Author Topic: Paying for Crazy Expensive Health Care?  (Read 9746 times)

oldtoyota

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Paying for Crazy Expensive Health Care?
« on: August 03, 2013, 07:29:53 PM »
In talking to older relatives, the expense of health comes up quite often. $16,000 for dental. Tens of thousands on nursing homes or in-home aides (Alzheimer's or stroke victim).

The above is something that concerns me. How do you all account for the possibility of an extremely expensive unexpected problem?

minimalist

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Re: Paying for Crazy Expensive Health Care?
« Reply #1 on: August 04, 2013, 09:02:27 AM »
Some options are:
-savings
-health insurance
-dental insurance
-long-term care insurance
-Medicare
-family caregivers

How does one spend $16,000 on dental?

Miamoo

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Re: Paying for Crazy Expensive Health Care?
« Reply #2 on: August 04, 2013, 10:18:29 AM »
"How does one spend $16,000 on dental?"

I'd like to know that too!  Can't be per year?  Must be over ????? years.  Or the older relatives are getting 'nibby' and threw out the wrong figure.

oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #3 on: August 04, 2013, 11:34:34 AM »
Some options are:
-savings
-health insurance
-dental insurance
-long-term care insurance
-Medicare
-family caregivers

How does one spend $16,000 on dental?

Medicare doesn't pay for everything though. For instance, Medicare will only pay for a certain amount of hospice. LTC is an option. I will look into that.

Savings, of course. However, I would then be back to the original plan of saving millions because one month in a nursing home is about $3,500.

« Last Edit: August 04, 2013, 11:37:10 AM by oldtoyota »

OzzieandHarriet

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Re: Paying for Crazy Expensive Health Care?
« Reply #4 on: August 04, 2013, 04:20:25 PM »
One month in a nursing home -- try $6,000 and up. It's not considered "medical care" and so is not covered by any type of health insurance except for acute care (after a hospitalization).

LTC insurance is being pushed big time by the insurance industry, but I don't trust it to pay back when it's needed.

Most people who do have to move to a nursing home only stay for about 2 years or less, though.

But you know what? I don't want to spend the rest of my good years saving up so I can stay in a higher class nursing home when I probably won't know the difference. I am hoping there will be other alternatives if it comes to that. The current model of end of life care is not sustainable.

oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #5 on: August 04, 2013, 04:55:18 PM »

But you know what? I don't want to spend the rest of my good years saving up so I can stay in a higher class nursing home when I probably won't know the difference. I am hoping there will be other alternatives if it comes to that. The current model of end of life care is not sustainable.

That is so true. Grandmother #1 spent a long time in a nursing home. The stay took all of her assets and more.

Grandmother #2 was technically dying when they took her, so the nursing home was acting as a hospice. Personally, I would have preferred a hospice--the ones I visited were so much nicer than the nursing home--but Grandmother #2 was lucid enough to make her own decisions. And, at the time, it was not 100% obvious to me she was going to die...and, because she was lucid, I did not feel comfortable saying, "Hey, you might be dying. Let's go to hospice."

Grandmother #3 had in-home care. I think assets paid for that too. She never went into a nursing home and died at home.

#3 probably had the best situation, and it was probably the most expensive.

bogart

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Re: Paying for Crazy Expensive Health Care?
« Reply #6 on: August 04, 2013, 07:54:57 PM »
Quote
How does one spend $16,000 on dental?

In a single chunk, probably relatively rare, but over a few years particularly for a couple, not challenging.  DH and I have probably accomplished this over the past 3 years -- I've needed 2 root canals and 2 crowns, each running about $1,250 (that's per canal and per crown), plus $300 (each time) for prep of the tooth for the crown, and he's needed two (ditto).  So that's upward of $5K per person for two of us, or $10K total.  One of his root canals ended up not working, leading to first to an apicoectomy (you can google it!); I honestly don't remember what that cost, but it didn't in the end work and that led to an extraction (again, I forget cost) and an implant (I know the actual "tooth" part of that is $2.2K, I think the cost of getting the post put in first (along with the bone graft that proceeded it) ran in the $3K range.  So there you go.  I'm having a fractured molar (old filling) that my dentist thinks should be crowned, crowned next week, so that will be another $1.2 K but avoids (touch wood) the root canal, not to mention the cost of a broken molar (again, touch wood). 

