If You Care for A Senior or Disabled Person: The Final Part, 4
This series is finally coming to an end. However, the feedback I’ve received from all of you has been fantastic, proving these articles were needed. After all, being a caregiver is not an easy job and requires a selfless person willing to give of their time, talent and kindness. So, once again, we salute you! Let’s review all of the questions covered so far and the final four in the If You Care for A Senior or Disabled Person series.
In article 1, we covered:
- How can I learn what my care receiver is eligible for?
- Is there any help available to lower prescription costs?
- Even though my care receiver has insurance, he or she still can’t afford the bills. What are his or her options?
- How do I know I’ve chosen the right plan for my care receiver?
In article 2, we covered:
- What’s the difference between SSD/SSDI (Social Security Disability) and SSI (Supplemental Security Income)?
- How does SSD or SSI affect when my care receiver is eligible for Medicare, and what to do in the interim?
- My SSD care receiver is now eligible for Medicare. What should I do?
- My SSD care receiver didn’t take Part-B because of the premium, but now wants it. What do I need to know?
In article 3, we covered:
- My SSI care receiver needs help with medical care. What can I do?
- My SSI care receiver was denied Medicaid. Can I appeal the decision?
- My care receiver received a hospital bill they can’t afford. What can I do?
- My care receiver is a veteran and goes to the VA, but still needs help with other needs like dental. What are his or her options?
And finally, in article 4, we will discuss:
- I need to work and worry about leaving my care receiver alone. What can I do?
- What can I do if my care receiver needs medical attention while traveling?
- My care receiver has trouble communicating. What can I do to make sure there are no medical mistakes made when I’m not present?
- My care receiver has some dementia. What can I do in the event of a medication overdose?
Whew! That’s a lot to cover, so let’s dive in!
I need to work and worry about leaving my care receiver alone. What can I do?
One of the hardest things for caregivers is they cannot be there 100% of the time, they also have a life to live. That’s why the PACE program was created. PACE stands for Program of All-Inclusive Care for the Elderly. Medical professionals agree that caring for a senior in the comfort of his or her own home is better. Why? The familiar surroundings, the people they love, their favorite foods and their pets give peace, lowers anxiety, allows them to rest better and heal.
PACE offers all the services Medicare offers from one’s home and community. The list includes:
- Adult day care
- Dentistry
- Emergency services
- Home care
- Hospital care
- Laboratory/x-ray services
- Meals
- Medical specialty services
- Nursing home care
- Nutritional counseling
- Occupational therapy
- Physical therapy
- Prescription drugs
- Primary care (including doctor & nursing services)
- Recreational therapy
- Social services
- Social work counseling
- Transportation
Medicaid.gov states, “PACE also includes all other services determined necessary by the health professionals’ team to improve and maintain an individual’s health.”
PACE even offers long-term care. If your care receiver is on Medicaid, there is no cost for the long-term care; if not, there is a monthly premium. However, the good thing is there are no hidden surprises like copays, coinsurances or deductibles to contend with. Your premium covers everything.
While PACE is spreading and growing in popularity, it’s not available in all locations. If you’re interested in finding a PACE program in your area, click here to search Medicare’s database.
What can I do if my care receiver needs medical attention while traveling?
First and foremost, the answer is if it’s an emergency, go to the nearest hospital and deal with the rest later. A more nuanced answer is, it depends on your care receiver’s insurance plan. Is he or she on MediGap, Medicare Advantage HMO, Medicare Advantage PPO or other health plan? Each plan has its own rules for emergency, urgent and medical care when not in the plan area.
MediGap Supplement
If you have a MediGap plan, also known as a Medicare Supplement Plan, as long as you are traveling where Medicare is accepted, you can use it. In other words, if you are in one of the 50 states, US Virgin Islands, Puerto Rico, Guam, U.S territories, etc., you can go to any medical facility or provider that accepts Medicare with no worries.
