December 14, 2020

Podcast 25: Does Medicare Pay for an Assisted Living?

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Does Medicare Pay for End of life care?

Podcast (Audio Only)

In this episode Joanne Williams, LCSW discusses what she has learned, that most American DON’T know about who is paying for living situations or medical care before the end of life.  A must listen for family.

Summary of today Podcast: You are not dying yet or even close to deaths door, but you can’t walk well nor fix your own meals and fall often. Or who cares for your mother if she falls and breaks a hip and her spouse can’t care for her. What can you do and what are your choices?

  1. What can family do to help now?
  2. What are the choices for care?
  3. What does Medicare pay for and doesn’t pay for?
  4. Does Medical Insurance or Medicare pay for an assisted living facility?  
  5. How much do An Assisted Living Facility cost?
  6. Can you pay for home care at $25 per hour?
  7. Does your Medical Power of Attorney make decisions for me before my death?

Question for today is? What are the choices I have for Assisted living cost?

My 90 yr. old neighbor has the fire department come at least 1-2 times per month to pick her up off the floor.  But she refuses to leave her home.  Her son visits almost daily.  She has a caregiver daily, but the fire department and ambulances keep coming.  What are the son’s choices?

This is a very typical scenario I heard, as I worked as a medial social worker for the largest medical group in Palm Springs, CA.  This agency has worked on preventing Hospitalization, if more social services were given in the home  I believe it has worked, since I started their program 10 years ago it is still functioning today.  70 % of people turning 65 can expect to use some form of Long-term care during their live according to AARP.

I have seen every kind of home situation possible, with 2 spouses struggle to keep the other one home, while this may be killing the other spouse.  The families with children living 1000s of miles away and not caring or no able to offer any support to their parents. Even for the children that can offer support by financial assistance, it is trying.

This Podcast discusses what Medicare does pay for: What insurance pays for and what it doesn’t.  Joanne Shares information about Medicare as the Insurance when you become 65

10 things that Medicare does pay for

Medicare advantage and “regular Medicare insurance”. Now is open enrollment, just for the next few weeks, you can’t change insurance unless you move.

  • 1. Does pay for certain Number of days or weeks in a Nursing home. They pay only for “skilled care” or you start paying at the Average cost of $225 to a semiprivate room.
  • 2. Hospice end of life care in your home
  • 3. Palliative care, for pain relief when there are no cures
  • 4. Respite care to give the caregiver a break.
  • 5.Transportation to doctor appts. Speak to a License agent for the commercial agency that can offer any of the Medicare advantage programs.
  • 6.Medical doctor visits
  • 7.Hospital visits for a certain number of days
  • 8. May pay for Home health aid
  • 9. Home visits if you need a skilled nurse to come to change a bandage.
  • 10.Physical therapy

What Medicare Doesn’t pay for:

  • Assisted Living facility that average $4000 per month or $48K per year.
  • Doesn’t pay for unlimited stay at a rehab or Nursing home to live.
  • Doesn’t pay for caregivers in your home. They average cost of 50K per year for in home care.
  • Look at the needs for care when you look at insurance coverage you need.

Advanced directive is the most important choice you can make ahead of time to make your wishes known. See Podcast # 24 On Having the End of Life Discussion with Family.

Alzheimer’s is increasing and is a terminal decrease of cognitive functions in that 80 % of the caregiver spouse succumbs to an illness or dies before the patient with dementia.

Emotional support animals can really help with agitation from Alzheimer’s.

These are the normal scenarios that happened over and over again.  My job was to advise offer resources and choices ahead of the inevitable need for more care.

Children can help if they give $$ per month for a care giver, or day care, or a camera in the home to know what is really going on in the home.

Put alarms at Home Depot that are magnets, if the front door is opened or the bedroom door opens.

There are things you can do to help.  Get ahead of the progression.

Join the Conversation

Our favorite part of recording is answering your questions, from Facebook at AnxietySimplified5.  Leave comments in the comment section, we will answer on a Podcast on that subject.  So, listen for your question.  Or share it with someone who may be helped with that answer. 

Our next podcast: Post Traumatic Stress Disorder and Best Treatment

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