We do have insurance through my employer that knocks $1k per year (max payout) for each of us off the costs above, but since the insurance itself costs close to $1K per year for the two of us, the savings is only $1K per year total for the listed costs (though the insurance is pre-tax, so it's a little better than that).  And of course I'm completely ignoring the cost of routine cleanings, etc. 

As for the thought of ...

Quote
I don't want to spend the rest of my good years saving up so I can stay in a higher class nursing home when I probably won't know the difference.

Yeah, me either.  But I look at my dad, in a nursing home with dementia where, because he's relying on Medicaid, his choice of facilities is basically zero and he's stuck with a roommate in a context where every patient (very much himself included) has issues, the rooms are too small, and the staffing is inadequate.  And make no mistake, he does know the difference; it's hard for him to e.g. be stuck in a room where his roommate has the tv on (loud) many, many hours in the day, and the dementia together with his own chronic anxiety has him imagining that every disaster he hears about (say, Sandy Hook, Boston Marathon, Oklahoma tornadoes, to name a few recent ones) is threatening his family. 

I don't really want to land there.  And sure, I have a living will and general commitment to not ending up like my dad, but one thing his experience has illustrated for me is that it's not necessarily the big, traumatic events that one tries to plan for, but the gradual decline (a stroke, onset of dementia, broken hip) that does it. 

The short answer to the OP's question is that I'm much more risk averse than MMM would advocate, and cheerfully so.  The longer answer is that -- fates willing -- I'll build up a bigger stash based on a lower SWR, buy more insurance (see below*) and generally try to think about how I'd manage unpleasant eventualities by considering things like how I'll get around if my mobility is limited and I can't drive (or bike) (or walk).  I'd like to remodel our house to increase its accessibility (roll-in showers and such) and add a separate apartment that could be an income generator but could also be a dwelling for a care giver.     

*I don't currently have (or necessarily plan to get) LTCI, though I would (do so) if I thought decent products were available. 

MoneyCat

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Re: Paying for Crazy Expensive Health Care?
« Reply #7 on: August 04, 2013, 08:45:36 PM »
To be honest, the one part of ER that would concern me is getting adequate medical coverage.  Currently, I have excellent health insurance which pays for my medication and treatment for a chronic health condition.  I suppose that once Obamacare goes into effect this won't be as much of an issue anymore, though.  My state is going to have a federal exchange instead of a state exchange, but after looking at the savings that folks in NY are going to get, a lot of my worries have gone away.

oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #8 on: August 04, 2013, 08:50:24 PM »
Bogart--I think the answer and considerations are different when you've experienced it. I spent days and nights on a death watch in a nursing home, and people could not believe I did not want daytime TV blaring in my ears all day.

It's a disease with a slow decline--like the ones you mentioned--that truly concern me. I've seen it up close. I wonder since the age of this board is pretty young if a lot of folks here do not think about that.

Edited: To fix some grammar errors.
« Last Edit: August 05, 2013, 07:01:38 AM by oldtoyota »

bogart

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Re: Paying for Crazy Expensive Health Care?
« Reply #9 on: August 04, 2013, 09:10:45 PM »
I wonder since the age of this board is pretty young if a lot of folks here do not think about that.

I think there's some of that, coupled with the ever-popular "it won't happen to me!" (I certainly hope not!), with some "My healthy choices will protect me from having that happen!" and, "I'll choose a bullet (or overdose) over a slow end." 

All reasonable hopes, but with you, I remain unconvinced that I can count on any or all of them with certainty.

pachnik

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Re: Paying for Crazy Expensive Health Care?
« Reply #10 on: August 04, 2013, 09:27:04 PM »
I'm in Canada so it is a bit different here for health care costs but dental care sounds about the same. 

I don't think younger people think about these kinds of things very often.  I sure didn't when I was in my 20s or 30s.

