What Does Your Plan Pay For Home Health Care?

OneEyedDiva

OneEyedDiva

SF VIP
Location
New Jersey
In trying to get all my ducks in a row by letting my son know what to do if I should need home health care, I finally called Aetna to get clarification on the home health care benefit. The representative said they will pay for 35 hours a week as long as the doctor certifies it as necessary. I"m thinking I might need at least 40 hours. Either way that's a huge savings over what out of pocket nursing home costs would be, something I have been striving to prepare for financially. Aetna only pays for 120 days of nursing home care for every benefit period. One has to be out of the nursing home for at least 60 days for a new benefit period to begin; prior hospital stay and doctor certification of need required. Due to what's happening with COVID in nursing homes, my family would never put me in one now.

My plan is a medigap plan but here's what standard Medicare covers and does not cover when it comes to home health care:
https://www.medicare.gov/coverage/home-health-services
What plan do you have? What will it cover?
 

When my wife and I were released from the hospital After having covid we really couldn’t do much for our selves the first week or so ..

we needed the daily life stuff done , like the laundry , eating , cleaning etc .

medicare and long term care covered no part of that help .

we ended up using door dash to provide us with all meals which were awesome ...we had the cleaning girl come in for 3 dates a week to clean and do wash ....

the meals were awesome as we have so many fabulous restaurants in our area ...we ate like pigs ...we still bring in a few meals a week .

we are home 4 weeks and two months from first symptoms and we still have fatigue as well as breathing capacity is still working its way back ...

having both of us laid up was something we never planned for ...no one had our mail box keys ...there were some bills we needed to handle coming in ,etc ....

The kids live out of the area so the fact before the hospital would release us they wanted the oxygen delivered for in home care .we had to scramble to find the building super and hope ha had our keys we gave 40 years ago to the apartment so oxygen could be set up

there were so many things we did not plan for if both of us were admitted ...something as simple as a car crash could have both in a couple out for the count.


we made little go bags now with things like poly grip for my denture .which the hospital did not have ..the denture eventually cracked from flexing .

longer charging cords for the iPad and phone so they reached the bed .

even a set of house keys ...I was brought by ambulance and I caouldnt remember if I took my keys until I was able to get out of bed .

there are so many things you want when you get stuck for weeks in a hospital unexpectedly
 
I just have the basic Medicare coverage.

If I'm able to get around enough to be left alone I think that I would be able to piece together the services I would need and self-pay for someone to come in a few hours each day or every other day. These days there are many home health service providers available but for me, the tough part would be to find someone that would be compatible, honest, and reliable.

If I get to the point that I don't feel safe alone I would move to an assisted living or rehabilitation facility where I would have access to limited assistance 24X7.
 

Aunt Bea said:
I just have the basic Medicare coverage.

If I'm able to get around enough to be left alone I think that I would be able to piece together the services I would need and self-pay for someone to come in a few hours each day or every other day. These days there are many home health service providers available but for me, the tough part would be to find someone that would be compatible, honest, and reliable.

If I get to the point that I don't feel safe alone I would move to an assisted living or rehabilitation facility where I would have access to limited assistance 24X7.
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No supplement ? Why not at least a high deductible as a back stop .

we have very few medical expenses typically . But that is only until you don’t .

covid hitting both of us was unexpected .

medicare did not waive any charges for covid events ..luckily our high deductible supplement did so they paid all the stuff Medicare didn’t .

because it happened at the end of year and crossed over in to 2021 all new Medicare deductibles reapplied for the doctors as well as the fact it was both of us made it x2 .

so that supplement really paid off ...so far not including the doctors bills yet. Our two stays were a quarter of a million dollars as far as what was billed ...our responsibly was ten bucks thanks to the supplement
 
mathjak107 said:
No supplement ? Why not at least a high deductible as a back stop .

we have very few medical expenses typically . But that is only until you don’t .

covid hitting both of us was unexpected .

medicare did not waive any charges for covid events ..luckily our high deductible supplement did so they paid all the stuff Medicare didn’t .

because it happened at the end of year and crossed over in to 2021 all new Medicare deductibles reapplied for the doctors as well as the fact it was both of us made it x2 .

so that supplement really paid off ...so far not including the doctors bills yet. Our two stays were a quarter of a million dollars as far as what was billed ...our responsibly was ten bucks thanks to the supplement
Click to expand...
I do have a supplement but it does nothing to help me with home care services or assisted living.

