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FIL in a really tough spot-looking for suggestions
Old 06-29-2016, 06:30 AM   #1
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FIL in a really tough spot-looking for suggestions

FIL is 84 years old, in poor health due to a stroke which makes it difficult for him to walk. He has not made the best financial decisions in life and seems to be making really poor health/financial decisions the last few years.

His situation is that he lives alone out in the country, in a very rundown house that I would not live in. He refuses to take care of his health because he cannot afford it. He does not have Medicare so unless he has cash to pay for health care his only option is the VA doctors but they are 120 miles away.

To make matters worse his drivers license expired on his last birthday. He did not remember to renew it. Last week he was in a traffic accident, (his fault), so now he is unable to drive, and it is questionable whether he will be able to pass a driving test to get a drivers license.

He wants to get new eyeglasses but he feels he must travel the 120 miles each way to get to the VA facility to get free eyeglasses. He fears he will not be able to pass the eye test for the drivers license without them. I have to assume he does not want to pay/can't afford to pay for a new pair from Walmart. I will probably foot the bill from Walmart other than taking a whole day of my time plus the cost to drive him to the VA facility, 240 miles roundtrip.

It is only a matter of time but if FIL is unable to get a drivers license he is basically screwed. He would be totally dependent on us to drive him anywhere. To make this worse, without Medicare he can't afford any health care locally. He refuses to discuss this, the one time I asked what we should do if he has a medical emergency. He has no money to pay for ambulance or the like, and more importantly how would it work being so far from the VA facility. His response was "just let me die". With that attitude, DW and I do not bring up this discussion anymore. He is not willing to discuss his own future as he does not want to change anything.

I wonder if it is possible for FIL to get health care locally that would be covered by the VA but I doubt it very much. I looked on the internet but could not find anything. I wonder what other VETs do that live in rural areas.

Just some further information, FIL probably has less than $10,000 in savings and his monthly SS is only about $1,400. He could not afford assisted living, and if his health deteriorates further, I am not sure he could even get into a nursing home. DW and I are not in a position to take him into our home and support him.

Sorry to the length of this post, I am looking for opinions/suggestions from anyone who has experienced a similar situation. A couple of questions I have;

1. Can a Veteran get any routine healthcare outside a VA facility when it is so far away and they can't themselves travel that far?

2. Can someone that never had Medicare get nursing home paid by Medicade? Sorry, if this is a stupid question but we are really concerned what will happen to FIL if he becomes incompacitated.
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Old 06-29-2016, 07:07 AM   #2
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1. Can a Veteran get any routine healthcare outside a VA facility when it is so far away and they can't themselves travel that far?

2. Can someone that never had Medicare get nursing home paid by Medicade? Sorry, if this is a stupid question but we are really concerned what will happen to FIL if he becomes incompacitated.
Yes. A vet can get care at a local facility. It needs to be approved. There is a program called the Choice Program that allows it. There are many veterans groups that also provide transportation to and from a VA Hospital.

Veterans Access, Choice and Accountability Act | About the Program

If he is low-income, low assets, Medicaid will pay for a nursing home.

There is no reason for him to NOT be on medicare. Sign him up.
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Old 06-29-2016, 07:14 AM   #3
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You might want to contact the VFW or you should have a vets affairs office at your local courthouse that might be able to give some guidance and help.
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Old 06-29-2016, 07:50 AM   #4
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Why isn't he on Medicare? Also, wondering why he would not qualify for Medicaid since he seems indigent or at least a low cost ACA policy.

If he has a prescription for glasses, check out zennioptical.com on-line glasses that many have had good results with. Or Costco or Walmart.

Sounds like he is getting to the point where he may need to move in with one of his kids.
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Old 06-29-2016, 09:01 AM   #5
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Make the time to take your FIL to the VA and have him screened for any and all possible service connected disabilities. Resign yourself that this will all to be done by you and your spouse. Contact a VFW or DAV branch for some help with this, do this first so you know the ropes.

Depending on how this works out, with his limited resources there could be help of several kinds provided by the VA up to and including free nursing home care. This takes some time so just get started on it and see what happens.

There is something going on here besides lack of money in regards to his not seeking medical care.
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Old 06-29-2016, 09:04 AM   #6
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Why isn't he on Medicare? I really don't know the whole story and that is a topic I will not try to discuss with him because he becomes belligerent. The best I can guess is that when he turned 65 he did not start paying for Medicare insurance because maybe he was still insured thru employment. Fast forward 10 years or so without paying into Medicare all that time, he was told he could pick up the insurance but he would have to pay a higher premium, or maybe catch up the past due premiums to become covered. Perhaps by that time he felt he could not afford a higher monthly premium so he never got it. I understand this was reviewed fairly extensively and either he can't get Medicare now, or the premium is so expensive he won't/can't afford it.

