Senior Advocate: Medicare doesn't always cover costs of 'custodial' care
Jun
25
Written by:
6/25/2009 9:28 AM
By Betty Berry
Wednesday, June 24, 2009
Q: Recently a neighbor returned home from the hospital and needed some assistance. I was surprised when I was told she had to pay for these services. Doesn’t Medicare pay for in-home care?
A: Although it sounds simple, in-home care is a complex subject and you are not alone in your thinking.
Keep in mind that Medicare pays only for “medically necessary” services. Medicare does not pay for “custodial” care.
Custodial care essentially covers the assistance with meeting the activities of daily living. It includes care with walking, getting in and out of bed, assistance with bathing, dressing, eating and going to the toilet.
It could also include preparation of special diets and supervision of taking medication that can be self-administered. It does not require the services of trained medical or paramedical personnel.
Home healthcare is skilled nursing care and certain other healthcare services received in the home for treatment of an illness or injury. Medicare does cover this type of care in the home if the patient meets the eligibility require-ments.
To qualify for home healthcare, the patient’s doctor must order such care and present a plan for that care. The plan must show that either intermittent, not full-time, skilled nursing care, physical, speech or occupational therapy is required.
The patient must be homebound. This means the patient is normally unable to leave home and leaving home is a major effort; leaving home must be infrequent and brief.
Last but not least, the home health agency caring for the patient must be approved by the Medicare program.
Home healthcare can be covered under either Medicare Part A or Part B. There are no deductibles or co-insurance associated with home healthcare except for durable medical equipment. In the case of durable medical equipment, Medicare will pay 80 percent and the patient or other insurance is responsible for the remaining 20 percent.
While this is a very simple answer to a complex service, I hope it shows you the difference between the two types of in-home care and explains when Medicare will or will not pay for the services.
Q: My dad has just gotten his disabled person parking license plate and I will be doing the driving for him most of the time. I know I can park in the designated parking spaces but have heard there are other locations I may also use. Do you know what those locations are?
A: I reviewed the DMV pamphlet No. 7, titled “Disabled Person Parking Placards and Plates,” to find this information.
In addition to the parking spaces with the wheelchair symbol you mentioned, you may park next to a blue curb that is authorized for handicap parking.
You may park next to a green curb; there is no time limit for a person with a disabled person placard or license plate. You may also park in an on-street metered parking space at no charge and in an area that indicates it requires a resident or merchant permit to park.
There also are places you cannot park. These include the spaces marked with a cross-hatched pattern next to a parking space with the wheelchair symbol. These spaces are for wheelchair and wheelchair lift access.
You cannot park next to red curbs, which indicate no stopping, standing or parking. You cannot park next to yellow curbs, which are for commercial vehicles to load and unload passengers or freight. And you cannot park next to white curbs, which are for loading and unloading passengers or depositing mail in an adjacent mailbox.
Remember, the only person who can use the disabled parking license plate is your dad. So if you are out in his vehicle without him, these permissible parking rules do not apply to you.
Misuse can result in a fine of $250 to $3,500 or imprisonment up to six months or both.
— Betty Berry is a senior advocate for Senior Concerns. The advocates are at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362; or call 495-6250. You are invited to submit questions on senior issues.