’s disease. However in 2011, the FDA approved the DaTscan which takes pictures of the dopamine system in the brain. Doctors are able to use these results to increase their certainty of a Parkinsons diagnosis. The disease is currently diagnosed by a doctor completing a neurological examination and looking for two or more of the cardinal signs of Parkinsons which include muscle rigidity, slowed movement, and tremor.
2. Why does a person with Parkinsons drool?
Researchers and doctors are not completely sure what causes drooling in individuals with Parkinson’s disease. Some theories suggest that drooling occurs due to:
- Difficulty swallowing excessive saliva in the mouth as it accumulates.
- Lack of dopamine which controls saliva production.
- The forward stooped posture and open mouth that is often characteristic of people with the disease.
3. My dad has Parkinsons and he gets emotional and cries so easily whenever we visit him. Ive never seen my dad cry before and it makes me uncomfortable. Should I be concerned that something is wrong or is this part of his Parkinsons?
4. Is incontinence caused by Parkinson’s disease?
Not all individuals with Parkinson’s disease are incontinent. However, for individuals who are incontinent, it is thought that this incontinence is due to impaired nerve cells impulses from the brain traveling to the bladder and/or bowel.
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Parkinsons Disease Treatments Covered
Parkinsons disease can come with a wide range of motor and nonmotor symptoms. The symptoms of this condition can be different for different people.
Since it is a progressive disease, symptoms can change over time. Medicare covers a range of different treatments, medications, and services that you may need to manage Parkinsons disease throughout your life.
Healthcare Power Of Attorney
A healthcare power of attorney allows an individual to appoint an agent to make healthcare decisions on their behalf if they should become incapacitated and unable to communicate their wishes.
This would include decisions about lifesaving measures such as resuscitation as well as administration of nutrition through an intravenous or feeding tube if the individual becomes unable to eat.
This document also gives the agent the ability to make decisions about providing care staff with do-not-resuscitate instructions for the person with Parkinsons disease as part of the persons end-of-life wishes.
It is important to note that a power of attorney for health care does not allow an agent to make decisions for an individual until they are no longer able to do so for themselves. Therefore, a person with Parkinsons disease remains in control of their healthcare decisions as long as they have the .
As noted above, all POA documents including the healthcare for power of attorney should be written as durable so these documents remain effective even if the principal becomes incapacitated.
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