New Article Sent by my CELA: 5 Medicare benefits consumers should know about. TRUE??

Mollykazoo

Hello fellow caregivers,

My CELA just sent me an article titled, "Alzheimer’s disease and dementia care: 5 Medicare benefits consumers should know" because she wanted me to know that it looks like Medicare Part A will pay for up to 35 hours of in-home care per week for dementia patients who are homebound and require skilled nursing care.

My husband is at stage 4 and only 56. He will not be eligible to receive Medicare until he is 58 so this does not apply to our circumstances YET but this information does seem hopeful but also doesn't seem to jive with anything I've read in posts on this forum. I've read multiple times here that Medicare does not cover any in-home care. Is it possible that this is a new change to benefits? Or am I misunderstanding something?

I guess I'm asking folks who know and understand more than I do to chime in, but I'm also passing on the article my lawyer sent me, in case it's good news I'm spreading—I sure hope so!

here's the link:

https://www.morningstar.com/news/globe-newswire/9156008/alzheimers-disease-and-dementia-care-5-medicare-benefits-consumers-should-know

—Molly

Iris L.

Thanks for posting. From the way I read this, the covered in-home care is avaliable when the patient is also receiving physical therapy or occupational therapy or skilled nursing care. This is not new, this has been the current benefit. This benefit is temporary, because PT and OT and skilled nursing are usually limited time benefits.

Iris

​fesk

I spoke with Medicare earlier in the year. It's the skilled nursing care that's the issue. If your LO doesn't need skilled nursing care, they will not cover home health care. I was not successful when I called and I spoke to 2 different reps who seemed to be confused about what could be provided. Skilled nursing isn't needed here; although assistance with all ADLs is needed, so no go for us.

I'd be interested to hear of anyone who managed to get Medicare to pay for home health care as in an aide.

SusanB-dil

We are dealing with this issue right about this week or next. From what I can gather with what MIL qualifies for, Iris is correct. They will help with PT and OT - for a limited time - and it was prescribed by her doc. and we aren't really sure the help will benefit MIL, but, if they will cover anything, we will go from there and at least try it. We are hoping the PT and OT will at least prolong her ability to walk and maybe continue to dress herself for just a bit longer.

​fesk

PT and OT have never been an issue. Medicare always covered that for my mother. That's for a certain amount of time.

Quilting brings calm

I think your CELA was just informing you of benefits that are offered that aren’t well known. No your spouse isn’t in skilled nursing care. However therapy might be helpful. My mom gets therapy by therapists with a location inside her assisted living facility and Medicare pays for it. She’s been at stage 4 for several years and is moving into stage 5. If nothing else- it gets you time to yourself while he’s in their presence.

Why doesn’t your spouse get benefits until he turns 58?

SDianeL

As others have posted, Medicare only pays for skilled nursing care at home or in a nursing home if there is a medical reason. Key word medical. For example, if someone with dementia has surgery & is sent home, they would get up to 35 hours of in home skilled nursing care, PT & OT. There is no Medicare coverage exclusively for Dementia or Alzheimer's care. Have you filed for Social Security disability? Alzheimer's & Dementia are on the Compassionate Allowances list. https://blog.ssa.gov/relief-for-thousands-suffering-from-alzheimers-disease/

Mollykazoo

Hello Quilting Brings Calm, I'm still learning about all of this, so I may be incorrect, but i only just applied for SSDI for my spouse on May 27. I read/heard someplace that he will be eligible for medicare ONLY after he's been officially disabled for 2 years (when he will be 58). This is super problematic, since I do not know what people are expected to do about medical coverage in the interim! SHRUG.

—m