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Does Medicare pay for Home Health Care?

Finishing Well / Hans Scheil
The Truth Network Radio
June 27, 2020 8:30 am

Does Medicare pay for Home Health Care?

Finishing Well / Hans Scheil

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June 27, 2020 8:30 am

Many people think Medicare will pay for home health care, but it really does not. Hans goes over what exactly Medicare covers and what other options you have for covering long term care costs! 

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Rob West and Steve Moore
Finishing Well
Hans Scheil
Finishing Well
Hans Scheil
Finishing Well
Hans Scheil
Finishing Well
Hans Scheil

This is Sam from the masking journey podcast of our goal with the podcast is help you to try to find your way in this difficult world. Your chosen Truth Network podcast is starting in just seconds. Enjoy it, share it, but most of all, thank you for listening and choosing The Truth Podcast Network.

You're listening to the truth and welcome to finishing well brought to you by Cardinal guy, certified financial planner long shy best-selling author and financial planner helping families finish well over 40 years of finishing well will examine both biblical and practical knowledge to assist families in finishing well, including discussions on managing Medicare IRA long-term care life insurance and investments and taxes.

Now let's get started. Finishing well today on finishing well with certified planner Hans Christian home healthcare with Medicare? Sober talk about Medicare and and and how does that exactly fit in well. Interestingly, biblically I think there's really a precedent to talk on the subject. You may be familiar with the Proverbs 31 woman or Proverbs 31 where you know King Lemuel's mother gives him instructions on the wife that that he supposed be looking for at an she instructs them in verse seven and eight excuse me Nate nine is is open your mouth for the mute for the rights of all who are destitute and open your mouth and judge righteously defend the rights of the poor and the median and when you think about people that are on Medicare that don't have long-term healthcare insurance and those kind of things you know, based on the information that you have and I came to find out through your trying to help from my fathers that there's a lot of people out there my friend Vinnie Menino was completely destitute completely destitute. I hate the way that he finished based on his misunderstanding of Medicare and what it did not, and did cover when it came to home healthcare, and for a lot of us. We like to finish well at home on well just like retirement planning and retirement money in retirement income starts with Social Security.

That's the basis of it retirement healthcare starts with Medicare doesn't end with Medicare but it starts with Medicare, meaning that if you work 65 or over. And you need any type of healthcare were to start with Medicare and were gonna Medicare is going to pay for with their gonna pay for and you fall under their rules so budget back to your three-legged stool, which I love the three legged stool what I just had a thought that I wish that my friend Vinnie had had you know that kind of help in a prior to you know what happened in his life, but if you got the one leg of the stool being Medicare and then you had another leg of astilbe and Medicare supplements with the third leg of the stool unit would be these home healthcare opportunities that were talked about you know and today show. Yeah I were to really talk about them next week as well. When were talking about long-term care is hard to separate these two subjects so the subject today that were going to be on is answering that question is what is Medicare pay, and how does it pay for home healthcare and and I certainly experienced this firsthand ask my father didn't have a long-term care insurance. He did, he did have a great Medicare and had a great Medicare supplement in effect at the time you told me it was the best you could get right absolutely was at and so we had no idea that being at home was an option.

You know when he fell and broke his neck and he went in the hospital and he started having issues with his bladder and and you know their deal was a need to get up and walk again. And so we've got to send him to rehab. We never heard there was any other option other than rehab and but the just plain is older absolutely and you know the key is, is that medical social work that meets with you in the hospital in there to meet with you and meet with the family mainly when they're saying you can't go home yet get out of the hospital because Medicare is now said he's in the hospital or she's in the hospital. They've served there for days with her six days or whatever and what they're saying is you can't go home. We can't just and you may be agreeing with them. You're just looking at the patient around the menu.

Just saying if you're the family and you may be saying is no way he can go home so where they send now that was exactly what happened to my father in there like we've got to send them rehab that was that was all that was discussed and you know and why are they sending them to rehab. While I did not want to question their motives, but it was obvious to me that they had bits to fill well yeah that mean that from their perspective, but from his perspective or for his needs. What are they gonna do form and read what what what I can accomplish over it rehab get back to the situation based on him being in bed so long. He was no longer able to stand up and you don't have normal everyday life to the bathroom and wash himself to anything like that so he needed rehab to be able to most importantly be able to walk again.