Medicare Advantage PPO
Depending on your plan (as each plan has different areas of coverage rules), many carriers like Humana, UnitedHealthcare and Cigna allow you to take your plan with you. In other words, wherever they have a PPO network, you can use your plan. For instance, if you have a plan in Florida and decided to take a trip to Chicago, you could use your plan locally in their network just like back home.
Another feature of a PPO is you can go out-of-network if you must. However, you will pay higher copays, coinsurances and deductibles. Therefore, if your care receiver needs care on the road and you are nowhere near a network, you won’t get stuck with the entire bill. Make sure to go through you Summary of Benefits and know what those fees are, so you can plan accordingly.
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My care receiver has trouble communicating. What can I do to make sure there are no medical mistakes made when I’m not present?
This was a concern of mine after my mother had a bad experience at a hospital, while she was asleep. The nurse came in to give her a medication she was allergic to (they forgot to put an allergy alert bracelet on her) and put her into anaphylactic shock. So, I created three documents (which are available for download):
- The Beneficiary Information Worksheet
- The Beneficiary Medical Condition Placard
- The Medication Schedule
These three (3) documents became lifesavers for me and my mom. Let me explain how to use them.
The Beneficiary Information Worksheet
Every time I took Mom to any provider, they always asked the same questions. And since Mom would go to the hospital often, it was the same song in the emergency room, constantly. So, I created her Beneficiary Information Worksheet. Every time I used it, I would get, “WOW! I wish everyone did this!”
It has all her important information: insurance info, primary care doctor, specialist if needed, allergies to food and allergies to medications (click on the image for a larger preview). Download PDF.
Word to the wise. Guard this document like you would your ATM card or Social Security Card. Only give it to authorized personnel, like the doctor, in-take nurse or triage nurse. When they are done inputting the information, ask for it back. It has all the information needed for medical identity theft (read more about medical identity theft here).
The Beneficiary Medical Condition Placard
Since Mom was given the medication by a nurse caring for her in her wing, I also created a limited version of this information into a placard that I would put over her bed on the wall, so whomever came to treat her when she was asleep, would know what they needed to know. It also had next of kin contact information, in the event something were to happen. Download PDF.
The Medication Schedule
Finally, occasionally I would have a night off with my wife, and someone might come over and check on Mom while we were gone, as she was cogent and able to do most things for herself. But I would take care of administering her medications. Therefore, I created a detailed, yet simple, schedule to ensure she was given the proper doses on time. Download PDF.
While it’s hard to prepare for all eventualities, these documents will help. Feel free to share them.
My care receiver has some dementia. What can I do in the event of a medication overdose?
Medication overdose is common in seniors with some dementia. They forget they took their medications, and they retake them. This happened to my mom and thank God the heroes at St. Anthony’s in St. Petersburg, Florida did miracles to save her. Now, if I had Narcan® (naloxone) on hand, it may not have been as close as it was.
Narcan is a nasal spray that you don’t have to inhale, like one would Afrin for unclogging your sinuses. Just simply put it into a nostril and pump. You can learn more about how to use it here. The best part is you don’t need a prescription to get it at your pharmacy. Simply download the following pamphlet and take it to your pharmacy. You can also inquire if your insurance carrier will provide it. For more information on how to get it, click here.
There you have it! All 16 questions answered. However, I am sure there are many more I did not cover. So, if you have a specific question, please leave a comment, fill out a form or call us. We will make sure to get you the right answer, and you may be credited with the next article based on your question!
Always remember that we are here to help you with many of these questions. Having your own agent only makes sense, since we have systems available to use to get answers more quickly than trying to call CMS or Social Security, many times. Plus, since we deal with many different circumstances, often we have tips and how-to’s we can share.
OH… one more thing! If you’ve not subscribed to our newsletter, please do so. You will get quality articles like these, to keep current with changes in Medicare and Medicare Advantage.
Eddie Velez | Licensed Florida Medicare Advantage Specialist
