Caring for an aging family member and Medicare coverage

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Below are a few questions that many ask when they are caring for an aging family member or wondering how to pay for the expenses. You can contact me directly to help answer any questions that you may have.

Ann Wittoesch 937-297-4300

1. My mother lives with me and my family. I take care of her most of the day and on weekends. I feel like I need a break.      What can I do?

Ask your mother’s doctor about respite care. You might be able to bring your mother to a facility such as Lincoln Park Manor to give yourself a much needed break. Lincoln Park Manor offers 24 hour nursing care in a compassionate and quality environment for your mother on a short term basis.

2. What does Medicare cover?

For any eligible beneficiary needing skilled nursing or skilled rehabilitation consistent with Medicare coverage criteria, Medicare Part A coverage will pay for a semi-private room, meals, nursing services, rehabilitation services, medications, supplies and durable medical equipment for up to 100 days in a benefit period. The first 20 days in a nursing home, Medicare covers 100 percent of skilled care. Day 21 through day 100, the resident must pay a daily co-insurance rate. Most supplemental insurance plans will cover the co-pay charges. Patients who are eligible for the services covered under Medicare Part B will be responsible for an annual deductible plus 20 percent of the total charges for services such as occupational therapy, physical therapy and speech therapy, as well as medical supplies. Again, a supplemental insurance could also pay these charges. For more information on Medicare, please visit their website Medicare.gov.

3. How do I know if my loved one qualifies for Medicare Part A benefits?

Your loved one must have a Medicare card that reads “hospital insurance” and have days left in their benefit period available to use. A qualifying hospital stay means an inpatient hospital stay of 3 consecutive days or more, starting with the day the hospital admits your loved one as an inpatient*, but not including the day of discharge from the hospital. The hospital stay must not have occurred more than 30 days prior to entering the nursing home. Further, a physician must certify that your loved one needs skilled nursing or skilled rehabilitation care on a continuing basis, and the need for skilled care must relate to the reason for hospitalization.

*Are you considered an inpatient?
Staying overnight in a hospital does not mean you are considered as an inpatient status. A doctor must order you to be admitted to the hospital formally to be considered as an inpatient. This is quite different from observation status.
Contact us for more information.

Visit our website for a copy of the Medicare 101 Booklet. You’ll find a link on the home page at LincolnPark-Manor.com.

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