WHAT DOES A CARE CONSULTATION OFFER? - Part Two

Care consultations help families avoid getting lost in the maze of payment options for elder care.

This blog series illustrate the ways a care consultation can save families money, time and trouble. These stories are drawn from our experience with families and their elders: identifying information has been changed.

Paying for elder care is like making one’s way through a maze. In a maze, you can backtrack and take a different turn and it will only cost you time.  In elder care, the wrong move can be very costly.  

Annie’s Mother was diagnosed with cancer and needed treatment.  Following treatment, she was sent to a rehabilitation facility and then went home with help. All went well until she fell. The paid staff found her on the floor and sent her to hospital.  Annie arrived to find her Mother in the ER. Tests showed she was dehydrated, poorly nourished and had not taken all of her medications.  

The hospital was overcrowded and so was the ER. Mother didn’t even get a room in the ER for 24 hours. The staff began treatments and Mother improved. Rather than sending her home, Annie decided it would be better to return her Mother to the rehabilitation facility. Annie also considered moving her Mother so she would not live alone to avoid future problems.  This was especially important because Annie’s job took her all over the state. In an emergency, she might not return quickly.  

Annie didn’t review her Mother’s Medicare coverage. Mother had only been in the ER under observation.  She had never been admitted to the hospital.  Medicare covered many parts of her ER treatment.  If her Mother had been admitted and had stayed long enough in hospital, she would have qualified for rehabilitation: she didn’t. Annie received the Medicare determination letter several weeks later: not covered. Annie returned her mother home, with more help, medication supervision, and more worry while she was on the road.  She had to pay $18,000 to cover that stay. Consultations don’t cost, they pay.