One of the most common questions that I get is,”Will Medicare cover this?” Unfortunately a lot has changed over the years with what Medicare/Medicaid will pay for and I am sure that you have been hearing about cuts and other issues that are arising with Medicare. This is why I found this article to be very helpful and I wanted to share it with all of you. It was written by Maria Lipani and is a great way to get a better understanding of Medicare. We at EvergreenChoice go out of our way to create affordable ways that you or your loved one can receive the great care that we provide. Please check out our promotional packages at http://evergreenchoice.com/our-services/current-promotions
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Medicare will not pay for the long-term care needs of your aging parent. Surprised? Many people are. That’s because Medicare is often confused with Medicaid, another health program for individuals and families with low incomes and few if any resources. Medicare (not Medicaid) is the coverage that your aging parent is most likely to have. That means that each of the seven things below can only be accessed by paying out of pocket. This is important because your aging parent is likely to need one or even all of them at some point in the future.
What Medicare Still Doesn’t Pay For
#1: Assisted Living Facilities. Medicare will only fully pay a short-term stay in a nursing home for physical and/or occupational rehabilitation (usually 20 days). But Medicare will not ever pay for an assisted living facility. Assisted living facilities are usually privately owned and operated and the cost can be prohibitively expensive. In a major city you can expect an assisted living facility to cost upwards of $3500 per month and this is just the entry-level cost. If your aging parent’s needs change additional care is available on site, but be prepared to open your wallet.
#2: Home Maker Services. Most older adults want to remain in their own homes for as long as possible. To do so many require assistance with tasks like making meals, keeping the home tidy and doing the laundry, for example. These daily tasks are considered by Medicare to be “home maker services” and are not a covered benefit. As a person ages, these services are often the first kind of assistance an older adult may need. Often family members and/or neighbors step in. However, if your aging parent needs more than occasional help and no family member can assist, the
next step is often to hire private help through a home care agency.
#3: Home Health Aides. “Home health aide” is the name given to the individual who would assist your aging parent with personal care (i.e. bathing, dressing, grooming, medication reminders, etc.). If your aging parent has mobility issues and/or is cognitively impaired, the services of a home health aide can often mean the difference between remaining at home vs. moving to a facility or nursing home. And here again, Medicare does not cover this kind of assistance. However, there is one exception to this rule. If your aging parent is home-bound and already receiving skilled nursing care or physical therapy, then a home health aide’s services would be covered for a limited amount of time.
#4: Transportation to/from doctors’ visits. For many, getting to and from the doctor can be a major challenge. If your aging parent is receiving some sort of treatment such as dialysis, transportation to and from the center may be covered by Medicare. Beyond that, you must rely on family, friends or community resources.
#5: Routine eye exams. A condition called Age-Related Macular Degeneration (AMD) is the leading cause of blindness among older adults and routine eye care is an important part of preventing/monitoring it. Unfortunately, Medicare provides no coverage for this important health screening or any other eye-related medical testing.
#6: Routine dental exams. As I’m sure you can imagine, dental work and/or dentures are high cost out-of-pocket expenses. They’re also necessary to ensuring that your aging parent is able to continue eating (and enjoying) real food. Unfortunately, dental exams are not covered by Medicare.
#7: Routine hearing exams. One in three people over the age of 60 and half of those over 85 have hearing loss. For many it can have a significant impact on quality of life. An examination by an ear, nose and throat specialist can confirm hearing loss, but Medicare won’t cover it.
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