He probably need occupational therapy. He needed physical therapy they needed. Just check in on them all the time you need somebody really around in caring for him. So it really wasn't an option. At least in that social workers mind and there your point of information for him to go home okay just right from the hospital.

At that point being able to walk. Needing all this therapy and what it may well not of been an option, so I'm not trying to get the whole world out there questioning social earlier when they're sending people to rehab going back to the story you know we tried it twice and unfortunately the rehab centers that we're involved with both put them in positions to fall three more times in a and and while there under his care; that's what happens at my dad was like no I'm not doing this anymore, and this was after two, three months of this and so we said no were not going. We went up going back to the hospital again because of another fall and where were in the hospital. Same thing we can't send them home and were like oh yes you can, because he's not going back into another rehab. Then all of a sudden a whole new world opened up a civil or Medicare will pay for okay and now were getting into. The questions were an answer on the show here jamming so that that's the perfect setup is that but just look at what it took to get those answers out of okay maybe just awarded talk of what is Medicare cover at home right so I don't want anybody just say what I heard from Ponce that Medicare cover me at home for this this and this. You still gotta convince the people that are communicating with Medicare to let you do this or have bears all kinds of rules and the key be able to continued on Medicare and and that's not to mention the date at one point in time going to come out of rehab because you have to be progressing in rehab in order to stand Medicare their anomaly or the right, at the hospital that kick out of rehab if you're not getting better but they're going to do it in their time with this plan and there's plenty of people the tick of the rehab and they don't get them anywhere because they can't go home just moved to a different section another called her in a nursing home or there in an assisted living with her really in the same place another in different place with the differences they're paying for right exactly so at that point in time. You know we we put our foot down. All of a sudden well, we could get up with these people, we ask you actually forcefully rehabbing men with you, and once they said what Medicare will pay for certain things then and it just worked out that fortunately for my dad. The actual feeding him dressing him, changing him and that kind of stuff that my wife Tammy pretty much took on that part of it with him being able to come in home the course. We were no possessions in opposition to for physical therapy or occupational therapy and there was another type of therapy that it just had to do with his personal hygiene. Okay, you know, I'm sure some you listeners are out there and thank you for listening to the show. By the way you wondering what is this have to do with me 65 or 60, 70, or whenever I'm in good health and on the way the golf course right now and it will mutate it is very hard to make decisions about the stuff when you're in the moment whether this is your parents with this is you and your kids are there along with your spouse trying to make all these decisions. This is something you really need to learn about the whole scenario today were talking about home healthcare paid by Medicare, which is unfortunately what the most insurance that most people have for this kind of thing is Medicare so we need to learn what it is and that this really what we want to talk about today.

The end. You know I looked it up right from Medicare before get ready for the show even though I renew a lot of the stuff I just thought, and I sent to Robbie and we studied this a bit and we lived it. So, just as you know it's gonna pay for part time or intermittent skilled nursing care and that's that's a mouthful. So you know means that it part time as opposed 24 hours a day mean you can't give Medicare a sense of know whether doing three shifts in on a day so just be part time.

It says or intermittent wishes and I look at up to us to see exactly what they say and that this is sporadic. It doesn't happen in exact intervals and their talking mostly is is about skilled care. It's in skilled care is defined as that which is, make you better or you got a progress. So for starters they're going to is going have to be skilled care as opposed to help with bathing, dressing, meal preparation, errands mean all the things that home healthcare agencies can do none of that stuff is skilled care that's custodial care.

So in order to get Medicare to pay for something it's gotta be skilled care.

Gotta be part time.

Gotta be in a room and has to be necessary, and then with a list years physical therapy, occupational therapy, speech language pathology services, medical, social services, which is the person you're meeting with the way out of the hospital while you can have one of those kind of people come out and sit with you and examine you look at your whole planet care help you out part-time or intermittent home health aide. So, in what I find is kind of interesting about that is, they say that they ran pay for home health.

It needs but aides don't do the type of skilled care that they'll pay for so there's some Catch-22 using here but by and large. If you if you can set it up, which is very possible and it was for your father. That you can get Medicare paid skilled nursing services at your house that was included for him physical therapy and occupational therapy and will find out all sorts of therapy. If you'll stay tuned as we get to go to break we want to mention to you today listing to Hans Shiley's are certified financial planner with cardinal guide cargo or you can find the seven ways to have one of which is Medicare and we don't watch the warrior wants know ahead of time. You know what's gonna be covered. What's not to be covered.

