Nysha Recent News

How to Get HamaspikCare:

November 16, 2016

By Mendy Hecht, Hamaspik Gazette

A Practical Guide

As HamaspikCare’s Outreach Coordinator for the upstate Hudson Valley region, it’s not uncommon for Mr. Joel Nojovits to encounter inquirers who think you can sign up for HamaspikCare and start getting services right away.

One such applicant, an older gentleman from Middletown in the process of nursing-home discharge, wanted to rush through his HamaspikCare application paperwork—“so that,” Nojovits recalls, “a home health aide would be waiting for him as soon as he got home.”

But getting HamaspikCare consists of a few steps, each taking at least a few business days.  From the first phone call to the first in-home care visit, then, it’s a minimum of two weeks—but usually closer to six.  Here’s how it works.

Step One: Determine insurance eligibility

Your first phone call to HamaspikCare’s competent staff, in the person of Mr. Nojovits or others, will walk you through all the “puzzle pieces” you must have first before qualifying for home care.  If you have any health insurance that HamaspikCare takes—private health or long-term care insurance, a Managed Long-Term Care (MLTC) plan, or Medicaid, you can then proceed to Step Three.

If you do not have a healthcare plan that covers home care, a capable HamaspikCare Intake staffer will assist you in applying for Medicaid or otherwise discussing your options.

Step Two: get Medicaid

If you can’t afford home care, your best bet is Medicaid—and “people usually already have Medicaid when they call,” explains Nojovits.  “If they don’t, we help them get it.”

(For applicants whose financial resources exceed Medicaid’s qualification limits, HamaspikCare works with a highly respected third-party Medicaid consultant to create pooled income trusts or other financial arrangements that permit Medicaid membership.)

Signing up with Medicaid is a process that typically takes about 30 days from initial submission of application information to Medicaid.

Step Three: get assessed by Maximus

Once you have Medicaid, your health will be assessed by a personal visit by a nurse from Maximus, the company that does these assessments for New York State (or one of their contracted affiliates).  The nurse will assess you in the comfort of your own home.

The purpose of this assessment is to determine and review your health, your diagnoses and your overall needs—and to ensure that you’re indeed a candidate for home care.

But at this stage, notes Nojovits, you only finalize your qualification for home care—you don’t get assigned your total home-care hours here.  That’ll come later.

Step Four: pick your MLTC plan

As your assessment wraps up, the nurse will ask you to pick a state-approved MLTC plan.  The nurse will provide you with a current list of New York State-approved MLTC plan from which you will select one.  With you listening, the nurse calls the Medicaid Choice state hotline to record your choice of plan.

Step Five: get MLTC-assessed

The state’s nurse assessment paperwork now gets sent to your MTLC of choice.  That MLTC will call you within a few business days to schedule its own nurse visit.  This visit is to again assess your needs—including any home-care needs.

Step Six: Verify you choose HamaspikCare

Because any MLTC coverage plan automatically includes home care, you’ll now be asked to verify that you prefer HamaspikCare as your home-care agency. 

Step Seven: get home-care hours assigned by your MLTC

Armed with your full assessment information, the MLTC nurse—and supervisor, if necessary—will draw up your complete plan of care.  Your total home care hours will now be assigned.  The MLTC will then contact you with your full coverage plan.  Following that, the MLTC will send your complete plan of care to HamaspikCare.

Step Eight: HamaspikCare contacts you

At this final step, a professional HamaspikCare Scheduling Coordinator will call you to welcome you to HamaspikCare and review your scheduled start and end date and hours, the time-sheet submission process, and your selected caregivers and their scheduled home-care hours—as well as respond to any further concerns.  You’re then set!  Your first home care visit—and an improvement in the quality of your life at home, as only HamaspikCare delivers it—will shortly follow.

Timing is everything

If you get that initial nurse visit done by the 15th of the month, you could be getting your home-care services, and all your MLTC services, by the start of the next month, or in about two weeks. Here’s why.

Each month, MLTCs have to turn all new-applicant information into the state DOH by the 20th—which is why they typically push for assessments to be done by the 19th.

This is because benefits start for new MLTC members on the 1st of each month—but only if their assessments were turned in by the 20th of the preceding month.

Thus, if your MLTC assessment gets in before the 20th of December, your services start ten days later, on the 1st of January.  But if they’re sent in on Dec. 21st, your services start not on Jan. 1 but on Feb. 1—about 40 days later.  Why cause yourself that delay?

And to give your MLTC enough time to assess you and send in your info before the 20th, you should get that first nurse assessment from Maximus done by the 15th.

For any questions and more information, HamaspikCare’s Outreach Coordinators stand eagerly by ready to assist.  Please feel free to contact them directly anytime—they will be happy to hear from you!  For Orange County, call Joel Nojovits at 845-503-0850.  For Rockland County, call Chuny Koenig at 845-503-0840.  You can also reach us at 855-HAMASPIK (426-2774).

Note: HamaspikCare accepts Medicare, most private health insurance plans that offer home-care benefits, and private long-term care insurance plans, which are geared specifically for home care and other long-term needs.