Living Independence
for the Elderly

What is Albright LIFE?

LIFE (Living Independence for the Elderly) is a Medicare/Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility.

With LIFE, you have a team of health care professionals working with you and your family to make sure you get the coordinated care you need. Usually they care for a small number of people, so they really get to know you.

When you enroll in LIFE, you may be required to use a LIFE-preferred doctor.

How Does LIFE work?

LIFE covers all Medicare/Medicaid covered care and services, and other services that the LIFE team of health care professionals decides are necessary to improve and maintain your health. This may include drugs, as well as any other medically necessary care, like doctor or health care provider visits, transportation, home care, hospital visits, and even nursing home stays when necessary.

What you pay for LIFE depends on your eligibility under Medicare and Medicaid. If you are eligible for Medicaid, or dually eligible for Medicare and Medicaid, you won’t pay a monthly premium for LIFE. If you don’t qualify for Medicaid, but you have Medicare, you’ll be charged a monthly premium for LIFE. If you don’t have Medicare or Medicaid, you can pay for LIFE privately.

However, in LIFE, there’s never a deductible or copayment for any drug, service, or care approved by the LIFE team of health care professionals.

Participants must receive all needed health care services, including primary care and specialist physician services (other than emergency services), from Albright LIFE or an entity authorized by Albright LIFE. Participants may be held financially liable for unauthorized, non-emergency services.

Who Can Get LIFE?

You can have either Medicare or Medicaid, or both, to join LIFE. To qualify for LIFE, you must:

• Be 55 or older
• Live in the service area of a LIFE organization
• Need a nursing home-level of care
  (as certified by your state)
• Be able to live safely in the community with help from LIFE

You can leave a LIFE program at any time.

What You Pay for LIFE Depends on Your Financial Situation

If you have Medicaid, you won’t pay a monthly premium for the long-term care portion of the LIFE benefit. If you don’t qualify for Medicaid but you have Medicare, you’ll be charged these:

• A monthly premium to cover the long-term care
  portion of the LIFE benefit
• A premium for Medicare Part D drugs
• There’s no deductible or copayment for any drug,
  service, or care approved by your health care team.
• If you don’t have Medicare or Medicaid, you can
  pay for LIFE privately.