What are ways that I can get a three legged stool so I don't fall over when all this. The fact that silly comeback.

Of course, you might want to go to cardinal guide. I should mention first in order.

Hans's book the complete cardinal guide in planning for retirement only good news email hunting delighted to send that to you or researching there at the seminary stands of we come back we can be more on home healthcare slant on Medicare.

What is it look like the same Hans and I would love to take our show on the road to your church, Sunday school, Christian or civic group. Here's a chance for you to advance the kingdom through financial resources and leveraging Hans expertise and qualified charitable contributions veterans aid and attendance IRA Social Security and care and long-term care. Just go to cardinal and contact Tom to schedule a live recording of finishing well at your church Christian or civic group. Contact Tom to cardinal that's cardinal welcome back to finishing well certified financial all brought you by card today show, home healthcare on Medicare. What is it look like you know what's available. We certainly don't want the destitute not to know what is available and when things get get rough, you know that they know some of the options that they have and there are options for home healthcare with Medicare and in trying to figure out what is that look like in an in house at work so well, yeah. And so it we found a much sure if Medicare will pay for all of these services, but I'm looking at a particular type of insurance policy that we offer a cardinal and is called short-term home healthcare insurance.

It's a small policy that's designed just for the situation that your father if your father had this kind of insurance your world would've been much different.

Okay and and and all your choices and on this plan. It lists actually nine types of skilled care that he pays for okay now.

Not sure if Medicare approves all of these but I want to distinguish skilled care from custodial care right okay and custodial care is just somebody helping you with the activities of daily living. Get in getting dressed, bathing, getting to the doctor, running errands did meals prepared eating just going through the basics of life and there is actually insurance that pays for that real clearly on the topic of the show. Medicare pays nothing for that stuff. Okay so so if you are planning to use Medicare to pay benefits at home are you just choosing to go home and I'm a get whatever care I can paid for by Medicare. You may be limited to skilled care is not that kind of stuff now.

Skilled care is know this thing was skilled nursing care, speech pathology, enter Austin will therapy general nursing care from an LPN or LVN occupational therapy, respiratory therapy, physical therapy or chemotherapy specialists or medical social services so there's a whole range of skilled care in earlier we define skilled care is that's which makes you better wear your improving your showing improvement.

Medicare is going to require that to pay for any of this stuff that they do this particular insurance policy is not can have the requirement of showing improvement. All they're going to need is your doctor to certifier the medical social worker to certify that says Robbie needs this care and if Robbie needs this care whether it's occupational therapy for you know they're gonna pay for this ongoing sound and that the loudest point to that my experience with you know they got to be progressing worked in both my parents.

My mother had cancer and and so they literally at one point said was she's not make any progress at rehab. They sent her home with it that the same exact deal and then when she got home she was making progress there and it was long and say no we can't do anything for her because she was in progress because she had that they knew that she was terminal with the cancer but there were still there were like five months from the time that she came out of rehab until she actually passed away and that burden fell to my sister with my brother and I coming as much as we could, but you know it was it was a real deal in my father's case and I can remember the day came when they called the social worker called me in and they said well he sees not progressing so we got it taken off Medicare knows the signal that that's a real thing.

It's if it really happens then and then what so Medicare is pretty clear about that. Gotta be skilled care, and then within the skilled care. You gotta be shown improvement, or new plan care, which means it's not can go on for a long time and they're also very clear that they don't cover intermediate care or custodial care. We got into that third want to meet your intermediate care and that's what they call his care.

That's the kind of care. Your sister was providing. It wasn't necessarily making your mom better. It was just maintaining her Southerner perhaps call that intermediate care where's custodial care. She was also providing that this is helping her get dressed helping her bays helping her just get through the activities of daily living and what what I meant to tell you is if you cannot go home and you're going to attempt to collect from Medicare or get payment from Medicare.

