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DDAdvocates Newsletter 20110724—This will Impact Every One of our Children | DDadvocates.com

 Got Medicare and Medicaid? The Good News and the Bad News is that you are Dual Eligible!! 

The Good News is that if you have a good medical advocate, you can find and access good doctors and therapists at major medical centers – for instance, my wife has sought out and found great doctors in several specialties who serve our daughter Deb well; in our experience, all major medical centers in the metropolitan area take Medicare and the co-pays are picked up by Medicaid. This is a good thing for someone who has a dedicated care giver to navigate the medical system on their be-half.

The Bad News is:

  • Without help navigating the system as may happen with a client who has no family involvement, quality of care is not always satisfactory
  • Apparently physical and mental / behavioral services are less well integrated making it difficult to make progress in either area

 The Really Bad News is that what is driving this dialogue is what you would expect:

MEDICAL TREATMENT FOR THE MOST PHYSICALLY AND EMOTIONALLY IMPAIRED INDIVIDUALS IN THE COUNTRY IS MORE EXPENSIVE THAN THE NORM – GO FIGURE!!!

 So the State of Michigan has volunteered to pilot a quality improvement, cost reduction integration of care for all persons with dual diagnosis. In other words, they want to manage not only the vocational and residential services for our family members, but they also want to take over management of their medical services (and related costs and revenues).

To kick the program off, the State is hosting 4 public forums including one in Southfield on July 27 –the last of the four. You can find additional information at: http://ddadvocates.com/2011/07/24/integrated-care-for-dual-eligible-beneficiaries-in-michigan/ 

Whether you can attend the session or not, you need to be familiar with the document and ongoing discussions. Even if your family member or client is not dual eligible now, he or she will be when the first parent begins drawing Medicare.

 These discussions will impact the future of every one of our children.

 

 

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