When Medicare pay for home care?

It is one of the most phone calls appear in the Office, where the mother or the father of one's own is admitted to the hospital. In this time of crisis, the answers are not easy to come.

How does their health insurance? What Medicare pays for? After parent ends, what happens when they go, how it is paid in the case, what are our options? What do we do if Mom and Dad's going to go home? How can we pay for it?

This ambiguity is expected as the Chief of the health care system can be very confusing and overwhelming. First you have to do is understand the basics of the system today.

In 1983, Congress created the potential payment system. This is important, because when a person 65 or older is admitted to the hospital, he is assigned to only one diagnostic related group of 473 (DRG). This is important, because Medicare hospital flat Dollar amount to compensate for the DRG is assigned to the patient.

Let me give an example. To say that my father is admitted to a hospital with lung problems and DRG is four days. If My father is completed within three days, the hospital makes one day of profit. If My father is completed within five days the hospital loses money and not bill the patient for one day.

Back in the Old good times, I remember when my grandfather was in the hospital and nurse asked him if he felt well enough to go home, because if he didn't, he may remain a few more days until he felt better.

Today is all about money. After the patient is already getting better or worse, in other words, it is considered "stable", and then the patient is discharged or home or Medicare certified nursing home or rehab facility.

For Medicare to pay for Rehab care must be patient in the hospital for three days (72 hours). Then, not later than within thirty days after discharge from the hospital, to be released for Medicare certified nursing facility.

If these criteria are met, then 2010, day one of twenty in a rehab are paid for 100% by Medicare. For twenty-one days by one hundred and pay what it is for this year is $ 137.00 per day.

Of the 101 and beyond, regardless of condition, is responsible for all costs of the instrument.

It should be borne in mind that to this undesirable repayment schedule, you must be getting better or worse. Like hospital after are considered stable, you can come to schedule payments and Medicare must pay for all costs.

In California, most patients will come from the Medicare reimbursement around week three and must begin with private payment from this point forward. The Office of the company will advise when is expected to take place.

If the object has a long-term care beds, the patient may be present in the same installation. But if the facility is strictly short-term care or rehab, then the patient must find another facility or go home.

How health insurance patient match this? Everything depends on the type of plan that higher patient is on. It is Medicare Supplement plan or PPO or Medicare Advantage plan is as HMO?

Medicare Supplement insurance, also called Medigap is private health insurance to supplement Medicare. For this, which is the age rating of the cover shall be paid the premium.

There are 12 standardized Medigap plans, and to the L in most States you can go to any doctor or hospital that accepts Medicare without pre-authorization. The framework of plans for c j. days one by twenty are fully paid by Medicare. For twenty-one days by one hundred co-pay Medicare for 2010 is $ 137.00, which is covered by a Medigap policy. From day one of the nine hundred and ninety-one and in addition to the patient is responsible for the full cost.

For Medicare Advantage plans such as HMO such as Secure Horizons, scan, and Kaiser patients have co-pay from the date of eleven $ 100. It is best to check the benefits booklet or contact customer support.

If someone goes to the plant without going to the hospital for the first time, you must first private payments from the first day.

When a patient comes off Medicare reimbursement, if eligible, Medi-Cal will contribute to the payment to cover the cost of nursing home. If you intend to instrument directly from the home, then, if eligible, Medi-Cal can help pay for the costs of nursing home on the first day.

Please consult with a specialist Medi-Cal for more information and exact procedures.

2010 copyright by Karl Kim

Karl Kim, CFP, CLTC, President of pension planning consultants, Inc. in La Mirada, CA and is a specialist for Medi-Cal can achieve at 714-994 -0599 and http://www.Medi-CalforLTC.com/blog.

Karl is a graduate of the University of Southern California and is originally from Honolulu, Hawaii. He began his career in the field of financial services in 1986 with the main company stock brokerage scenario, New York. Pension planning consultants, began in 1991. So far, the office submitted more than 1000 applications for Medi-Cal does not include annual redeterminations.