A few months ago, I was having a conversation with a friend who is in her early 60s.  I am in my late 40s.  We were talking about our family members' and friends' health.  You know, how so-and-so was doing these days.  We both realized that 20 years ago there was no way we'd be having such a discussion.  It is just how it is.  You get older and things change.

Worsted Skeins

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Re: Paying for Crazy Expensive Health Care?
« Reply #11 on: August 05, 2013, 05:33:58 AM »
My 87 year old father passed away recently.  He had lived (relatively) independently until last autumn.  When he first had a heart attack (age 82), Medicare covered the hospitalization, rehab, physical therapy visits at home for a couple of weeks.  Meals on Wheels not only ensured that he was receiving a meal a day (he liked to cook but did not have energy to prepare every meal), the MoWs delivery person was a welcome visitor.  She had once found him on the kitchen floor after a fall.

People often talk about how family should care for the aged.  It is a lovely idea but my father reached a point where he needed assistance in the bathroom.  He did not want his daughters wiping up after him--nor did we want to do this in all honesty.  It was a slow decline but he eventually had to have someone available to assist him 24/7.  For Dad that meant a nursing home.

So it was about $6K per month but he did have both Social Security and a pension check coming in monthly.  The difference came from his savings.  Even with interest rates being nonexistent, he had some income coming in from municipal bond funds.

My Mom died of cancer at home under Hospice care.  They were wonderful.  My Mom's situation was different than my Dad's. Mom had a death sentence, Dad just slowly declined. 

Lessons learned:  be prepared for future medical expenses and nursing care especially if you are in good general health as my parents were.  Mom (older than Dad) also died at age 87  Mom had a single hospitalization eight months before she died, then entered into hospice care.  Dad was in and out of hospitals and rehab in his slow decline.  Neither received significant medical care until their 80s because of their general good health.  Neither accumulated massive medical bills but Dad still needed funds for the nursing home.

I will make an annual contribution to the Hospice organization that cared for Mom until the day I die.  This to me is the best model of palliative care commonly available in the US.  What comes with it though is the need for survivors to acknowledge that medical intervention is not necessarily the best option for the elderly.  This is part of the problem:  adult children or spouses who cannot let go.  Of course our lifestyle choices are indeed a larger problem but I know that I would be preaching to the choir on that one.


oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #12 on: August 05, 2013, 07:08:37 AM »
I will make an annual contribution to the Hospice organization that cared for Mom until the day I die.  This to me is the best model of palliative care commonly available in the US.  What comes with it though is the need for survivors to acknowledge that medical intervention is not necessarily the best option for the elderly.  This is part of the problem:  adult children or spouses who cannot let go.  Of course our lifestyle choices are indeed a larger problem but I know that I would be preaching to the choir on that one.

The above is an excellent point.

In my case, there was probably some trouble with letting go, but there's also something else. Once, my grandmother got a virus and nearly died. She recovered in a rehab (fancy word for nursing home) and got out and lived for a long time (and a good life too).

On the one hand, I feel like who am I to stay someone is going to die? It's not an easy call. I asked the doctor once what was going on, and she said "only God knows." I appreciated that because the situation was confusing. One caregiver told me that giving my grandmother fluids was just prolonging things while on the other side a different doc was requesting the best throat specialist in the state (one of the joys of aging is trouble swallowing).

My grandmother had to go through some physically painful situations with the throat specialist, and I sat nearby listening to her scream in pain. Maybe I should have told her not to try? I just had no idea what was involved. Doctors also have trouble letting go, which is why I think the one guy ordered the specialist.

I don't think anyone wants to be the person to blame. That's what it boils down to--for me at least. Also, my grandmother was lucid and able to make her own decisions. If she asked me for my advice, I would have given it.

Also, the signs of death are not all tidy. She would request a special meal (this is what the dying do, evidently) and then check her stocks. It was confusing.


oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #13 on: August 05, 2013, 07:09:49 AM »
My 87 year old father passed away recently.  He had lived (relatively) independently until last autumn.  When he first had a heart attack (age 82), Medicare covered the hospitalization, rehab, physical therapy visits at home for a couple of weeks.  Meals on Wheels not only ensured that he was receiving a meal a day (he liked to cook but did not have energy to prepare every meal), the MoWs delivery person was a welcome visitor.  She had once found him on the kitchen floor after a fall.

