My mom has both a heart condition, previous strokes and mild dementia, stage 1. She uses Medicare and may be moving into our home. If so, I want to get her set up with a primary care physician and services for her stroke condition. She is currently in a stroke club. Etc. Can anyone speak about what it was like to get a new medical team set up and the time it took? Thanks, Newdawn
The nursing home had a doctor on site so that wasn’t anything difficult to deal with, but know that there is a cut-off date each month with insurance companies if you want to make any changes, and you have to let them know before that date in order for their insurance to start up the following month.
For example, we moved my mother on July 5, but I made the decision about a week before, in late June. It was too late to get her insurance switched over to start at the new location for July, so we had to pay out of pocket for July and then her insurance picked up again in August with the new changes.
This was because she moved to a different county and also changed doctors. I was surprised to find out that the new county had better benefits than the old one, such as a $100 copay for an ambulance rather than $200 in her old location. She moved a whole 30 miles away, but there were quite a few changes.
I’d advise that you check with her insurance if she has a Medicare supplement policy to see what that cut-off date is for changing doctors. In my mom’s case, the cut-off was the 20th of the previous month, so I missed that cut-off by about five days.
My husband and I both called for 3 days trying to find doctors, with no luck, my doctor said take him to the ER. That got him all the doctors he needed.
If your mom has a Medicare advantage plan it will not cross county or state lines. (County only if the services are not available in the county of residence.) We found this out when my dad was hospitalized and had no insurance.
One benefit of moving out of the service area of an advantage plan is that they cancel you and then you can get into a supplemental policy and standard Medicare without any preexisting or waiting periods. It was a huge blessing for my dad.
When my Mom came to live with me from another state, her doctor there had already contacted the specialist she needed to see. I called Philly's department on aging, and they were excellent. The time it took for this to get everything done was about a week total.
Even though we've been here in central Pa about 8 years, my husband is in a good health care system, there are times when his care there has been not so great. Not much here for care givers. It would almost be worth moving to Philly, just to get more help.
what does she have for her secondary health insurance?
Do you both currently live in the same state? and the same city?
Is she on any type of community based services right now… like a adult day Center? Is the stoke club within a PACE program?
the answers on these pretty much determine what needs to happen next for changing (or not) her Medicare.
But I’m more concerned about the feasibility of your mom moving in with you. What is her currently living situation and why the need to move right now? Has she had a needs assessment done? What are her capabilities right now….. can she select her clothes and get dressed on her own? Can she transition from her bed to walk to the bathroom and toilet on her own? Ditto for bathing? How much support do you - you not her - have with others to come in on a regular basis to provide caregiving for her? Or is this move planned as you being the 24/7 oversight for your mom in your home?
The new practice is part of a GP group tied to a large known and high quality hospital system, with a teaching hospital too. So if any specialists are required, it is a simple referral from her GP. And importantly, since the use the EPIC electronic health record system ANYONE in their system can see all her records across doctor office, outpatient, inpatient, etc.
This fluid access to all her records was very helpful when she had a 2-week hospital stay AND all those hospital records, tests, Rx, etc reports all all in that same record now. Obviates her having to remember what Rx, what doses, when was last EKG, etc. And easy for me to track it too.
All to say, perhaps look for a GP practice that is part of a larger and quality hospital system near you and get her plugged into that system. All major hospital systems accept Medicare so should not be an issue.
hospital and various specialists. Also I could access his lab reports when needed. Recently I had to find a new doctor since my doctor of over 20 years retired. I found a younger one who hopefully won’t retire on me because it was a pain trying to find a new one that I liked.
I got a new list of Doctors, checked them out online. Found a great Family Practitioner nearby, which she used until she became completely bed-bound. Easily transferred her prescriptions to a local pharmacy. It was all very simple and uncomplicated.
The big issue arrived when she became bed-bound. Took awhile to work it all out, to find a Doctor's office in the area who sent a NP to make house calls, and to find a lab that made house calls. And found a Medical Transport company to take her to Specialists.
My biggest shock - and a shock that would have made me choose another county to live in had I known... was that Medics here charge $175 for lift assists, and $200 ~ if they make a call for service and the patient declines hospitalization. It's the things like this that are the tricky issues. The insurance updates & changes, and finding Doctors was the easy part.