(says Toni) Need assistance selecting a house well being care company? | opinion

Dear Tony: Help!!! My mother-in-law is 85 and lives alone in an independent living facility. After being hospitalized in November, she required 24-hour medical care at home.

The hospital and manager of the facility where she lives told us that Medicare would not pay for 24-hour home care because she wanted to stay at home and not go to a qualified nursing facility, which she was offered.

The services the independent living facility provides are not Medicare certified, and she must pay for home care herself. It’s costing us a fortune now.

She’s doing better and a friend told me about home health care and that Medicare will pay for it. I looked for home health care agencies on the Medicare website and found more than 700 in my area that are Medicare certified. How can we make the right Medicare decision by choosing a home health care provider for my mother-in-law? Thanks. – Jennifer from Little Rock, Ark.

Jennifer: The 24-hour out-of-hospital medical care offered to your mother-in-law that Medicare would pay for is qualified nursing. With qualified care, the first 20 days are free, with days 21-100 costing $200 per day beginning January 1, 2023.

During your Toni Says consultation in November, you told me that your mother-in-law had a Plan F Medicare supplement that would have paid for qualified nursing, so she would have $0 out of pocket for her stay in qualified nursing if it was a medical necessary.

They also told me that she wanted to go home and refused to go to the skilled nursing facility. Her husband (her son) made sure her wish was granted and as you said 24 hour home care is costing you an absolute fortune.

You’re right, trying to find the right home health care agency can be a daunting task as there are numerous Medicare-certified home health care agencies in your area to choose from. The National Association for Home Care & Hospice (https://tinyurl.com/mwn84e6r) suggests asking a number of questions to help narrow your search, including:

is

  • the agency medicare certified?

is

  • the state-approved agency?

What

  • are the agency supervisor credentials?

Are

  • the agency for healthcare professionals, nurses and caregivers or are they contract workers?

Make

  • they create a written care plan for each patient?

Don’t forget that there must be a medical need for Medicare to pay for the services provided by a home health care business. Home health care includes nursing, physical therapy, and other medical needs for Medicare beneficiaries who are “homebound.” Medicare does not pay for child custody, e.g. B. Making sure your mother-in-law takes a bath, gets dressed, or is ready for bed every day. You pay for the care on an hourly basis.

Order medical care:

A

  • The doctor must order home nursing care and sign off on the plan.

That

  • The home health care facility must then arrange a face-to-face meeting with the patient and their family members to cover what care and services are needed.

That

  • The care plan and certification takes up to 60 days.

That

  • The 60 Day Care Plan should be recertified as the patient improves and the physician must sign off to approve the recertification periods.

Americans should be aware of the home health care and other medical services that Medicare may provide to them or their loved ones to improve recovery at home.

Toni King is an author and columnist on Medicare and health insurance topics. She has been a top sales manager in this field for more than 27 years. For a Medicare investigation, email: [email protected] or call 832-519-8664. You can now visit www.seniorresource.com/medicare-moments to listen to their Medicare Moments podcasts and find out more information for baby boomers/seniors.

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