Granny's gone and done it again

[lovesfarms]

who am I calling, Medicaid or Medicare? After the way he was talking today Im wondering if I should probably bring him home.

Call the number on the back of the insurance card. They have access to both. If the person on the line doesn't have all the answers, they will put you on hold and find out or connect you with the correct dept. That way, they can tell you what both Medicare and Medicaid services will provide. Sometimes it has to go through Medicare and be denied by it and the gets directly picked up by Medicaid. They will tell you.

But make sure they understand all the details and that you may need extra care if he comes home.
It sounded like the people coming to your house weren't much help. If they offer home care again, make sure the insurance knows it if they aren't helpful

 

[lovesfarms]

Granny, remember, the insurance keeps record of your discussions, so after awhile it gets easier as they get to understand your cases complexity

 

[microchick]

@Granny Hatchet A lot of well meaning information and advice is being tossed at you all at once. I know it's a lot to sift through.

As a nurse with a lot of experience with this both professionally and personally, pls talk to his doctors first. The one that is taking care of him in the facility and the one he had before he went in. That person is your biggest ally as diagnosis' on record have a lot to do with him being admitted to any facility or hospital.

Also. Insurance companies/Medicare/Medicaid are not your friends. I dealt with these people daily as a nurse and as a family member and professionally as a filer and never encountered one that I trust. IMHO they only like you and care about you if they don't have to pay any money out on you. They are a business first and foremost so when dealing with them keep that in the back of your mind.

Finally, write down all of the questions that you want answered by whoever before you talk to them. Start now. Don't wait till 30 days are breathing down your neck. If the facility he is in can't provide for him there are others, trust me, who will welcome him with open arms if necessary.

God bless. I'm praying for you, Tom and your son.

 

[lovesfarms]

@Granny Hatchet A lot of well meaning information and advice is being tossed at you all at once. I know it's a lot to sift through.

As a nurse with a lot of experience with this both professionally and personally, pls talk to his doctors first. The one that is taking care of him in the facility and the one he had before he went in. That person is your biggest ally as diagnosis' on record have a lot to do with him being admitted to any facility or hospital.

Also. Insurance companies/Medicare/Medicaid are not your friends. I dealt with these people daily as a nurse and as a family member and professionally as a filer and never encountered one that I trust. IMHO they only like you and care about you if they don't have to pay any money out on you. They are a business first and foremost so when dealing with them keep that in the back of your mind.

Finally, write down all of the questions that you want answered by whoever before you talk to them. Start now. Don't wait till 30 days are breathing down your neck. If the facility he is in can't provide for him there are others, trust me, who will welcome him with open arms if necessary.

God bless. I'm praying for you, Tom and your son.

Granny may do what works best for her, but the insurance knows what they cover and do not cover. You have to understand what you are covered for. Insurance, when it includes both Medicare and Medicaid can get very complicated.

Once you understand what you are covered for, then you can go from there. Drs and nurses have a lot on their hands without having to understand everyone's insurance. That is why the insurance does a lot of 3-way calling. They have you and the Drs office on the call at the same time.

 

[Nomadicus]

Another day of mostly rest and light duty stuff. No heavy lifting or such. A few more days of antibiotics and I hope this stuff is gone. I hope it is gone before company comes in Wednesday.

 

[Nomadicus]

Granny please don't worry right now. Take good care of yourself first so you can care for others when needed.

 

[Holly Hobbie]

Another day of mostly rest and light duty stuff. No heavy lifting or such. A few more days of antibiotics and I hope this stuff is gone. I hope it is gone before company comes in Wednesday.

I hope so too

 

[lovesfarms]

Even though you have Medicare, you still choose your own company and their coverage differ.
Same with Medicaid. You choose your own company and their coverage differ.
It's nearly impossible to know what each one approves.

You need to understand what you are approved for before you can make an informed decision

 

[microchick]

@lovesfarms, that is where his doctor comes in. He is where he is now due to his diagnosis. I dealt with these people professionally. You cannot go to war one on one with them without having your doctor behind you with the right diagnosis. Without them they will deny anything they want to.

I never had problems with my father's coverage nor was it complicated, and I knew only what nurse's needed to know and that was enough to make me distrust them immensely.

Which is why I also recommended that Granny talk to the Social Services dept at the facility where Tom is. They can explain everything to her in a way that the common lay person can understand. That is what they are there for.

I had more people approach me about their insurance coverage when I worked with my husband. All coverage was basic for the major insurance companies. I could tell them what their co-pays would be and a rough estimate on how much they would be charged. Plus, Medicare I know for sure gives out an annual handbook for all members. Tom probably has one. I know I just got a new one myself I think within the last couple of months.

But it all comes back to the doctor. Without good communication between the doctor in charge and the patient's family, nothing is going to get straightened out so I stand by my statements.

Talk to the doctor first. If the facility won't put you in contact with him or her, find out what his name is and do it yourself. The nurses at the facility should be getting in touch with her whenever the doctor goes through to inform family of any medicine changes/etc. A family member has asked me when the doctor was due to make rounds so they could be there to ask questions. We always told them and called them when we knew for sure.

If that communication is not there, he's not in the right facility anyway. Just the opinion of an experienced nurse who cared about her residents like they were my own family.

 

[microchick]

Another day of mostly rest and light duty stuff. No heavy lifting or such. A few more days of antibiotics and I hope this stuff is gone. I hope it is gone before company comes in Wednesday.

What what?

I didn't know you were sick, Nomadicus. Must have missed that along the way. Nothing serious I hope.