Dear Toni,
Ten days ago, I placed my mother who has Medicare in a “re-hab facility” for approximately three weeks, thinking that her post-hospital therapy would go better there than it would here at home….WRONG….I enrolled my poor mother into The Halls of H*ll, and now, I desperately need to spring her OUT OF THERE!
My problem is this: we are fearful that we will be penalized in some way for NOT staying the entire 20 days.
Thank you in advance for the advice/help. Sincerely yours, Loretta from Sugarland
Hello Loretta:
I have never seen a Medicare penalty for not spending the 20 days in a skilled nursing or re-hab facility. If you feel the facility is not giving your mother the care she needs, it is her right to leave. I would report her unhappiness to the facility’s administrator.
I would talk with your mother’s doctor or facility’s case manager before trying to release her. Maybe hiring a personal care provider to spend some time at the rehab facility making sure that your mother is taken care of. You might want someone to sit with her, so that she is not by herself and to take some of the burden off of you, since you can’t be there 24/7.
Medicare will pay only for medically- necessary health related claims. Many think Medicare helps with Long Term Care, but Medicare will only pay for skilled nursing. If one cannot qualify or does not meet Medicare’s qualification for skilled nursing, then they may have to pay 100% of the cost. Skilled nursing has 100 days of benefit with day’s 1-20 having
$0 co pays per day and days 21-100 with a $144.50 co pay per day. Medicare pays absolutely nothing for assisted living, personal care homes or extra provider care that is not medically –necessary at home.
Many need some help at home with everyday routines generally involving functional mobility and personal care, such as bathing, dressing, toileting, and meal preparation.
If your mother has a Long Term Care policy, then it can help pay for non-medical service.
If not, then she will have to pay for it herself until she spends down to qualify for Medicaid or Community Based Alternative (CBA). CBA provides home and community based services to people who are elderly or adults with disabilities. CBA is a cost effective alternative to living in a nursing home. It doesn’t hurt to call your local Medicaid office to see what it will take for her to qualify.
There is financial help, known as Aid and Attendant benefit from the VA. With the Aid and Attendant benefit a Veteran or surviving spouse of a Veteran that needs additional care, may qualify for assistance and could receive $1,632 per month to a veteran, $1,055 per month for a surviving spouse or $1,949 per month to a couple. This is a secret that many do not know about. There is over 20 Billion dollars available to Vets as a pension, so that the Vet or spouse of a Vet who needs additional care at home or to help pay for assisted living facility or non medical personal care at home.
I have consulted with many caregivers/family members who are struggling trying to find what to do for their loved one. Here are some tips to help you choose a non-medical provider:
1) Decide if “At Home Care” is the right choice. Non-medical or At Home Care is different that home healthcare which is provided with Medicare.
2) Evaluate the pros and cons of “at home non-medical caregivers”, assisted living, personal care or nursing homes.
3) Determine the cost of senior care options.
4) Always talk to your loved ones doctor.
For help visit www.caregiverstress.com or email me I can recommend names of non-medical providers as well as other service providers.
Toni King is an advocate/consultant for those “Confused about Medicare”. Email questions to asktoni@medicaretruths.com or call 281/830-3896. Visit her website www.medicaretruths.com.
