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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Medicare does not look at assets. Medicare is available to folks over the age of 65 who have paid into the system. Part A is free; Part B assesses a monthly premium that has various tiers dependent upon your income. But there is NO asset test.
Medicaid is "means tested", meaning that it is available only to those who meet certain income and asset guidelines.
The eligibility criteria is very much dependent upon what state you live and which program you are applying for. It's probably best if you call the Medicaid office in your state, or talk to your local Area Agency on Aging.
For New Jersey:
DHS Home > Division of Aging Services Home > Get Help Paying Your Medicare Costs Get Help Paying Your Medicare Costs
Low-income beneficiaries can save over $5,000 a year.
Save more than $1,600 annually with a Medicare Savings Program (MSP) Most seniors and individuals with disabilities on Medicare in 2019 will pay $135.50 each month directly out of their Social Security check for their Part B premium. If your annual income in 2019 does not exceed $16,872 (if single) and $22,836 (if married), and your assets, not including your home and car, total no more than $7,730 for a single person or $11,600 for a couple, you can get the State of New Jersey to pay your Part B premium and save at least $1,600 each year on healthcare expenses. Lower income individuals may save even more.
Save an average of $3,900 with a Low Income Subsidy (LIS) The average monthly premium for a Medicare Part D prescription drug plan is $37.20. In addition, each time a senior and individual with disabilities on Medicare goes to the pharmacy, they must pay their co-pay and, in the donut hole, about half the cost of their medication. If your annual income in 2019 does not exceed $18,735 for a single person or $25,365 for a couple, and your assets, not including your home and car, total no more than $14,390 for a single person or $28,720 for a couple, you can get the State of New Jersey to pay your Part D premium, lower your co-pay amount and pay only that reduced co-pay amount throughout the year (i.e., you have no donut hole). People on LIS also pay no late enrollment penalty. The average person on LIS saves $3,900 each year in prescription costs. To learn more about and apply for these programs contact your County State Health Insurance Assistance Program (SHIP). You can also go online and complete an NJ Save application that screens and enrolls eligible individuals in up to 10 different assistance programs including a Low Income Subsidy or Medicare Savings Program.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Medicaid is "means tested", meaning that it is available only to those who meet certain income and asset guidelines.
The eligibility criteria is very much dependent upon what state you live and which program you are applying for. It's probably best if you call the Medicaid office in your state, or talk to your local Area Agency on Aging.
For New Jersey:
DHS Home > Division of Aging Services Home > Get Help Paying Your Medicare Costs
Get Help Paying Your Medicare Costs
Low-income beneficiaries can save over $5,000 a year.
Save more than $1,600 annually with a Medicare Savings Program (MSP)
Most seniors and individuals with disabilities on Medicare in 2019 will pay $135.50 each month directly out of their Social Security check for their Part B premium.
If your annual income in 2019 does not exceed $16,872 (if single) and $22,836 (if married), and your assets, not including your home and car, total no more than $7,730 for a single person or $11,600 for a couple, you can get the State of New Jersey to pay your Part B premium and save at least $1,600 each year on healthcare expenses. Lower income individuals may save even more.
Save an average of $3,900 with a Low Income Subsidy (LIS)
The average monthly premium for a Medicare Part D prescription drug plan is $37.20. In addition, each time a senior and individual with disabilities on Medicare goes to the pharmacy, they must pay their co-pay and, in the donut hole, about half the cost of their medication.
If your annual income in 2019 does not exceed $18,735 for a single person or $25,365 for a couple, and your assets, not including your home and car, total no more than $14,390 for a single person or $28,720 for a couple, you can get the State of New Jersey to pay your Part D premium, lower your co-pay amount and pay only that reduced co-pay amount throughout the year (i.e., you have no donut hole). People on LIS also pay no late enrollment penalty. The average person on LIS saves $3,900 each year in prescription costs.
To learn more about and apply for these programs contact your County State Health Insurance Assistance Program (SHIP). You can also go online and complete an NJ Save application that screens and enrolls eligible individuals in up to 10 different assistance programs including a Low Income Subsidy or Medicare Savings Program.