At the very best there only can pay part of, but it may be enough to get you home and you're just going to fill in either self-pay or family members are going to come in and fill in the gaps of an example is I have a friend different. I teach special needs with on Sundays, as she really needed this knee surgery or needs. This knee surgery but based on covert and not want to go into rehab's design on a rehab want to go home but and I said well you can go Medicare will help you with initiative and I said below that will help you the physical therapy and occupational therapy in Chicago. She says these were exact words we have, but who's going to feed me in his chemically my receipt that you know I loosely screw sharp sheet she knows the drill here right okay so what I've done for most of my career that I so long-term care insurance and Medicare insurance is I just simplify this whole conversation I just said that Medicare isn't gonna pay for long-term care and for all practical purposes it doesn't pay much. So what were doing on this show is we're wanting to acknowledge around assure you they do pay for some home healthcare and we want to make you aware of this and for you to utilize it to do exactly what she was talking about his just entirely skip the rehab in the nursing home and just go to go home and get your care at home. They will pay for some of so that's you know and we could we could talk all day on defining what that line is we looked it up, but with a don't say in all the literature is what they don't pay for it when I'm trying to tell you is a custodial care at home or in a facility is on you when that's what you need you not getting paid by Medicare so this is where the three-legged stool that we had another leg we're gonna need right sure the next week were going to talk about the specific home healthcare insurance or short-term facility care. So for the listeners that are wondering where do I fit into this equation.

You know that's kind of a key part of this discussion today will end in part of the thing with the insurance that this plan sells enemy if we look at one of the things that people use to get rid of me.

You know me when I'm, you know, if any, long-term care insurance salesman emeritus and have been doing this quite a while. Okay since they invented long-term care and you know I'm in a discussion about this.

And sometimes this is that the door or in a casual conversation, people are going to say well I can afford, that's just before they even know what it cost, but I mean maybe they do know what a cut I can afford long-term care insurance. That's can be one of the ways that you really make another one. If they can't use them because they got too much money to just say I'll just pay for it myself I'll use my own money and I'm you know I'm not can get into answering those today but there's a whole list of them and then another one is my health. I try to apply for that stuff and I got turned down because I've got XYZ health condition or the guy ran away and he started avoiding me bills out the application because he knows I have XYZ own so all three of those issues can be covered with this short-term home healthcare insurance so we have a policy we actually have a couple versions of this that are going to give you benefits to pay for that skilled nursing care in your home and a pay for for 365 days so it'll pay for much more than intermittent or short-term. And then if it is the policy that my wife and I have that we bought from you. Along these lines, you know the cool thing is if you get better in six months than they renew it and you got another whole year. You know, in other words, I will use those words what it is as if you get better and you recover right and then you have a period of time where you don't use the policy, then the benefits get restored for later use. Okay, so if you buy one of these things when you're young you could use up your year of benefits several times this one works the same way and then this thing has a 60 day benefit for AIDS for people to come and do just that to come out and help you with bathing, dressing, meal preparation, all I can stuff is going to pay for 60 days and you say will 60 days and very long well is not very long till you're sitting there on the first day and you got no insurance. You don't even know who to call in some of those wealthy people upset with a lot of wealthy people that have told me that or somebody else. 20 years ago were there said you know well just pay for myself will that sounds simple but a lot of them in the middle that your dad was in the situation.

He had some box and he you did note a call. Who's going to come give you help with bathing, dressing, transferring, toileting, and then also come in and do physical therapy so this you know this is a glitch in the door, get you get your home and get you situated and then after this thing runs out of benefits. Then you can use your own money. But the whole time you're at home and this will get you. It's much easier to get this care started to spend the insurance companies money and is your money absolutely right so you can see that there is home healthcare available through Medicare but it it's it's nice to know what's covered what's not covered and certainly to disseminate the information to that you know it been really nice to be prepared with all this, know, or at least to have Hans on my team know when the stuff started to come down because it was it was a crazy complicated the needed medical social worker mean you really you need you need those people to come and recommend a plan care and sometimes we have to educate them a bit of some options because they tend to track people there sending of the rehab thing of beds available so there's there's lots of know. Again, this show is brought to you by Cardinal if you go to Cardinal you'll see the seven worries The show is the one on Medicare so you can just get the whole PDF of a positive chapter on the complete Cardinal guide to planning for living in retirement on Medicare or just email them there at that at the website or something else that you may want to cover on the show. I'm sure he would love to hear for you to hear from you and in and help us all through what is a can be a somewhat complicated time really when we're not necessarily in the position is. Thank you for listening today. Thank you, thank you.

We hope you enjoyed finishing well brought you by Cardinal visit Cardinal for free downloads of the show or previous shows on topics such as Social Security, Medicare and IRAs, long-term care and life insurance, investments and taxes as well as ponds best-selling book, the complete Cardinal guide to planning for and living in retirement and the workbook once again for dozens of free resources past shows get Hans book go to Cardinal if you have a question, comment or suggestion for future shows.

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