Medicare Open Enrollment Advice for Adult Children

Medicare Open Enrollment Advice for Adult Children

Dear Donna:

For the first time this year I will be helping my father with his Medicare Open Enrollment. My mother passed away unexpectedly last year and it is something she always did for both of them. I know it is an important process, but I’m not quite sure how to help him. I’m not yet eligible for Medicare myself so I don’t really understand what is covered, what isn’t and why he might need to make changes.

Can you help?

Doris in Holland, Michigan

Dear Doris:

First off, please accept my condolences. I’m sure this has been a tough year for you and your Dad.

It isn’t uncommon for adult children to find themselves struggling to help a parent with Medicare Open Enrollment. Like you, many have not yet reached the age when they are eligible for the benefit. So the alphabet soup of Medicare A, B, C and D can be very confusing. Here is just a quick overview of what each part of Medicare covers:

  • Medicare Part A:
    • Inpatient hospital care
    • Short-term skilled nursing and rehab (if qualifying conditions are met)
    • Hospice care
    • Home health care (if qualifying conditions are met)
  • Medicare Part B:
    • Physicians & other health care providers
    • Outpatient rehab (up to a pre-determined limit)
    • Some medical equipment
    • Ambulance services for an emergency
    • Some preventative services and screenings
  • Medicare Part D:
    • Prescription medications

Equally important is understanding what is NOT covered by your father’s Medicare benefit:

  • Long-term care in a nursing home or assisted living
  • Routine dental care and eye care
  • Hearing aids & exams
  • Routine foot care
  • In-home care

Medicare has a brochure you may find helpful in getting started. Yearly Medicare Plan Review is a free download that has important dates and resources to assist you with Medicare Open Enrollment.

I hope this information makes the process go more smoothly for you and your father, Doris!

Sandy

 

Heritage Senior Communities is pleased to announce that our newest community is opening soon in Holland, Michigan. The Village at Appledorn West will offer adults over the age of 55 one- and two-bedroom independent living apartments. The campus will also be expanded to include assisted living in the spring of 2015.

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Helping Michigan Seniors Understand the Medicare Rehab Benefit

Helping Michigan Seniors Understand the Medicare Rehab Benefit

Dear Donna:

My mother will be undergoing hip replacement surgery at a hospital in Saginaw, Michigan in late June. Her surgeon has advised us that she will likely need to go to a rehab center for a few weeks of therapy after she leaves the hospital. We are trying to figure out if Medicare will pay for that and how to choose the best one for her recovery. Can you help us understand what this means?

Diane in Adrian, Michigan

Diane:

It is a definitely a good idea to tackle all of this before your mother’s surgery. That will help her make a smooth transition to the skilled nursing and rehab center and then, eventually, back home.

Here is how the Medicare Skilled Nursing & Rehab Benefit works:

  • Your mother will qualify for the benefit if she spends three nights at an inpatient level of care in the hospital.
  • Once she transitions to the skilled rehab center, Medicare will pay for the first 20 days in full.
  • Beginning on the 21st day, she will be liable for a co-payment amount. In 2014, that is $152 per day. If she has a secondary insurance, it may cover this amount.
  • If she still isn’t back on her feet after day 100, she will be liable for the entire cost of the stay. But don’t worry. Most seniors are back on their feet and home long before this!

As far as finding the best provider, Medicare has a few tools that can help. One is the Nursing Home Compare rating system on Medicare.gov. It allows you to review each provider’s state survey results and (if applicable) complaint surveys from residents and their family members. Medicare also has a Skilled Nursing Facility Checklist you can download to help you compare one community with another.

Finally, our best piece of advice is to tour every community you are considering for your mother. It would probably be a good idea to have a list of 2 or 3 options. That way if one or two of them are full, you still have another option that your family has already visited and approved of to turn to for rehab.

I hope this helps, Diane! Best of luck to your mother in her surgery and rehab.

Donna