My mother is in a assisted living facility and we have insurance that pays for the lodging is confined to a wheel chair or bed can barely speak can not feed herself we have a do not resistant order and yes she is on hospice 14 months the facility says she can pass there they are not restricting this
we are still maintaining supplement insurance, question is it time to drop the supplement insurance we pay about. 350 month
So, you need to look at it this way. In the 14 months has she needed the supplimental. Some cover prescriptions, dental and vision which Medicare does not cover.
Moms not using Drs. She is not getting labs. Are you worried about her vision or dental issues? Prescriptions, from what I understand the only prescriptions Hospice pays for are the ones being used for her comfort. Anything she was using before hospice and still using, unless a med for comfort, is not covered by Medicare.
Me, I would call her supplimental and see what it covers. Then I would figure out, based on the last 14 months, how much out of pocket Mom would have incurred without the supplemental. If under $350 a month, $4200 a year, I would drop it. Or if possible, drop the dental and vision and keep the prescriptions if allowed to do that.
You have replied that the supplement will not pay as long as she is on hospice. That hasn’t been my experience.
want to clarify that on original Medicare, with part A&B and a supplement that pays the 20% that Medicare doesn’t pay, it does indeed pay while a patient is on hospice IF you have had an occasion to use Medicare aside from hospice. ~
a supplement is just that. It supplements Ipays) on the portion Medicare does not cover so yes, you have to have used Medicare for something that leaves a balance for the supplement to pay. If she has only seen the hospice doc, only taken meds provided by hospice, then little to no chance to use it.
Insurance on a car, a person, a house, an appliance is for IF something happens that we have a problem. Not knowing that we try to minimize our risk by having insurance.
Since the insurance is provided (in my aunts case) I kept it. Otherwise she would have no funds to pay the 20% as she is on Medicaid. Your situation is different.
I chose not to drop the supplement but I’m not paying for it.
It pays up to the 20% of what Medicare doesn’t pay on Part B depending on the level of supplement. At the price of your mom’s supplement sounds like she has a good plan as my 97 yr old has a Plan F through AARP at about the same cost which is paid by her SS which Medicaid allows.
97 yr old has been on and off hospice about 3 or 4 years with dementia. Also has DNR, is in a NH, has just gotten her strength back after an illness that required hospitalization in Nov of 22. She is now able to feed herself. Her weight is stable, she has a great appetite, has great care as she sees a hospice aide daily. She is bedfast, helped to a wheelchair to go to showers and occasional (like 3 times a year) to the dining room. Refuses to go other times. So she sounds in about the same condition as your mom except even though she doesn’t wear her teeth she doesn’t require blended food. She can talk just fine when she wants to which is seldom.
Hospice is the one who suggested I take her off hospice to go to an acute care hospital until she got over her respiratory issues in 22. She and I both got a break from NH environment and her very good insurance was a blessing. She is on Medicaid in the NH but she is not limited when she needs care and I don’t worry whether she can afford it. She had therapy when she came back to the NH and then went back on hospice. She just had her geriatric provider check up last Friday and her insurance pays at Medicare rates and the supplement pays the copay. I don’t have to worry that she will need care that Medicaid doesn’t cover. The geriatric is the only real doctor she sees albeit by the use of MYChart and my iPad. Others are NP or PA dujour. Since the NH knows she has this coverage she is always included in any and every pseudo medical treatment that comes through like PsychCare. I doubt it does her any good except for the visit she gets from the very nice young woman who wants to be a real doc when she grows up. It’s a visit by someone who has time for her.
Not all patients have the same situation so it’s hard to say what you should do. You could look at her summary of benefits from 2023 and see what it paid vs what it costs, that might help you decide. Since Medicaid allows it to be paid out of her SS, and it doesn’t cost me to keep it, there wasn’t much of a decision to be made for aunt regarding cost so I’m glad I kept it. She also has her Part D.
I read your post to indicate your mom is NOT on Medicaid. That she has a LTC policy that the ALF accepts.
Someone made sure she had good insurance, perhaps herself. I try to keep aunts good decisions working for her until she is gone.
If you are POA you are paid for expert advice, so ask an elder law attorney this simple question re the ramifications, meanwhile, of dropping insurance when there will be no more hospitalizations.
If everything is or would be covered by Medicare or Medicaid then the supplemental insurance payment is just tossing money away.
Medicare and Medicaid both cover Hospice. This includes any and all supplies, equipment and "formulary" medications.
It will NOT cover the actual cost of the facility (room and board so to speak) If the supplemental insurance is covering this then it is probably wise to continue.
I would make sure that dropping her supplemental won't impact her hospice (or ability to choose a good/better one).