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Old 04-05-2005, 12:48 PM   #1
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Cost of Care : Assisted living, Nursing Home, In Home assist

My mom is on Medicare but the card I've always used for her appts is from Pacific Care. So I called them this morning to see if she had any kind of additonal supplement that might help with some of this.

The lady on the phone said she did have an HMO supplement and it would pay for in-home nursing care if the doctor ordered it. I said well she isn't ill or doesn't have any other problems.

She says, if he insists that she needs 24 hour care, then that's nursing care.

That just seems a little too easy to me. I'm wondering if she's wrong about that. Anyone know?

Sandy
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Old 04-05-2005, 01:34 PM   #2
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Re: Cost of Care : Assisted living, Nursing Home, In Home assist

Dear Sandy,

I hope for your sake that it's true. I've checked out just about every HMO in the New York area, and none of them cover anything else (for Medicare recipients) than the other 20% Medicare does not pay. Any procedure or tharapy or hospital stay NOT covered by Medicare, will not be insured with them either.

My Mom is on a very good supplementary plan, a subsidiary of Blue Cross/Blue Shield ..but they will not contribute a cent towards home health care or nursing home/assisted living care.

It is frustrating!

Yet, Mom is still pretty capable of living in the ouside world as long as she is not alone (That's where the idea of 'being a prisoner' comes from.) Her new aide, thank God, is now being assigned to my Mom as her 5 day/week aide. She is a nice woman and so far no hassles, but as Mom's 'keeper,' Mom will soon get sick of her constant presence and start to tell me all the bad things she can find about her. She did that with the previous aide, and did that I am sure at Elsie's house when talking about me. Just like kids and teens often resent parental supervision, AD patients resent NEEDING care, and get to - well, not hate - but resent the caregiver. This is a sad part of this care.

It is as so many here have said, part and parcel of this role we did not ask to play but had thrust upon us.

Love and prayers,

Martha

Last edited by Martha H; 04-05-2005 at 01:42 PM. Reason: typos

 
Old 04-05-2005, 01:40 PM   #3
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Re: Cost of Care : Assisted living, Nursing Home, In Home assist

Yep, that's what I'm thinking too. I think what she's referring to is if she needs actual medical attention.

That bad part is, that's the number to call.....and you can't even get a straight answer from them.

I've checked the same policy she has online and it says "no assisted living."
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