I am sorry to hear about your father. Peace to you.

Worsted Skeins

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Re: Paying for Crazy Expensive Health Care?
« Reply #14 on: August 05, 2013, 08:49:38 AM »
My 87 year old father passed away recently.  He had lived (relatively) independently until last autumn.  When he first had a heart attack (age 82), Medicare covered the hospitalization, rehab, physical therapy visits at home for a couple of weeks.  Meals on Wheels not only ensured that he was receiving a meal a day (he liked to cook but did not have energy to prepare every meal), the MoWs delivery person was a welcome visitor.  She had once found him on the kitchen floor after a fall.

I am sorry to hear about your father. Peace to you.

Thank you.  Dad coped with losing his mobility.  Less than three days before he died, he lost the ability to communicate in that he was trying to say something but no one could understand.  This really frustrated him.  I am glad that this final stage was not prolonged.

About your grandmother:  I understand that too.  I think there are reasonable measures and heroic measures with a very fuzzy line in between.   For example, my father wanted a knee replacement but his compromised heart (damage from a heart attack) would not have handled the surgery.  If it had been possible, I suppose he would have gone ahead with it at age 85.  It would have been decision under the direction of his physicians.  But would the procedure have been wise?  Certainly I don't know. 

Zelda01

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Re: Paying for Crazy Expensive Health Care?
« Reply #15 on: August 05, 2013, 10:46:17 AM »
How does one spend $16,000 on dental?
What happens is, at some point an older person's dental troubles escalate, and they need crowns, bridges, etc.  Also, certain medical conditions and treatments affect the teeth.  The dentist wants the person to keep their teeth as long as they can.  Then finally the dentist will say: "The top teeth have to go."  Oral surgeon is several thousand, temporary dentures cost, then permanent ones once the mouth shrinks.  Then "The bottom teeth must go too."  SO back to the oral surgeon, dentures again. 


oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #16 on: August 05, 2013, 12:55:26 PM »
Yeah. I think young folks can't believe one would spend that much.

On another note, we often talk of the glow or retirement. I would like to see someone more advanced than I am address this subject of expensive care.

My friend's FIL had a stroke. He was in the hospital. They discharged him b/c the health ins ran out (or would not pay more) and he was sent home without being able to use a toilet by himself. Who pays for the person to come help him use the toilet? Feed himself? Brush his teeth?

Health insurance stopped paying after 14 days of hospital care for my grandmother. That's when she was sent to a nursing home to die. Also, insurance would not cover the blood treatment for her, so that sealed her fate.

It sounds like there is not insurance for the above, and the cost of a home aide has to come from savings. This is disturbing to me.


oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #17 on: August 05, 2013, 01:44:29 PM »
I found some data that could be useful to others with this question:

"In a March 2010 paper from the Center for Retirement Research at Boston College, researchers indicated that the present total of lifetime uninsured health care costs for a married couple at age 65 is about $197,000 (including insurance premiums, co-pays, and home health services). Add to that nursing home care costs, and the number balloons to an estimated $260,000. Using these numbers, one-third of all Americans turning 65 in 2010 will eventually need at least three months of nursing home care.

...Another source indicated that Medicare beneficiaries between ages 65 and 74 spend an average of $2,920 a year on out-of-pocket expenses, including Part B premiums and prescription costs. After age 85 this nearly doubles, to an average of $4,615."

SOURCE: http://vanguardblog.com/2011/06/13/affording-health-care-in-retirement/

More from the ERE Forum:
http://forum.earlyretirementextreme.com/viewtopic.php?t=3159



Zelda01

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Re: Paying for Crazy Expensive Health Care?
« Reply #18 on: August 05, 2013, 01:56:16 PM »
...Another source indicated that Medicare beneficiaries between ages 65 and 74 spend an average of $2,920 a year on out-of-pocket expenses, including Part B premiums and prescription costs. After age 85 this nearly doubles, to an average of $4,615."
This is the part most younger people do not know.  They don't realize that Medicare comes with copays.  Many older people will then get Medigap Insurance, which fills in the gaps. 

