Medicare -- After this, I think I need a Doctor!

Having terminated Jeanne's full-time caregiver and re-claimed the job as my own, I soon realized that life would require me to be out of the house on occasion and I wondered how I would handle that.  First, I differentiated between those trips away from home that were less than an hour in duration and those trips away from home that were longer than an hour in duration.  I decided that Jeanne could handle the "less than an hour" trips on her own.  So I was covered for the "life happens" trips -- supermarket, bank, dry cleaners, etc.  On to the "longer than an hour" excursions. 

Prior to her release from the hospital, one of the nurses told me that she thought Medicare covered home health aid activities.  I visited the Medicare website.  Here it is, verbatim: 

Medicare generally doesn’t pay for long-term care. Medicare also doesn’t pay for help with activities of daily living or other care that most people can do themselves. Some examples of activities of daily living include eating, bathing, dressing, and using the bathroom. Medicare will help pay for skilled nursing or home health care if you meet certain conditions.

Well, I thought that was kind of interesting in a self-contradictory way.  "Medicare doesn't pay for long-term care," followed by, "Medicare will help pay for skilled nursing or home health care if you meet certain conditions."  And so I called Medicare to find out what those "certain conditions" were. 

It turns out those "certain conditions" were very straightforward!  If Jeanne's physicians were recommending that a Registered Nurse visit Jeanne (which she does, twice each week) or that Jeanne should receive physical therapy (which she does, every week), then a home health aid could "stop in".  And so I further inquired, "Well, when would this person 'stop in'?  Here's what Jeanne needs assistance with:

• Feeding three times a day by means of her feeding tube
• Receiving medications 4 times a day by means of her feeding tube
• Being turned every 2 hours in the hospital bed we have set up for her
• Dressing
• Bathing
• Etc., Etc., Etc.

Not to worry, I was assured.  That home health aid would be there to handle all of this and more.  All I had to do was contact any one of the 52 approved service providers in my area!  And so I started calling these 52 approved service providers, and this is what I discovered:

• Only 1 out of 52 even knew they were "Medicare approved"
• Not one of them would take the assignment because...
• All of them had no idea of how or when or if they would be paid by Medicare.

And so I contacted Medicare again.  This time I was told, no...they don't provide home health care.  Except under certain conditions.  (This started to sound familiar).  So here's what we're going to try:

Jeanne's doctor has put in a new order for home health care.  A home health aid will come to our home and make a determination of how long she would be spending there, and then inform me of same. I honestly have no idea when or how this story will end.  For now, I'm still enjoying my role as Jeanne's primary caregiver.  Of course, the other night a couple of friends needed my command of obscure factoids to round out their trivia team, so I picked up the phone and called one of Jeanne's former caregivers and hired her for 3 hours that evening.  Jeanne slept through most of those 3 hours.  Our trivia team just missed placing in the money at the trivia competition (wait 'til next season!) and all was right with the world.  Necessity may or may not be the mother of invention, but it is certainly the mother of common sense. 

Stay tuned...

Comments

[Patti]

Thanks for posting this info. I will copy and paste and send to my father. How is Jeanne's spirit lately? Hope she is doing well. My prayers are with her as well as YOU!

[Jon Strum]

Hi Patti,

Jeanne's spirit is sky-high lately. Since we terminated our live-in caregiver and I took over that responsibility, Jeanne has improved in ways I didn't think she could. We're both pretty happy about that!

And thank you for your prayers. It seems as if they are being heard!