Where Can We Find Help For Questions About Health Emergencies and Financing Nursing Homes?
Q: Dad passed away a few years ago at age 90, after going to the emergency room during a health emergency and then spending a few days in the hospital. He was released to a nursing home where he lived a few more months. When all this happened, we didn’t have any professional counseling, and had no idea how complicated this situation would turn out to be. We didn’t know what Medicare covered or that it would not cover his nursing home care. Nor did we know how to get Medicaid assistance. Now Mom has no income left but her Social Security, and dad’s impossible nursing home bills that she will never be able to pay off. How can we find help with questions about nursing home care, and how the costs would be financed in case Mom needs it next?
A: While Medicare covers emergency room care, unless your father was admitted to the hospital as an inpatient, Medicare Part A may not have covered his hospital stay. If emergency room doctors held your dad “under observation” or as an “outpatient,” then his stay was covered under Medicare Part B, and there may have been expensive bills for that hospital stay depending on what other type of insurance your dad had in addition to Medicare. In addition, Medicare has strict rules about the length of stays in the hospital, in order to qualify for limited nursing home coverage for rehabilitation. Medicare does not cover most long - term stays in nursing homes.
While you probably won’t find any single professional who can provide you with all the answers you may need for your mom, most areas of the country have access to an Agency on Aging that can help put you in touch with a number of valuable resources and people who can answer your questions. Most agencies serve specific geographic areas of several neighboring counties, although some operate statewide in less populated states. All Area Agencies on Aging receive federal funding that is supplemented with additional state and local funding.
Each Agency on Aging provides a different list of services, but there are some basic services that are provided by nearly all. These include the following:
- Medicare counseling: Counselors provide free one-on-one assistance to help you and your mom understand what Medicare covers, and other insurances, such as Medicare supplements and Part D plans, and Medicare Advantage. In addition, you can get information about the limitations of Medicare coverage of long-term care. A counselor may be able to explain the requirements to help you determine if your Mom would qualify for Medicare Savings Programs or Medicaid.
- Senior meals: Agencies on Aging often have congregate meal programs and act to coordinate with home delivered meal programs in your area.
- Transportation: Info and assistance in coordinating shared, non-medical transportation services in your area.
- Caregiver support: You and others helping with your mom can get caregiver training and information about respite care (should you need a break).
- Information and referral: Depending on her income your mom may qualify for other assistance programs, like Medicare Extra Help, and you can get contact information for other types of programs (dental or vision care).
- Long Term Care Ombudsmen: Find information about long term care facilities in your area, and investigations of complaints if you’ve encountered a problem.
To locate your Area Agency on Aging visit the Eldercare Locator or call toll free 1-800-677-1116.