The process of applying for a home attendant requires many documents and a lot of patience when waiting for a response. Medicare typically provides home attendant assistance for a maximum of 28 hours per week, and in some cases, up to 35 hours per week. However, for many elderly individuals who are incapable of walking, cooking, and showering by themselves, around the clock attention is crucial. Oftentimes, the process of increasing home attendant hours is even more gruesome. Medicare will justify any reason against extending current hours and make the vulnerable individual’s life easier. In this article, the Trust and Estate planning office will explore ways to maximize the amount of home attendant hours so that you or a loved one can receive the care that suits your needs.

Understanding The Current Home Attendant System

To receive at-home medical care, the applicant needs to fit multiple criteria. Primarily, you will receive a physical assessment to determine whether or not you are eligible for the program as well as assess the amount of hours you will receive each week with a home attendant. A physician's recommendation is often required to support the need for a home attendant. In many cases, patients may receive less hours than they feel is necessary. In these cases, there are various ways to obtain additional home attendant hours. It is important to assess each option to determine which one works best for you.

What You Can do to Receive Additional Home Attendant Hours

1. Medicare advantage plans- A Medicare advantage plan, or Medicare part C, is an alternative way to obtain additional home attendant hours. These plans are offered by private insurance companies that are approved by Medicare. Depending on the plan that you chose, they will provide the benefits of Medicare as well as additional services and coverage. For example, if Medicare provided you with a limited number of home attendant hours, a Medicare advantage plan can cover the costs of additional hours if needed.
2. Medicaid waiver programs- Some states have implemented Medicaid waiver programs in which Medicaid and Medicare can work together to fulfill the needs of those who require additional support. This program will allow you to receive additional home attendant hours if eligible and allows individuals who require constant care to reside at home rather than a nursing facility. However, these programs have many eligibility requirements, including proof that you need an equivalent amount of care that you would receive in a nursing home. If you believe that you qualify for additional care, consulting with a knowledgeable and experienced attorney will assist you in applying to these programs.
3. Appeal the decision- If you disagree with the amount of home attendant hours Medicare has provided, it is in your best interest to file an appeal as soon as possible. Attorney Inna Fershteyn is an experienced and proficient attorney who will help you appeal a Medicare decision pertaining to your home attendant hours and provide you with additional care if you feel it is necessary. Consulting with an attorney regarding your appeal can relieve stress and increase your chances of approval. Additionally, if your home attendant hours were reduced by Medicare, appealing the decision can help restore your initial amount of hours. 

In 2020, Attorney Inna Fershteyn was introduced to a case in which a client’s home 

attendant hours were reduced substantially although the client required round-the-clock care. Attorney Inna Fershteyn helped this client win a fair hearing and ensured that their amount of care would be restored to the original amount of hours.

1. CDPAP- The Consumer Directed Personal Assistance Program is a Medicaid program which allows an individual to designate a family member to be a home attendant and get paid hourly in the process. Although Medicaid pays for up to sixty hours of care based on eligibility, home attendants may apply to get paid overtime which will compensate for additional services.
2. Request a physical reassessment- Before receiving a home attendant, a patient must undergo a physical examination to establish their eligibility and the extent of care necessary. A physical reassessment can reevaluate your necessity for additional care and can grant you extra home attendant hours.

How can I benefit from an attorney in this process? 

If you or a relative feel that you need to increase your home attendant hours for any amount, but your claim has been unfairly denied, a Medicaid attorney will help. In fact, consulting with a knowledgeable attorney is the best approach to take in preparation for a fair hearing or challenging Medicare’s response. Inna Fershteyn has over 20 years of experience helping clients extend their home attendant hours. She will assist you by preparing a strong application for CDPAP, Medicaid waiver programs, or Medicare advantage plans. Most importantly, she will attend to your emotional needs through this long winded process. If you believe that you require additional home attendant hours and fit all of the requirements, yet your request has been unjustly denied, please contact the Trust and Estate Planning Office at (718) 333–2395.