My parents need to move closer to me from FL to TX. My mother needs minimal care and is ok living with me. My father recently broke his hip and has had several strokes. He will require more skilled care. He is currently in rehab hospital but I want to move him to a nursing home in Texas closer to me. I am the sole caregiver but live out of state. Will Medicare or Medicare advantage insurance pay for him to be moved/transport?
At some point in the past, they made a decision to removed themselves from traditional federal Original MediCARE and instead go to an Advantage Plan. They are touted as being of low or no premium and have extras like “Silver Sneakers” exercise class. The Plans run on an “in network” system for paying for care with a participating hospital system or perhaps two systems & pay a prenegotiated rate. Any providers or labs or services that are not within network will either be paid on a low & limited payment (maybe 20%) or not paid at all. Please please read this again, you need to ASAP find out if where dad is right now is within network for his Plan and if all his providers - like MD, PT, OT, Speech Therapist, etc - are in his Advantage Plan. If not, his bill will be huge.
imo Advantage Plans are maybe, just barely maybe, good for healthy boomers who don’t travel & likely never need beyond regular maintenance, on standard drugs & ok with PA or NP for doing initial evaluations. If not, gonna cost you big time.
Rehab facilities can be on Advantage Plans. Usually their speciality places, like for brain injury or stroke or cancer care. The more traditional NH aka skilled nursing care facility with a smallish rehab wing, usually are not in network as they are more about long term residential care which is not covered by Medicare (whether it’s Original Medicare or Medicare Advantage). Long term residential care in a NH is either private pay or a LTC insurance policy or their state of residence LTC Medicaid program.
If they have $, maybe 200-300k, they have enough $ to rent a van or RV & then for him to enter a NH as a private pay resident. TX NH run 8-10k for ones that have both private pay & Medicaid beds. There will likely be a medication management daily fee added atop his room & board.
But if no $, then LTC Medicaid can get applied for. For couples, LTC Medicaid is not a DIY project imo and they need an elder law atty as thier assets have to be evaluated as to how to have mom possibly & legitimately keep assets they have to enable her to stay living & using those assets as the “community spouse” but still get dad eligible for LTC Medicaid.
Personally I think if they have FL assets - home, cars - it will be a pretty daunting full time project for you to get them to TX, get those FL assets sold, caregive till he can enter a NH, do whatever needed to establish TX residency for both of them and get him eligible for TX Medicaid even with an elder law atty, plus juggle getting mom settled.
Ask the NH your looking at in TX, just what they need to have to have him move in both financially and medically. It may be 4 months room & board prepaid and that you personally sign a financial responsibility contract. And they get a copy of his chart at his current rehab facility or need a fresh needs assessment done to determine if they can provide the level of care needed. Also ask them which Medicare thier residents have. By moving out of state, it enables them to leave their current Adv Plan and go into another one in TX. Good luck
Advantage plans are county specific health insurance or the nearest medical services if the county you reside in does not have services.
You should contact a Medicare specialist insurance broker in your area to help you with the insurance end of this move.
From my personal research, no insurance will pay for a non medical move, meaning they would pay to transport him to receive required medical care, but not a move nearer family.
I would rent a motorhome and transport him. It is far cheaper than a medical transport company.