There are people too poor to get Medigap insurance, and they can't afford the co-pays or out-of-pocket. 

Also, Medicare has a monthly cost - I don't know if it does for everyone, or if that is income-based.
« Last Edit: August 05, 2013, 01:59:35 PM by Zelda01 »

bogart

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Re: Paying for Crazy Expensive Health Care?
« Reply #19 on: August 05, 2013, 08:56:31 PM »
@oldtoyota @worstedskeins, I am sorry to hear of your losses.

...researchers indicated that the present total of lifetime uninsured health care costs for a married couple at age 65 is about $197,000 (including insurance premiums, co-pays, and home health services). ...

...Another source indicated that Medicare beneficiaries between ages 65 and 74 spend an average of $2,920 a year on out-of-pocket expenses, including Part B premiums and prescription costs. After age 85 this nearly doubles, to an average of $4,615."


Neither of those surprises me.  I know my dad's Medicare and medigap premiums run about $300/month between them (even though he is on medicaid now, the state allows him to pay those premiums because, of course, it saves them money over the state paying for his medical care -- distinct from his long-term care, of course, which neither Medicare nor medigap cover -- through Medicaid).  So that's approaching $3600K per year and Medicare's individual (no household Medicare or Medigap plans), so for a couple you'd be looking at ~$7K annually or ~$140K just for premiums between the ages of 65 and 85 (and that's ignoring drug coverage, which has its own premium). 
« Last Edit: August 07, 2013, 01:46:16 PM by bogart »

NestEggChick (formerly PFgal)

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Re: Paying for Crazy Expensive Health Care?
« Reply #20 on: August 07, 2013, 12:50:21 PM »
I don't agree with every position taken by MMM and by others in the forum, but the only one that really worries me is the suggestion that if you live a healthy lifestyle, it isn't necessary to save much extra for the future.

In my own family, I saw my grandparents live independently into their early 90s, but then they needed help, so they had to either hire someone, or move into an assisted living facility. They did the second. They stopped spending much when they moved in - meals were provided, etc. Still, the cost wasn't cheap. But what was the alternative? And then my grandmother got ill, and medicare didn't cover the aides she needed to have 24/7. It's not as if their kids could be there all day and all night, and their kids didn't have the proper training anyway. That was really costly, and we're just grateful they could afford it. I think it's necessary to save up just in case you do need something like that.

Of course, you could need help at a younger age, too. What if you have a stroke at a young age? What if you're in a car accident? There are so many "what ifs" and you can't plan for each one individually. I guess it's just a matter of having both savings and insurance and then doing the best you can with what life hands you. There's no perfect solution, but we can at least try to have a cushion.

jfer_rose

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Re: Paying for Crazy Expensive Health Care?
« Reply #21 on: August 07, 2013, 02:02:44 PM »
As my aunts and uncles have begun passing away over the last few years, I've seen that this is really a gamble. There are some health issues that can't be prevented with a healthy lifestyle. And you just can't predict whether you're going to need long term care or whether it will be a sudden health issue that gets you.

My sweet, 80-something aunt has been in a nursing home for years. She thrives there-- she loves all the social activities that the home offers. If they have a bus trip somewhere, she's on it. But I wish I understood better how she pays for it. As she and my uncle were getting on in years, they worked with a financial planner and determined it would be best to give away a good chunk of their assets because if they didn't spend them, they would get eaten up by long term care costs. So, in 2008 each member of my enormous family got a check. My uncle soon passed away soon after and my aunt moved in to the nursing home. I don't know if the nursing home is paid for by a combination of a pension and social security or what but I do know that they eliminated a good chunk of their savings before any of this happened.

So basically, I just used a whole lot of words to say that I wish I understood the options for funding long term care better than I do. So thanks for asking this question.


jfer_rose

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Re: Paying for Crazy Expensive Health Care?
« Reply #22 on: August 07, 2013, 02:10:13 PM »

It sounds like there is not insurance for the above, and the cost of a home aide has to come from savings. This is disturbing to me.

