By Tony King
Dear Toni: 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 director of the facility where she lives told us that Medicare would not pay for 24-hour home care because she chose to stay at home and not go to a qualified nursing facility that was offered to her.
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 searched the Medicare website for home health care facilities and found over 700 Medicare-certified facilities in my area. How can we make the right Medicare decision by choosing a home care provider for my mother-in-law? Thank you Jennifer, Little Rock, AR
The medical care 24 hours away from the hospital that Medicare would pay for is qualified nursing that was offered to your mother-in-law. With Skilled Nursing, the first 20 days are free, with days 21-100 costing $200 per day starting January 1, 2023.
During your Toni Says Medicare® consultation in November, you told me that your mother-in-law had a Plan F Medicare supplement that would have paid for qualified nursing. Leaving you with $0 (zero) out of pocket for your qualified nursing stay if medically 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 of Home Care suggests asking the following questions to narrow your search:
1. Is the agency Medicare certified?
2. Is the agency state licensed?
3. What certificates do the agency supervisors have?
4. Are the healthcare professionals, nurses, employees or contract workers for the home health care business?
5. Will there be one written care plan for each patient?
Don’t forget that there Got to be a medical necessity that Medicare pays for the services provided by a home health care company. 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.
Ordering home health is not complicated:
• A doctor must order home nursing care and sign the plan.
• The home health authority schedules a face-to-face meeting with the patient and family members to determine what care and services are needed.
• The care plan and certification takes up to 60 days
• And the 60-day recertification periods continue as she gets better, and her doctor must sign off on the recertification periods.
• Home health care includes nursing, physical therapy, and other medical needs for Medicare beneficiaries who are “homebound.”
Most Americans are unaware of the medical benefits they can get from Medicare, such as: B. Home health care that can contribute to their recovery at home.
For a Medicare investigation, email [email protected] or call 832/519-8664 for an answer to your Medicare question. Medicare Survival Guide Advanced Edition is available at www.tonisays.com.
Visit www.seniorresource.com/medicare-moments to listen to Toni’s Medicare Moments podcast and for more information for boomers/seniors.