Elder care costs, insurance, etc.

[Brat]

When my elderly Dad was at a nursing facility after surgery he became a pita after about 8 weeks because he believed that they would kick him out if he tried hard enough. What really happened is that Mom concluded she couldn't manage his behavior and kept him there until he became convinced that being nice would get him home sooner.

In the hospital and for several weeks post-op he would try to pull out IVs. The fact that he didn't expect to wake up in a nursing facility impacted his attitude, and since he had brain surgery his medical issues also played a significant role.

Also, I think men look at incapacity differently than women. First elderly men are much more likely to hasten death if they conclude that they are facing life long incapacity. Second, elderly men expect their wife to take care of them at home - often without a clear understanding of each of their needs and capacities.

[bright eyed]

Praise the universe...after pestering the poor overworked county social worker (called every day for 10 days at least...) I got a response! Once they switch FIL status to long term care, his costs are covered and MIL gets to retain her income based on the catastrophic coverage legislation to prevent spouses from dire bankruptcy in these situations...

Just prior to this, we had received the first bill for his share of cost and it was over $1300/month which would have put MIL on the street (not really, but a 300 mile move to our house and nobody to visit FIL)...the change in status will allow medi-cal to cover his expenses until his wound is healed. I am very, very grateful for this safety net...

[youbet]

bright eyed....

I'm pleased there is some sensibility in the system of safety nets there and that your MIL is being helped!

Im curious though..... Are they taking your FIL's SS and allowing MIL to keep only her disability? Or is she getting to keep both, the combined $1900/mo?

I follow along on this sort of thing because we have a family situation which will likely evolve similarly.

[chinaco]

Children are paying the bill. Both in time/effort and out of pocket spending. Here is a CBS new piece on the topic.


CBS News Video - Top Stories and Video News Clips at CBSNews.com


Once someone is broke... they qualify for Medicaid. However, be warned. Nursing Homes are horrible. The sad truth is... It is ironic; the more one is dependent on a nursing home's personnel, the more likely they are to be neglected or not receive adequate care.

[Sandy]

bright-eyed,

I am glad that you have been able to get the system to work for your ILs. Hope he recovers quickly.

[bright eyed]

Quote:

Originally Posted by youbet bright eyed.... I'm pleased there is some sensibility in the system of safety nets there and that your MIL is being helped! Im curious though..... Are they taking your FIL's SS and allowing MIL to keep only her disability? Or is she getting to keep both, the combined $1900/mo? I follow along on this sort of thing because we have a family situation which will likely evolve similarly.

Yes, she's allowed to keep up to $2500 for 2007 and 2008 is slightly higher...so she's below that limit - she keeps both incomes - part of the rational is that all of FIL's needs are covered by the nursing home.

I would definitely triple check everything they tell you - it was no small feat getting the right info and figuring out what to do.

Plus the daily calls, getting put on hold, having calls dropped - was not fun at all! But I was very patient and did not take it out on the people i was talking to - and they were all very patient too (considering they are so obviously understaffed)...

Also, the social worker didn't know the policy as well as i did and so i told him what i knew, he double checked and fixed it. so that's why i say, check check check again! i can't imagine how many people's cases get screwed up because of errors!

Youbet - some of this is CA policy, some is federal - i think the catastrophic coverage law is federal so i think the amounts above apply to everyone (but of course, i'd check that if you are not in CA)...so all of this plays into how much medi-cal is willing to cover them.

but most states' the insurance program works in a similar way - where medicare is the primary coverage and the state coverage helps fill in the gaps.

the oddest part is - now that he is in nursing care - their coverage is all "covered" - but before they had that insane share of cost that would have put them in negative. now they both have full medi-cal - so there are some weird inconsistancies in the policy.

on the other front, FIL is still not cooperating in any consistant way and i can hear the frustration in the staff's voices. at least this alleviates some stress for MIL and we can all focus on his mental state....