This must depend on the insurance that you carry then. Especially now that you get to choose your Medicare plan. Because my Mom needed open heart surgery this past December. I was home for Christmas and there was a huge flurry of home aides. Sometimes multiple in a day. I asked her how she was paying for it and she said it was all covered by insurance.

In some ways, my Mom suggests to me that early retirement might actually be a possibility. She's had so many expensive health problems and she and my Dad are still doing fine financially. She and my Dad are pre-mustachian-- they get their frugal ways simply by having lived through the Depression. Anyway, she's gone from one major surgery to the next. Of course, they have not yet reached 80 (although they are close), so they could have a lot of years left to test that (and I hope they do have a lot of years left!!).

KimPossible

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Re: Paying for Crazy Expensive Health Care?
« Reply #23 on: August 07, 2013, 03:24:53 PM »

This must depend on the insurance that you carry then. Especially now that you get to choose your Medicare plan. Because my Mom needed open heart surgery this past December. I was home for Christmas and there was a huge flurry of home aides. Sometimes multiple in a day. I asked her how she was paying for it and she said it was all covered by insurance.


That's _very_ rare.  I spend my days working on getting people out of a rehabilitation unit at a hospital.  I don't think I've EVER had a patient with in home aides covered by insurance. 

Don't count on being able to find that kind of insurance.

Home health care (therapies, nursing, bath aides) are often covered by insurance, but that's different than in home aides.  Home health personnel come in to do a job, then leave.  You might get PT twice a week for an hour each, OT twice a week for an hour each, and a nurse to come out three times a week and draw labs, check a wound, etc.,---but they aren't going to stick around and get you in and out of bed, help get you dressed, get meals, clean, do laundry, etc.

(Edited to clarify the difference between Home Health and in home aides)
« Last Edit: August 07, 2013, 03:29:19 PM by KimPossible »

jfer_rose

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Re: Paying for Crazy Expensive Health Care?
« Reply #24 on: August 07, 2013, 05:59:01 PM »

This must depend on the insurance that you carry then. Especially now that you get to choose your Medicare plan. Because my Mom needed open heart surgery this past December. I was home for Christmas and there was a huge flurry of home aides. Sometimes multiple in a day. I asked her how she was paying for it and she said it was all covered by insurance.



Home health care (therapies, nursing, bath aides) are often covered by insurance, but that's different than in home aides.  Home health personnel come in to do a job, then leave.  You might get PT twice a week for an hour each, OT twice a week for an hour each, and a nurse to come out three times a week and draw labs, check a wound, etc.,---but they aren't going to stick around and get you in and out of bed, help get you dressed, get meals, clean, do laundry, etc.


My apologies, I don't know the terminology. My Mom had exactly that, nurses, occupational and physical therapy, bath aide, etc. The bath aide did help her get dressed after helping her bathe. I didn't know that was different than a home aide. I guess it goes to show how little a person can know about these things without the personal experience (heck, even with the personal experience it doesn't mean you know the vocabulary). Before getting there and seeing all the help she was getting, I had been really worried my Dad wouldn't be able to handle helping my Mom during her recovery. So from my perspective, I was pleasantly surprised with how much help my Mom was getting.  But it certainly is true, most of the time it was just up to my Dad to help my Mom-- help her get up from sitting, etc, etc.

KimPossible

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Re: Paying for Crazy Expensive Health Care?
« Reply #25 on: August 07, 2013, 08:16:04 PM »

My apologies, I don't know the terminology. My Mom had exactly that, nurses, occupational and physical therapy, bath aide, etc. The bath aide did help her get dressed after helping her bathe. I didn't know that was different than a home aide. I guess it goes to show how little a person can know about these things without the personal experience (heck, even with the personal experience it doesn't mean you know the vocabulary). Before getting there and seeing all the help she was getting, I had been really worried my Dad wouldn't be able to handle helping my Mom during her recovery. So from my perspective, I was pleasantly surprised with how much help my Mom was getting.  But it certainly is true, most of the time it was just up to my Dad to help my Mom-- help her get up from sitting, etc, etc.

No worries--I just wanted to clarify things :).  Most people have very little experience with these types of situations.  Unfortunately, it often leads to difficult conversations when we explain that the only way to get much help at home is to pay for it out of pocket, at about $18/hour (and that's in a low COL area).