Being single I don’t worry about leaving an estate. I’m willing to deplete my assets to pay for my care. If for some reason I run out of money I will have to rely on Medicaid.
 
mathjak107 said:
When my wife and I were released from the hospital After having covid we really couldn’t do much for our selves the first week or so ..

we needed the daily life stuff done , like the laundry , eating , cleaning etc .

medicare and long term care covered no part of that help .

we ended up using door dash to provide us with all meals which were awesome ...we had the cleaning girl come in for 3 dates a week to clean and do wash ....

the meals were awesome as we have so many fabulous restaurants in our area ...we ate like pigs ...we still bring in a few meals a week .

we are home 4 weeks and two months from first symptoms and we still have fatigue as well as breathing capacity is still working its way back ...

having both of us laid up was something we never planned for ...no one had our mail box keys ...there were some bills we needed to handle coming in ,etc ....

The kids live out of the area so the fact before the hospital would release us they wanted the oxygen delivered for in home care .we had to scramble to find the building super and hope ha had our keys we gave 40 years ago to the apartment so oxygen could be set up

there were so many things we did not plan for if both of us were admitted ...something as simple as a car crash could have both in a couple out for the count.


we made little go bags now with things like poly grip for my denture .which the hospital did not have ..the denture eventually cracked from flexing .

longer charging cords for the iPad and phone so they reached the bed .

even a set of house keys ...I was brought by ambulance and I caouldnt remember if I took my keys until I was able to get out of bed .

there are so many things you want when you get stuck for weeks in a hospital unexpectedly
Click to expand...
I'm so sorry you and your wife got infected with COVID and for what you've endured! I mentioned in another thread that I hadn't "seen" you around here. I especially missed you on the financial forum and was concerned. It's too bad that you've been paying for a LTC policy that couldn't be used in this instance.

I do try to think of "everything" but I guess as much as we plan, something might slip through the cracks. I have a trusted neighbor who lives upstairs; she has my mailbox and apartment keys. My son also has them but for awhile he was driving long distance truck and might not have been able to get back here on time in an emergency. My oldest grandson also has my apartment key and there's an extra mailbox key in the box where I keep my keys. I'm blessed that my family is only a couple of miles away in either direction and I know they'd take good care of me.

It's nice that you are enjoying your meals. I've never tried Uber Eats or Door Dash. I hope you and your wife will recuperate fully and quickly Mathjak. Take good care.
 
mathjak's go-bag is an excellent idea for all seniors especially those that don't have a strong support network of family and friends that live close by.

I first ran into the idea when my mother moved to assisted living. Each resident was given a small orange nylon bug-out bag to pack with essentials they would need for a quick trip to the hospital.
q

https://www.homehelpershomecare.com/blog/2016/october/what-s-in-your-senior-care-ready-bag-/
 
OneEyedDiva said:
I'm so sorry you and your wife got infected with COVID and for what you've endured! I mentioned in another thread that I hadn't "seen" you around here. I especially missed you on the financial forum and was concerned. It's too bad that you've been paying for a LTC policy that couldn't be used in this instance.

I do try to think of "everything" but I guess as much as we plan, something might slip through the cracks. I have a trusted neighbor who lives upstairs; she has my mailbox and apartment keys. My son also has them but for awhile he was driving long distance truck and might not have been able to get back here on time in an emergency. My oldest grandson also has my apartment key and there's an extra mailbox key in the box where I keep my keys. I'm blessed that my family is only a couple of miles away in either direction and I know they'd take good care of me.

It's nice that you are enjoying your meals. I've never tried Uber Eats or Door Dash. I hope you and your wife will recuperate fully and quickly Mathjak. Take good care.
Click to expand...
Thanks so much
 


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