Why ALTCS?

By March 18, 2010Uncategorized

Lately, it seems that I am frequently asked  by professionals that work in the health care field – “Why should someone apply for ALTCS benefits given the economy and our state’s deficit problems?”   It’s a good question.   If we hear that eligibility is harder, services are more difficult to ascertain, that providers are opting out of the program because of low reimbursement…it may seem the barriers are too many to overcome. 

I suppose it would be great if everyone could pay privately for all of their care, or find alternative benefits, such as the Wartime Pension through the VA to help out.  But, as I see it, it is important to remember that  few folks can pay privately for long-term care for very long.  Think of your parents or your own personal situation, if faced with a nursing home bill of over $5,000/month….How long could you pay privately?   Would you need help?

 Our state has devised a program that works, it covers care at the lowest level possible in the most cost effective setting.  Seems like this is the right thing to do.  We could be in a state that basically gives help to those only needing a nursing home at the highest cost to the state.  Instead, ALTCS provides services – not 24 hour – but certainly a lot of care, in their own home with a variety of home and community based services to help keep the member in the lowest level of care possible.  Then will also cover assisted living and group home care.   Nursing home care is a reality for some, but our state allowing members to get care in a lower cost setting makes sense for both the state and the member.

The program contractors ( insurance companies contracted by state to provide care)  are in a difficult spot, they must provide all needed care in a cost effective manner.  They are stewards of the State/Federal dollars.  They need to make sure there will be monies left for the next guy while at the same time keeping our members safe and well taken care of .  I’d say this is a good thing.   Is our system perfect?  No.  But since the majority of folks needing long term care…assisted living….home and community based services…do not have enough money to pay for  services for any length of time, I am glad we have this safety net here in Arizona.   I’m glad help is out there and I am proud that our system is working in a cost effective manner to make it work for both the state and the Arizona resident!