The Cost of Being Sick – $$$$$
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September 14, 2010 at 2:15 pm
Do we really know what our insurance will cover? My story: a senior (a word I hate) on Medicare as my primary with a very generous retiree 2nd insurance to pick up the 20% lag. I thought I was very well covered. One day my brother brings a letter to me at the rehab facility. The letter is from Medicare and it informs me that my 100 days are up. What are they talking about? Well, it seems that while in rehab, outside of the hospital setting, you are limted to 100 days regardless of your illness. Obviously, GBS in some cases takes more than 100 days of rehab. I was trapped thereat for $270.00 a day. I stayed there two weeks short of one year. You can imagine the rest. I walked out using a walker. My reason for writing this piece is to alert anyone with GBS what could happen to them. If I knew this years ago, I would have inquired about long term care insurance that would override Medicare. I have brought this to the attention of the Foundation. It seems crazy that one size fits all when it comes to rehab coverage. Incidently, the facility was mixed with every kind of patient – not just rehab people. It was dreadful. I doubt Medicare will ever change the formula for rehab. I hope this helps someone.
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September 14, 2010 at 2:24 pm
Hi Hedley
Sounds rough. My hospital stay was not a vacation but I received no bill. I hope your discussing this brings about some changes.
GBS is so rare that many in the levels of bureaucracy do not understand.
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September 17, 2010 at 8:46 pm
I know that they have billed my insurance over a million dollars so far and now my employer just went to a new insurance company as of august 1 and they are now starting IVIG at home for a 5 day period once a month for the next 6 months
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September 26, 2010 at 6:14 pm
Although I only had a portion of the bill to pay, it is the longterm effects of prolonged stays that weigh heavilly on your insurance. Most have a lifetime cap and if the stay is several months it can deal one fits.
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September 26, 2010 at 10:36 pm
Just some info I have learned with my recent tribulations with my mom’s death and my dads nursing home “journey” If you are married and you currently have a will, your spouse can re-do the will and take everything from you and leave it to your children or whomever. While there is a 5 year look back, the other spouse has the right to do this. The hospitalized person has to be removed from the deed or other accounts, bank statements etc. You have to have 109K or less in the bank account and have the house in the other persons name. Then you can qualify for public aid in a nursing home. This is Illinois law. Way more complicated, just a touch of all that needs to be done, but it is possible to protect assets. You cqn even set up a will and leave all assets to children with you able to draw from it. As well, there are other trusts. The state can appeal the will regasrding the sudden change, but if you have a sharp elder attorney (10K$) it is possible. The appeal will cost $ as well, but it is cheaper than loosing all assets at 87K$ a year to a nursing home. just some ideas, the laws are different in all states.
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September 27, 2010 at 8:09 am
Good advice from Dawn. But each case is different. For instance, I am single and do not own a home. But forget me, the elder care attorney may be able to lessen the blow. Consult one. I considered a trust but was told that I could not regain personal control once I was better, so that was out. I found my elder care attorney through the rehab place. They offered three names and I picked the one from hell. He wanted $750.00 for one hour to discuss my options. And he wanted it before we spoke. In the end, I did get some help from the Medicaid people, but they went after all the cash assets I had first. When that was gone they subsidized the balance of payments minus my net monthly income for the months of my confinement.
Back to the reason for the post: Check the number of rehab days you have on your insurance policy and think about what you will do when they run out. I could have switched insurance carriers and gotten another 100 days but my rehab place did not take that carrier. Insult to injury.
Did you know that Medicare will give you another 100 days if you are out of the facility for 90 days. But where would you go – you need a family to take care of you.
Thanks Dawn, for the eldercare attorney advice. This is of great importance. Lots of people should be thinking about this before they get sick. What happens if I get sick? Also, consult with the social worker at the facility, along with the Medicaid Coordinator.
I wish this post could get to healthy people before they get GBS. -
September 27, 2010 at 10:16 am
[QUOTE=Hedley LaMarr]Good advice from Dawn. But each case is different. For instance, I am single and do not own a home. But forget me, the elder care attorney may be able to lessen the blow. Consult one. I considered a trust but was told that I could not regain personal control once I was better, so that was out. I found my elder care attorney through the rehab place. They offered three names and I picked the one from hell. He wanted $750.00 for one hour to discuss my options. And he wanted it before we spoke. In the end, I did get some help from the Medicaid people, but they went after all the cash assets I had first. When that was gone they subsidized the balance of payments minus my net monthly income for the months of my confinement.
Back to the reason for the post: Check the number of rehab days you have on your insurance policy and think about what you will do when they run out. I could have switched insurance carriers and gotten another 100 days but my rehab place did not take that carrier. Insult to injury.
Did you know that Medicare will give you another 100 days if you are out of the facility for 90 days. But where would you go – you need a family to take care of you.
Thanks Dawn, for the eldercare attorney advice. This is of great importance. Lots of people should be thinking about this before they get sick. What happens if I get sick? Also, consult with the social worker at the facility, along with the Medicaid Coordinator.
I wish this post could get to healthy people before they get GBS.[/QUOTE]
Hey Hedley, that’s deadly.I get accused of being a ‘wannabe Yank’ by my fellow citizens quite a bit. Simply put, I’m gonna be listening to Hendrix or Louis Armstrong before Bryan Adams or Celine Dion.
However, as I watch America beat itself up over whether everybody has a [U]right[/U] to medical care, I do feel my patriotism. Though we don’t get to live in the greatest county on Earth and have earned no exceptional status outside our borders we can go into a hospital and not come out in the poorhouse. From watching media coverage, it seems to some loud Americans that a universal health-care system like Canada’s is somehow evil, even (inexplicably) linked to Nazism.
I wish you and others well in the US
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