I hope your mom is doing well, and I'm glad to hear that your/her experience was good :)

bogart

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Re: Paying for Crazy Expensive Health Care?
« Reply #26 on: August 07, 2013, 08:30:22 PM »
@Jfer (and anyone else interested) -- as I understand it, Medicare will pay for skilled nursing-home care for a limited time (up to 3 months under some circumstances, I believe) if someone needs it to recover/recuperate after an acute "event" that requires hospitalization for 3 or more days.  I don't know if this would extend to in-home care, but particularly with (some) private insurance policies it might.  Obviously your mom's situation would fall in that category, i.e., a recovery period following a crisis.  I hope she is doing well and has many healthy years in front of her. 

The big gaps for most Americans seem to be (a) ongoing care if you need it for more than 3 months or the need arises independent of a crisis/acute event, and/or (b) care that is about basic/ordinary needs and isn't about "recovery." Medicaid covers those things, but is only available for the "needy," with pretty stringent definitions of how little one can have to qualify. 

madgeylou

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Re: Paying for Crazy Expensive Health Care?
« Reply #27 on: August 08, 2013, 06:34:05 AM »

My apologies, I don't know the terminology. My Mom had exactly that, nurses, occupational and physical therapy, bath aide, etc. The bath aide did help her get dressed after helping her bathe. I didn't know that was different than a home aide. I guess it goes to show how little a person can know about these things without the personal experience (heck, even with the personal experience it doesn't mean you know the vocabulary). Before getting there and seeing all the help she was getting, I had been really worried my Dad wouldn't be able to handle helping my Mom during her recovery. So from my perspective, I was pleasantly surprised with how much help my Mom was getting.  But it certainly is true, most of the time it was just up to my Dad to help my Mom-- help her get up from sitting, etc, etc.

No worries--I just wanted to clarify things :).  Most people have very little experience with these types of situations.  Unfortunately, it often leads to difficult conversations when we explain that the only way to get much help at home is to pay for it out of pocket, at about $18/hour (and that's in a low COL area).

I hope your mom is doing well, and I'm glad to hear that your/her experience was good :)

In PA, there is a wonderful stay-at-home program, where my grandma got 8 hours of help everyday. The women who worked with her helped her bathe and dress, hey did her cooking and housework and some of her shopping. It was a bit of a project to manage the workers -- some of them were great and others just decided not to show up now and then, but overall, it was an enormous help.

Worth investigating if your state has a similar program. Of course you have to be broke to get it.

jfer_rose

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Re: Paying for Crazy Expensive Health Care?
« Reply #28 on: August 08, 2013, 06:48:03 AM »

In PA, there is a wonderful stay-at-home program, where my grandma got 8 hours of help everyday. The women who worked with her helped her bathe and dress, hey did her cooking and housework and some of her shopping. It was a bit of a project to manage the workers -- some of them were great and others just decided not to show up now and then, but overall, it was an enormous help.

Worth investigating if your state has a similar program. Of course you have to be broke to get it.

Is it paid for by Medicaid? I'm not certain about this, but I think Medicaid may be what is covering my aunt's nursing home. Is that possible?

oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #29 on: August 08, 2013, 08:13:02 AM »
I don't agree with every position taken by MMM and by others in the forum, but the only one that really worries me is the suggestion that if you live a healthy lifestyle, it isn't necessary to save much extra for the future.


Agreed. That is one reason why I raised the issue.

oldtoyota

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Re: Paying for Crazy Expensive Health Care?
« Reply #30 on: August 08, 2013, 08:18:42 AM »

My apologies, I don't know the terminology. My Mom had exactly that, nurses, occupational and physical therapy, bath aide, etc. The bath aide did help her get dressed after helping her bathe. I didn't know that was different than a home aide. I guess it goes to show how little a person can know about these things without the personal experience (heck, even with the personal experience it doesn't mean you know the vocabulary). Before getting there and seeing all the help she was getting, I had been really worried my Dad wouldn't be able to handle helping my Mom during her recovery. So from my perspective, I was pleasantly surprised with how much help my Mom was getting.  But it certainly is true, most of the time it was just up to my Dad to help my Mom-- help her get up from sitting, etc, etc.

