AHCCCS

What does AHCCCS mean?  It is Arizona’s Medicaid program call Arizona Health Care Cost Containment Systems.  It is an umbrella with over 12 programs available to help people and their healthcare needs.  One being ALTCS (Arizona Long Term Care Systems) which is the more difficult one to get approved for.

With most of the AHCCCS plans the main eligibility requirement is income.  With ALTCS the main requirement is being at nursing home level of care.  Income and resources are crucial too but there are ways to get the person qualified if they meet the medical portion.

Is this right for you or someone you know?  Not always, if a person owns a home there will be a lien placed on the home property.   Think of it as getting a loan from the State for your healthcare & then when you pass away the State wants the money they spent on you back.

 

Advertisements

Life in a box

As you go through life you find yourself moving around and making changes.  Some good some not so good.

Packing is always a chore but is it necessary to carry so much “stuff” around?

Why keep things, if they are in a box doesn’t it mean you do not need it?  Is it a memento & you want to keep it to pass it on?  Would the person you are passing it on to even care?  Your memories are yours and not the other person so why carry that extra piece of luggage around.  Why place a burden on that person so that they can pass it on?

Your memories are the only box you need.  Your whole life has been a box and you have the power to get out of the box, make your life a great one.  Do not depend on others to make those choices for you.

GET RID OF THE BOX!

 

Good customer service

Why is it important to you?   Vosun feels that if you get good service you will keep coming back to that business because they care about the person.

Recently, one place stood out.  Brawley, California has 4 motels in its little town. Two are everywhere you go and two are local.  Vosun went local to the Brawley Inn.  The minute we went through the door someone called out “hello, welcome”.  How many times do you walk in to an establishment and not one person acknowledges you?  The staff including the maintenance person all greeted us everytime we saw or walked past them.

On the other hand, Enterprise car rental in Phoenix (19th Ave & Dunlap) failed miserably in this area.  A reservation was made beforehand, a call from them the day before was made to make sure car was being picked up & they still lost the reservation, made us wait, gave us a filthy car (who wants someone else’s germs) and didn’t even offer to apply a discount or give us a tank of gas.  We walked out and did not rent a car & will not use them again.  The last 3 times were no better but at least we would get some sort of apology.  Time to move on to a better rental company.

Thank everyone that comes into your life even if you cannot help them but maybe all they need is someone to hear what they need.

 

ALTCS Prior Quarter

Prior Quarter Coverage
Prior Quarter Coverage is a different time period from Prior Period Coverage and refers to the timeframe PRIOR to an individual’s month of application for AHCCCS coverage. The dates of eligibility for Prior Period Coverage and Prior Quarter Coverage do NOT overlap. Prior Quarter Coverage is limited to the 3 month time period prior to the month of application.
If a member is determined to qualify for Prior Quarter Coverage, then the AHCCCS Administration (not the Contractor) will provide reimbursement for AHCCCS covered services for up to 3 months PRIOR to the month of application, if the member received AHCCCS covered services during the Prior Quarter Coverage timeframe. Prior Quarter Coverage is limited to the 3 month time period PRIOR to the month of application for any/all of the 3 months in which all AHCCCS eligibility criteria are met and the member has received a Medicaid covered service. The date of enrollment is not a consideration under Prior Quarter Coverage. Under Prior Quarter Coverage, reimbursement of all claims (acute, ALTCS, behavioral health, pharmacy etc.) will be managed through AHCCCS Fee for Service (FFS). Contractors are NOT involved or responsible in paying Prior Quarter Coverage claims
Example:
In using the example above, the member’s effective date of eligibility is April 1st . At the time of eligibility, the member will also be evaluated to see if s/he were Medicaid eligible for the 3 months prior to April: January, February, and March. If the member received AHCCCS covered services during any of the Prior Quarter Coverage months and would have qualified for AHCCCS at the time those services were received, then AHCCCS will reimburse the provider for those services.

Meeting Medicaid/ALTCS medical

People think that because they cannot cook or clean their house they need Medicaid assistance to pay for that care.  ALTCS (AZ Medicaid program) is not for that.  ALTCS is for people that fall under this criteria:

What is medical eligibility? This means that the person applying for Medicaid/ALTCS has to be at nursing home level of care requiring assistance with Activities of Daily Living such as bathing, dressing, getting in & out of bed/chair/toilet, etc. A person does not have to be in a nursing home to meet this criteria.

Having  Alzheimer’s, Dementia, Parkinson’s or a serious condition that affects activities of daily living will help qualify a person vs someone that does not have these conditions.

The doctor has to have his or her medical records with these conditions too.  If a doctor says, “patient needs supervisor care” that is a big NO for ALTCS.

Aging not dying

Once you hit your 60s most people want to live.  They start to exercise, eat right, get lose weight and start doing things they did not do when they were younger.

Dating after 70 you betcha, dancing into their 100s why not?

With doctor’s approval anything is possible.  As long as things are done in moderation and keeping an eye out for scammers such as dating sites where you do not meet the person but can feel sorry for someone and start sending money.

Miracle creams that will banish those unsightly wrinkles are also scams, gravity is not something you can prevent from happening unless you go to get stretched and pulled your skin will fail you.

One of the most common places to be treated well ( I hear) are cruises.  Plenty of dancing, lots of fun and nowadays fairly inexpensive.  You can get massages, facials, relaxation and lots of conversation.

Yoga is good for getting your body and mind in a good place.  Reading is good for your brain and sometimes to take you away.

Vosun found a good place to get information about your health. Go to healthday.com for some good articles.

Pet Peeves

This is not related to Medicaid/ALTCS but need to release pent up negative energy.

What are your pet peeves?

VOSUN has a few but will only talk about 3.

  1. School zones – if they are posted, have lights flashing then SLOW DOWN!
  2. Drive-thru – banks are the worst, have your check signed, your card out do not wait until you get there then start. Seeing someone push one card after another and not getting any money means you should not have been in the line to begin with! The same with restaurant food lines, why do you sit & stare at the menu? Just order and get out of the way.
  3. Drivers on your rear end, the limit says 45 you are doing 50 but someone has to come right up your rear to make you go faster. But wait, there are cars in front and next to you so you cannot go faster or move out of the way. What is funny is that the person behind you moved to what they thought was a faster lane and wound up at the same red light you stopped at too.

Somethings you just have to laugh about it and go on your way.  Enjoy the rest of your week and let me know what your number one pet peeve is.