Dementia Care Management FAQ
How does the GUIDE Model Program differ from my current care with the Community Memorial Dementia Care Management Program? What is changing?
- The care you and your loved one currently receive with the Community Memorial Dementia Care Management (DCM) Program will remain the same. You’ll continue comprehensive visits, as-needed follow-ups, and communication with your dementia care specialist and DCM team. Enrolling in the GUIDE model can provide you with additional benefits if you are eligible.
- Unlike the DCM program where cost-sharing applies, the GUIDE Model Program has no cost-sharing – it is waived – and is offered at no cost to those who are eligible.
What if I do not want to enroll in the Community Memorial GUIDE Model Program?
- We understand that personal circumstances may vary. We respect your right to decline participation in the GUIDE Model. GUIDE-eligible patients who decide not to participate can continue enrollment in the DCM program.
- If you change your mind and would like to enroll in GUIDE, we can initiate the enrollment process at any time.
I don’t have straight Medicare Part A&B, but I have Medicare Advantage, commercial insurance, or another type of insurance that Community Memorial providers accept. Will I be able to enroll in the GUIDE Model Program?
No, the Community Memorial GUIDE Model Program is only available to those who meet the eligibility requirements and have Medicare A&B as their primary insurance.
Do I have to have a home visit?
It’s required for participation if you meet the eligibility requirements for the GUIDE Model. If you do not consent to a home visit, we can’t keep you enrolled in the program. We understand that personal circumstances may vary. We respect your right to privacy and your decision.
What if my loved one doesn’t qualify for a home visit, can we still get one?
We can’t provide a home visit if you don’t meet the eligibility requirements.
How can I use the respite fund?
Once we identify the need for respite services, the Community Memorial GUIDE Model program arranges for these services to begin with a home care agency or refers you to an adult day care center. The partner agency will contact you to schedule services. Once services are provided, the agency bills the Community Memorial GUIDE Model program, and we pay the agency using Medicare funds. You should not receive a bill from the partner agency.
Who has access to the respite services fund?
Community Memorial GUIDE Model Program manages respite service funds for all eligible GUIDE enrollees. Funds are not given directly to the GUIDE enrollee.
Who can provide respite services?
- Only adult-day centers and in-home care agencies that have established partnerships with the Community Memorial GUIDE Model program can provide respite services.
- GUIDE enrollees cannot use respite funds for their personal caregiver, In-Home Supportive Services (IHSS), or receive direct payments.
I am not eligible for GUIDE respite benefits through CMS, but do have Medicare or a Gold Coast Health Plan (GCHP) as my primary insurance, will I be provided with a respite fund?
No, this is a CMS benefit that is only available through CMS for those that are eligible. For those that have GCHP, there may be additional benefits that you may be eligible for through their Community Supports services.
What if I run out of the respite fund before the end of the year? Will the Community Memorial GUIDE Model program cover additional respite costs?
No, if your respite funds run out before the end of the year, you are responsible for the costs of additional respite care.
