Dad, age 93 ready for release from rehab hospital to home with 90 year old mom, but p/t will only approve it if we have 24/7 caregiver in addition to mom (she is not able to handle it alone in pt opinion). If we do not have that 24/7 in place and something happens to dad while home, are we at risk of losing medicare coverage?
Hospitals and Skilled Nursing Facilities are under new Medicare guidelines with respect to discharge in an attempt to reduce "recidivism". This includes specified recommendations and followup. He may not be discharged if the conditions recommended are not in place.
As suggested above, if the recommendation is that Dad should be supervised 24/7, that is what should be provided. If such care is unaffordable or not practical at home, then a long-term nursing home placement should be considered until such time as he has recovered sufficiently to be safe at home.
Of course this may never occur (full recovery), and at 90 and 93, an alternative to home may be the best bet, i.e., assisted living.
Presuming this is NOT affordable, consider assisted living expenses versus all of the expenses maintaining them at home (taxes, insurance, food, transportation, utilities, etc.).
Between their combined income, Medicaid community benefits that may be available (what state do they live in?), and possible Veteran benefits if Dad was a vet, you may indeed find assisted living a viable alternative.
Check out:
Medicaid home and community benefits.
Veteran benefits.
If you can be more specific with respect to their financial and medical situation (and disclose what state they are in), I can be more specific as well.
Carol
But, here are some general rules that apply to your situation:
1. Your father’s eligibility for basic Medicare coverage – also called “original Medicare” – is primarily based on his citizenship and the length of time that he paid Medicare related payroll taxes. If he worked for at least 10 years and paid payroll taxes that hole time, he should get Medicare Part A for free and Medicare Part B for $115 per month. That $115 premium is usually deducted from a person’s monthly social security check. There are always exceptions with Medicare, but these rules and prices apply for most people.
2. I’m not aware of anyone’s Medicare coverage being cancelled for any reason, except in instances of fraud. Although, again, there are always exceptions with Medicare.
If I’m reading between the lines of your question correctly, I’d assume you’re more concerned about whether or not your Medicare coverage will cover the cost of a professional caregiver, if they’re not the caregiver prescribed by your father’s treatment center. And, again, this will likely depend on what type of coverage you have, what state you live in and whether or not the caregiver services you wish to select are covered by The Center for Medicare and Medicaid Services, or by your father’s ancillary Medicare insurance, if he has any.
If you have supplemental insurance – Medicare Advantage or a Medicare Supplement - the best advice I can give you is to contact the insurance company directly and explain the situation. They should be able to tell you if your desired caregiver would qualify. But, the issue should not affect basic Medicare eligibility. Worst case scenario, you still have Medicare but pay for the caregiver out of your own pocket.
For more information on your specific problem, I would encourage you to speak to Medicare at 1-800-MEDICARE.
p.s. Jeannie, get real.
Is cost the concern? Is Dad on Medicaid? Would he be eligible? Have you discussed with pt how this 24/7 could be made possible?
Is it Dad's stubborn resistance to in-home care that is the stumbling block? Would it help to present this as something to help Mom, who cannot cope with all the responsibilites?
Is this 24/7 recommendation for a limited time, until Dad fully recovers? Or is this the likely state of things indefinitely?
In any case, you have a wealth of experience as a caregiver to offer here. You can share those experiences, offer encouragement, caution others about what didn't work for you, and generally extend a helping hand. You don't need to be an expert on medicare and medicaid or any other technical topics to make a huge contribution here. Share what you do know, what you feel, what you believe. I just ask that you not disrespect the statements (or in this case the questions) of others.
Truce?
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