He might qualify for Medicaid but he only seems to want to go thru the VA which is not realistic if he has to travel 240 miles round trip. I thank you for the tip about the Choice Program.

With his attitude I doubt very much any of the children want to have him move in with them.
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Old 06-29-2016, 09:10 AM   #7
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Sorry to hear this about your FIL.

I would suggest contacting a county social worker. They know what programs are available, how to determine eligibility, and also how to work with individuals that are uncooperative.
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Old 06-29-2016, 09:10 AM   #8
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Tom52, if he went directly from employment to VA care I don't know that there would be a huge penalty for Medicare sign-up. VA care is considered compliant with ACA.

Is there any chance he would sign a POA so that someone can dig into this?

Now if he won't do a POA or talk to people, there really isn't much you can do, unless you want to involve social services in your family.
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Old 06-29-2016, 09:10 AM   #9
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....With his attitude I doubt very much any of the children want to have him move in with them.
Totally understandable but a tough call know his situation and struggles.
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Old 06-29-2016, 09:13 AM   #10
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He should be eligible for free Medicare Part A if he has enough work history credits. Part B may be too expensive with a LEP add-on but he may be Medicare/Medicaid Dual Eligible.

SHIP counselors at the local Council on Aging can answer questions about Medicare eligibilty, dual eligible coordination, and local assistance programs.
Locate a SHIP counselor

Quote:
Can I have VA health coverage and Medicare at the same time?

Yes. If you have VA coverage, you automatically get Medicare Parts A and B when you become eligible for Medicare due to age or disability. When your date of eligibility approaches, you will receive a notice and an ID card from Social Security. You will also receive information about your Part B premium, which is deducted from your monthly Social Security check unless you choose to pay your premiums in some other way. If you are eligible for Medicare Part B, but decided to not take it, you will have to pay a penalty later if you change your mind and add it to your Medicare coverage. The penalty can be substantial.
Reference: https://www.allsup.com/personal-fina...-faqs/veterans
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Old 06-29-2016, 10:34 AM   #11
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Sorry to hear this about your FIL.

I would suggest contacting a county social worker. They know what programs are available, how to determine eligibility, and also how to work with individuals that are uncooperative.
What he said.
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Old 06-29-2016, 11:04 AM   #12
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What he said.
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Sorry to hear this about your FIL.

I would suggest contacting a county social worker. They know what programs are available, how to determine eligibility, and also how to work with individuals that are uncooperative.
+2

Sorry that you and your FIL are in this situation. Unfortunately many of us have faced something similar or will at some point. The positive here is that you're trying to determine the best course of action now and not when he is facing a much more serious issue (which will come). Someone has to help him get to acceptance of the help that is available. Maybe it's his daughter or others but only then IMO will you get any real movement towards a solution.
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Old 06-29-2016, 11:04 AM   #13
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The SHIP counselor (State Health Insurance Program may be what it stands for) can be very helpful. I believe every state has SHIP counselors. Some have a different counselor for each county.

Also - someone else one the forum may be able to confirm this strategy - try to see if he is eligible through the VA for "Aid and Attendance". It's paperwork that you have to bulldog, but this designation can help with some things now such as home health aides (cooking, cleaning, grocery shopping, help with showering), and more down the road. Example: some areas have a V.A. Medical Foster Home program. These are people or families who take care of two or three veterans in their homes. The official designation of being eligible for "Aid and Attendance" means the VA may pay him an amount to make up the difference needed to pay for the Medical Foster Home. By the time he needs this, you can select a Medical Foster Home near you and your wife. It does not have to be one in his rural area.

Hopefully if he knows that there are possible benefits to be rightfully had, he will cooperate with you to sign papers.

Kindest regards.
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Old 06-29-2016, 11:53 AM   #14
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Our local senior center has counselors on site to help people like this with housing and healthcare options. You might want to see if this is an option in his area. There are many programs at least in our state for help for low income seniors - free phones, senior housing, Medicaid, utility bill supplements, food stamps, etc.

We had older relatives who lived out in the middle of nowhere and also lost the ability to drive. DH and I sent them money for taxis for a few years for groceries and medical appointment and then eventually they ended up moving into town near one of their adult children. They did find a senior club with some sorts of free transportation as well. But the adult child had to really take control of the situation and finances later on and buy and sell the old and new houses.
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Old 06-29-2016, 02:10 PM   #15
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we've just gone through a version of this - parents decided to move into assisted living. Would have been improbable without VA assistance for my Dad, who is 84. They will pay more than half of the rent. They can also greatly help with a nursing home if/when that's needed. We're glad to deal with this now, rather than later.
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