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?
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?
p.s. Jeannie, get real.
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.
The fact is that most who are offering "free" services in the private sector are insurance agents who are seeking to sell high commission annuities. This is problematic on two fronts.
First, there is an automatic conflict of interest when a person offering services is compensated solely by the sale of a product.
Second, the fact is that most who need this benefit have absolutely no use for an annuity and, the purchase of same, can cause serious problems if the elder is seeking Medicaid benefits simultaneously or at a later date.
I would avoid insurance agents offering to assist with this type of planning as most simply have no idea what they are doing. I spend a lot of time undoing these mistakes and it is very, very costly to the client.
Anyone can call themselves a "financial planner".
However, to earn the Certified Financial Planner (R) designation one must go through rigorous examination, scrutiny, and continuing education.
Moreover, CFP's are required to act in a fiduciary capacity with respect to their client's affairs. This is the highest standard of conduct proffered by statute and a responsibility that no one in the profession takes lightly.
Although I am a Certified Financial Planner (R), I do not sell financial products, I do not invest client money, and I earn no commissions. My services are offered on a flat fee basis.
There are many non-lawyer planners who operate the same way and do an excellent job assisting families with these complex matters.
Naturally, such advice should only be sought if needed. If assets and income pose no problem with benefit approval for either Medicaid, VA, or both, then certainly take Evelyn's advice above.
What is unique about the VA in particular is that their stated mission is to assist veterans in receiving claims, not denying claims. My experience has demonstrated to me that this is true and the VA does a great job at every level.
Carol
It appears that most of these planners want to sell Annunities. I must have been asleep in Econ class the day that they taught Annuities, for there is a lot that I do not know. The offer by a CFP to me was: "Put up $100,000.00 into an annuity. I'll add $10,000.00 to that. In return you will receive $600.00 per month which is taxable at the rate of Ordinary Income. ( Normal Distribution). If you live long enough, the $100,000.00 will be eaten up by distributions. If you die before that, your contribution will be part of your estate" . p.s. I still do not know what the term Annuitized means.
Question: Why would I give up $100,000.00 to a guy when I could keep it in a low-yield CD, or Series I Bond, or better yet a low paying Money Market Account?
"Is Dad on Medicaid?".....my comment to you: Of course not, he doesn't qualify.
Medicaid is a state-sponsored program with low, (very low) income requirements and additional disability, not sickness. One does not usually have Medicare and Medicaid, although it is possible (rarely).
Your comment: "Is this 24/7 recommendation for a limited time, until Dad fully recovers? Or is this the likely state of things indefinitely?" My answer to you: He's not going to "recover". He's 97.
Mom is 90. These people have all they can do to take care of both Mom and Dad and keep their sanity. Let Medicare provide for them both. They will not lose Medicare. Hopefully they have a Supplemental Plan, and continuous S.S. checks for each of them until the day they die.
I personally know three people on Medicaid and Medicare concurrently. It never occurred to me that that is rare. How on earth you know that "of course" the man in question is not only not on it but doesn't qualify for Medicaid is a mystery to me. I'd rather ask than assume.
We certainly don't have to agree with each other on these discussion boards. A diversity of answers is often useful. But I would hope we could be respectful of each other, whether we agree or not.
(I believe the wording of the question has been edited since I responded.)
You Do see the reason for all of this, don't you? No state should carry anyone financially capable of paying for their own insurance while taking offerings from Medicaid.
Those under 65 applying for Medicaid who are disabled must wait two years after disability determination to qualify for Medicare. They may be covered by Medicaid alone in the interim but once eligible for Medicare, Medicare will be primary.
Those under 65 who are NOT disabled will not be eligible for Medicare until they are 65 but still may qualify for Medicaid.
Those over the age of 65 do not need to be determined "disabled". Most will already have Medicare in place and as I stated earlier, Medicare is primary.
It is possible to have private insurance AND both Medicare and Medicaid.
Example: For those over the age of 65 Medicare will be primary. Most also have a Medicare Supplement from a private insurer which will be secondary. Medicaid will then be tertiary. For those over 65 receiving Medicaid and NOT in a nursing home I always recommend a that a Medicare supplement insurance plan be in place (not an HMO or "Medicare Advantage Plan" by the way).
Since most of us here are 65 plus, and receiving Medicare with a supplemental coverge to pay the additional 20% that Medicare does not pay, we are all in different financial situations. Hopefully we also have Medicare Part D to pay for drug and medicine coverage. (They take the premiums out of the S.S. check every month). I personally do not know ANYONE who is a " Dual Eligible". Nor, do I know anyone who is a Medicaid recipient......the financial qualifications preclude most of us from qualifying. So there!
As I said in my opening statement, I stand corrected. I hope that the 93 year-old "recovers", and none of us will become financially eligible for Medicaid.....As they told Arthur, "you don't know how to be poor".
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?
I'm so glad you didn't get taken in by that annuity nonsense. Unfortunately the CFP Board allows CFP's to sell commissioned products...however commissions must be disclosed. I'm curious, where you told that the agent would make between 4 and 12% commission if he/she sold you that annuity?
General rule for all investing: If it sounds to good to be true, it surely is. In your case you were being offered the equivalent of a 7.2% interest. I'm sure you were told the annuity was a "safe" investment. So let's look at the interest rate on what used to be the safest investment on the planet.
As of today, 8/2/11 the interest rate on a 30 year US Treasury is 4.07%. So you were being offered an interest rate 43% higher than a 30 year Treasury.
On top of that they were promising you a 10% "bonus"...they were going to add $10,000 to your $100,000. Sure beats a toaster!!
And on top of that, the agent was going to earn between 4% and 10% of the $100,000.
Does this seem like a viable business deal to you? Of course not! Good for you for stepping away. Have patience. Interest rates will soon be soaring, unfortunately, so will inflation.
By the way...no offense taken.
Best wishes to you, Jeannie, and may you find peace and true contentment, a blessing in itself. May you continue to be kind to others as you have been to me.
I'm glad that I did not engage. As for interest rates, what can I say? Returns are down today ( 08/02/2011). Inflation is a slow burn....will rise of course.
Somehow I'm not too worried. Thank you again for sharing your great knowledge!
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.