Any help is greatly appreciated. We have caregivers 8:30 am-7 pm. Currently paying all out of pocket. Will medicare pay any? Also, do they pay with any costs to help keep her safe (shower chair, shower/toilet bars, walker)?
Sally When I use the word Medicare I mean Original Medicare. You may mean the same or you may mean one of the many Medicare Advantage plans. They are not all the same, you have to check with your moms plan to see if she has original Medicare or a MAP and contact them to see what is covered and how. Either way you will need a doctors prescription. If you know a DME (durable medical equipment) company, you can call them and they will guide you on what the options are and what to ask for. The larger ones know the insurance plans and what they will pay for. It is their business to know. They will also send the request to the doctor, etc. So, if your mom has original Medicare, it will pay for 80% of the cost. It is like a rental. Each month (or maybe it’s each quarter) Medicare will pay the DME company the 80%. If you keep the equipment long enough, it will be paid off and your mom will own it. The other 20% is paid by her supplement policy if she has one. My mom did have a supplement so her combined benefits paid for her hospital bed, wheelchair, etc.
Some items like a shower chair or bedside commode I think are paid in full. The more expensive items are prorated over two or three years.
The area agency on aging had a program when my mom needed services that they sent out to do grab bars and a wheelchair ramp. This is something that the AAA had approved for seniors in her area. Last I checked it wasn’t being offered any longer. You have to check with them to see what services they might have available. The DME companies sell those as well but be very careful of the suction type in showers. My mom had two bedside commodes. She used one in her shower and one over her toilet. It allowed her the arms to assist in standing. She had arthritic knees and was tall so the shower chairs were too low for her. She had wooden grab bars going up and down steps. Again if your mom has original Medicare you can ask her doctor to order home health services. Under Part B for homebound seniors there is a benefit which is very helpful to me if you use them as they are intended. A nurse will come weekly to check vitals and set up meds. A bathing aide will come to bath the patient..My mothers changed her sheets and put them on to wash, occasionally heated or brought a meal. If she needs blood work, UTI test etc., they will take care of it working with your moms primary for orders. Additionally you can have her assessed for PT/OT. They are not caregivers like you have hired but they are an extra set of eyes who can be part of your care team to keep mom safe at home. My private caregiver for my DH aunt was not there to bath her. She gave her meds, cooked her meals, did light housekeeping, did laundry. Home health did the baths.
My mom just tried to purchase her first walker (rollator) through Medicare... she needed a note ("prescription") from her doctor and it had to be purchased through a medical goods company, so the one she chose at Costco was not eligible. Also, it would not have been covered 100%. As far as I know Medicare will only pay for 1, but not sure if they will ever pay for a second one.
If Medicare doesn't cover the other items, go onto Nextdoor.com and do a ISO (In Search Of) for those items and maybe on craigslist.org and you may get them for free.
As to the walker, that may be covered under DME (durable medical equipment) the doctor may have to write an order for it. The same for the shower chair or shower bench. If a raised toilet seat with "arms" or bars to make getting up easier is what you are talking about it also might be covered under DME. Not sure about regular grab bars that might be needed. If you do install them PLEASE make sure they are done properly. When I was looking for grab bars there were none that I could find that would go into a wall stud unless you set them at an angle. You had to use special bolts if the bar was going into dry wall. Same if you are going into tile. Make sure whoever is putting them in knows what they are doing.
You say your mom is in Independent Living. Does this mean she is living at home (private residence) or does this mean she is living in an Independent Living Community? If it is the latter it might be time to transition her to either Assisted Living where she would get more help OR Memory Care where all her care would be covered by the staff. If you mean she is living in her private residence then a few suggestions... contact local Area Agency on Aging and see if she qualifies for any services they may be aware of. Contact local Senior Center they may be aware of programs. Both will have Social Workers that can help navigate some of the organizations that may be of help. And the off chance that mom is a Veteran check with the local Veterans Assistance Commission and see if she qualifies for any help from the VA
When I use the word Medicare I mean Original Medicare. You may mean the same or you may mean one of the many Medicare Advantage plans. They are not all the same, you have to check with your moms plan to see if she has original Medicare or a MAP and contact them to see what is covered and how.
Either way you will need a doctors prescription.
If you know a DME (durable medical equipment) company, you can call them and they will guide you on what the options are and what to ask for. The larger ones know the insurance plans and what they will pay for. It is their business to know. They will also send the request to the doctor, etc. So, if your mom has original Medicare, it will pay for 80% of the cost. It is like a rental. Each month (or maybe it’s each quarter) Medicare will pay the DME company the 80%. If you keep the equipment long enough, it will be paid off and your mom will own it. The other 20% is paid by her supplement policy if she has one. My mom did have a supplement so her combined benefits paid for her hospital bed, wheelchair, etc.
Some items like a shower chair or bedside commode I think are paid in full. The more expensive items are prorated over two or three years.
The area agency on aging had a program when my mom needed services that they sent out to do grab bars and a wheelchair ramp. This is something that the AAA had approved for seniors in her area. Last I checked it wasn’t being offered any longer. You have to check with them to see what services they might have available.
The DME companies sell those as well but be very careful of the suction type in showers. My mom had two bedside commodes. She used one in her shower and one over her toilet. It allowed her the arms to assist in standing.
She had arthritic knees and was tall so the shower chairs were too low for her.
She had wooden grab bars going up and down steps.
Again if your mom has original Medicare you can ask her doctor to order home health services. Under Part B for homebound seniors there is a benefit which is very helpful to me if you use them as they are intended. A nurse will come weekly to check vitals and set up meds. A bathing aide will come to bath the patient..My mothers changed her sheets and put them on to wash, occasionally heated or brought a meal. If she needs blood work, UTI test etc., they will take care of it working with your moms primary for orders. Additionally you can have her assessed for PT/OT. They are not caregivers like you have hired but they are an extra set of eyes who can be part of your care team to keep mom safe at home. My private caregiver for my DH aunt was not there to bath her. She gave her meds, cooked her meals, did light housekeeping, did laundry. Home health did the baths.
They do not provide or pay for caregivers.
If Medicare doesn't cover the other items, go onto Nextdoor.com and do a ISO (In Search Of) for those items and maybe on craigslist.org and you may get them for free.
The same for the shower chair or shower bench.
If a raised toilet seat with "arms" or bars to make getting up easier is what you are talking about it also might be covered under DME.
Not sure about regular grab bars that might be needed. If you do install them PLEASE make sure they are done properly. When I was looking for grab bars there were none that I could find that would go into a wall stud unless you set them at an angle. You had to use special bolts if the bar was going into dry wall. Same if you are going into tile. Make sure whoever is putting them in knows what they are doing.
You say your mom is in Independent Living. Does this mean she is living at home (private residence) or does this mean she is living in an Independent Living Community?
If it is the latter it might be time to transition her to either Assisted Living where she would get more help OR Memory Care where all her care would be covered by the staff.
If you mean she is living in her private residence then a few suggestions...
contact local Area Agency on Aging and see if she qualifies for any services they may be aware of. Contact local Senior Center they may be aware of programs. Both will have Social Workers that can help navigate some of the organizations that may be of help.
And the off chance that mom is a Veteran check with the local Veterans Assistance Commission and see if she qualifies for any help from the VA