No worries--I just wanted to clarify things :).  Most people have very little experience with these types of situations.  Unfortunately, it often leads to difficult conversations when we explain that the only way to get much help at home is to pay for it out of pocket, at about $18/hour (and that's in a low COL area).

I hope your mom is doing well, and I'm glad to hear that your/her experience was good :)

The above is one reason my grandmother had to die in a nursing home. Insurance would no longer pay for the hospital after 14 days. Hospice was one option but at-home hospice would mean a family member would be tied to the house 24-7. One can't legally leave a dying person alone. That is what they said. So, I would not have been able to leave to get groceries. Also, no one wanted to change diapers and my grandmother would not have wanted us to do that anyway.

So, we had to do the nursing home hospice, which was horrible in other ways.


madgeylou

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Re: Paying for Crazy Expensive Health Care?
« Reply #31 on: August 08, 2013, 09:04:11 AM »

In PA, there is a wonderful stay-at-home program, where my grandma got 8 hours of help everyday. The women who worked with her helped her bathe and dress, hey did her cooking and housework and some of her shopping. It was a bit of a project to manage the workers -- some of them were great and others just decided not to show up now and then, but overall, it was an enormous help.

Worth investigating if your state has a similar program. Of course you have to be broke to get it.

Is it paid for by Medicaid? I'm not certain about this, but I think Medicaid may be what is covering my aunt's nursing home. Is that possible?

Yes, it is paid for by Medicaid. We had to get her accepted for Medical Assistance (welfare) before she could benefit from this program. Medicare paid for her nursing home care for approximately the first 100 days ... then Medicaid kicked in to pay for the nursing home (and they took her SS check) ... then she came home and Medicaid/Medical Assistance paid for her at-home care. Apparently even having someone there with her 40 hours a week is far cheaper than a nursing home, which is why I think they were willing to help so much.

Miamoo

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Re: Paying for Crazy Expensive Health Care?
« Reply #32 on: August 22, 2013, 12:56:49 PM »
Quote
How does one spend $16,000 on dental?

In a single chunk, probably relatively rare, but over a few years particularly for a couple, not challenging.  DH and I have probably accomplished this over the past 3 years -- I've needed 2 root canals and 2 crowns, each running about $1,250 (that's per canal and per crown), plus $300 (each time) for prep of the tooth for the crown, and he's needed two (ditto).  So that's upward of $5K per person for two of us, or $10K total.  One of his root canals ended up not working, leading to first to an apicoectomy (you can google it!); I honestly don't remember what that cost, but it didn't in the end work and that led to an extraction (again, I forget cost) and an implant (I know the actual "tooth" part of that is $2.2K, I think the cost of getting the post put in first (along with the bone graft that proceeded it) ran in the $3K range.  So there you go.  I'm having a fractured molar (old filling) that my dentist thinks should be crowned, crowned next week, so that will be another $1.2 K but avoids (touch wood) the root canal, not to mention the cost of a broken molar (again, touch wood). 

We do have insurance through my employer that knocks $1k per year (max payout) for each of us off the costs above, but since the insurance itself costs close to $1K per year for the two of us, the savings is only $1K per year total for the listed costs (though the insurance is pre-tax, so it's a little better than that).  And of course I'm completely ignoring the cost of routine cleanings, etc. 

 
To Bogart and Zelda01 . . . after reading your posts and actually thinking about it, yep, I can see how it might cost that much per year.  My husband has what we call 'The Million Dollar Mouth' - around $25K worth of work in a 5 year period.  At this point (may sound crazy) we've decided enough with this BS and he's just having the teeth pulled instead of a crown on top of a crown on top of a root canal with a crown on top of that.  Both of his parents had dentures by their mid 30's so he's predisposed to problems and we've kind of accepted that he'll most likely need them as well.  Best to get this all done before we retire completely.

Bogart I will 'touch wood' for you (kinda late).  We say 'knock on wood' and I usually knock on my head.  Same thing.  :-)