OP stated that the Dr. associated with the facility sees her Dad. Thats what I did with Mom.
Surfgirl, When your Dad went on Medicaid for his care it also includes for his health. It becomes his secondary to Medicare. You need to pay for any other suppliment especially if it means you have to pay it. Medicare is the primary. So lets say the Dr bills Medicare $200 each time he sees Dad. Medicare pays 80% of what they consider reasonable so lets say reasonable is $160. They then pay 80% of that which is $128. Medicaid will pay the 20% which is $32. A Medicare Dr cannot bill for more than Medicare feels is reasonable.
"So a dentist, hearing doctor, podiatrist, and eye doctor come in periodically." This is part of his Medicaid.
If they find Dad has a broken arm or whatever, he will be sent to the hospital to see what they will do. If they feel a specialist, IMO, thats on the NH how that will be handled. Medicaid does supply some type of transportation. The only problem is if a staff member will be sent with him. Thats what u need to ask.
You said in response to me: He has been in the facility for about six months now so this is all new to me. I have just been letting the doctor/nurses at the facility take care of him. I just can’t handle taking him to a doctor’s appointments etc… any longer. I’ve done it for 13 years. He is a big man that is in a wheelchair most of the time due leg weakness. I physically can’t do it.
i am unclear on who see’s your dad for his care.. the facility can let you know if they have a medical group who visits their residents…get your dad on board. You won’t have to take him out. It’s charged as an office visit, when they see him. I don’t know how much Medicare picks up. You can call them and ask. My mom had very good health insurance so I didn’t have to worry about it. If your dad needs to go to the hospital for treatment, the facility can arrange for transport.
Having a medical group see your dad at the facility will be a big relief for you. My moms had an excellent patient portal and the nurse practitioner was great at communicating with me.
If you feel he has a broken shoulder, bring it to the Director of Nursing's attn. She can order a portable Xray be done at the facility. Then the doctor associated with the facility can go from there. My Mom broke her shoulder in a place they could not cast. She had to use a sling and keep it close to her body. That maybe all they do. Elderly don't do well going under for an operation. Dad can be transported to a local hospital for treatment and transported back. If he is on Medicaid, they will pay for it. Family is not responsible for the cost of any care a resident gets.
If you are continuing to take him for Dr appts outside the facility, I would re-evaluate. Once Mom was in LTC, I allowed their Dr. to take over her care. Before that, I had cut down on Dr visits. Her PCP had her coming every 2 months. She was on two meds, Cholesterol and B/P. Every 6 months for refills was enough. The only reason she was seeing one Dr was because during a hosipital visit they saw something in an xray of her stomach. Dr. figured it was just a thickening from her Gerd. Watched it for a year or so, never enlarged so we went to once a year. Her bladder Dr. She had been cancer free for over 5 years and he still wanted to scope her and she was tired of it. Stopped going to him. Why, because she was in her 80s showing signs of Dementia and if she got cancer she had already said she was going to do nothing about it. She was tired of being poked and prodded.
Check with the facility. I am assuming Dad still has his own MD? Or is the facility providing medical and MD? Check with them to get your question answered. Who has notified you of injury or concern re Dad's shoulder?
No longer seeing his MD. I just couldn’t manage getting him there anymore. I did get him set up on this program, I think it is called 360 care or something like that. So a dentist, hearing doctor, podiatrist, and eye doctor come in periodically. It may be a state program, not sure if all states offer it. I am so thankful that. Thanks for answer
The dr in charge of your dads care can arrange for X-rays to be done at the facility he lives. The facility may have an arrangement for nurse practitioner to oversee residents care. If your dad normally is managed by a Dr outside of his facility, his care gets transferred over. This is the most streamlined way . My moms care was handled this way and I didn’t regret it..
He has been in the facility for about six months now so this is all new to me. I have just been letting the doctor/nurses at the facility take care of him. I just can’t handle taking him to a doctor’s appointments etc… any longer. I’ve done it for 13 years. He is a big man that is in a wheelchair most of the time due leg weakness. I physically can’t do it.
So if the doctor at the facility determines he has a broken bone, torn ligament or whatever is bothering his shoulder and needs to have something done what do they do? Do they take him to a hospital or a specialist?
Surfgirl, When your Dad went on Medicaid for his care it also includes for his health. It becomes his secondary to Medicare. You need to pay for any other suppliment especially if it means you have to pay it. Medicare is the primary. So lets say the Dr bills Medicare $200 each time he sees Dad. Medicare pays 80% of what they consider reasonable so lets say reasonable is $160. They then pay 80% of that which is $128. Medicaid will pay the 20% which is $32. A Medicare Dr cannot bill for more than Medicare feels is reasonable.
"So a dentist, hearing doctor, podiatrist, and eye doctor come in periodically." This is part of his Medicaid.
If they find Dad has a broken arm or whatever, he will be sent to the hospital to see what they will do. If they feel a specialist, IMO, thats on the NH how that will be handled. Medicaid does supply some type of transportation. The only problem is if a staff member will be sent with him. Thats what u need to ask.
He has been in the facility for about six months now so this is all new to me. I have just been letting the doctor/nurses at the facility take care of him. I just can’t handle taking him to a doctor’s appointments etc… any longer. I’ve done it for 13 years. He is a big man that is in a wheelchair most of the time due leg weakness. I physically can’t do it.
i am unclear on who see’s your dad for his care.. the facility can let you know if they have a medical group who visits their residents…get your dad on board. You won’t have to take him out. It’s charged as an office visit, when they see him. I don’t know how much Medicare picks up. You can call them and ask. My mom had very good health insurance so I didn’t have to worry about it. If your dad needs to go to the hospital for treatment, the facility can arrange for transport.
Having a medical group see your dad at the facility will be a big relief for you. My moms had an excellent patient portal and the nurse practitioner was great at communicating with me.
wish you the best
Barbara
If you are continuing to take him for Dr appts outside the facility, I would re-evaluate. Once Mom was in LTC, I allowed their Dr. to take over her care. Before that, I had cut down on Dr visits. Her PCP had her coming every 2 months. She was on two meds, Cholesterol and B/P. Every 6 months for refills was enough. The only reason she was seeing one Dr was because during a hosipital visit they saw something in an xray of her stomach. Dr. figured it was just a thickening from her Gerd. Watched it for a year or so, never enlarged so we went to once a year. Her bladder Dr. She had been cancer free for over 5 years and he still wanted to scope her and she was tired of it. Stopped going to him. Why, because she was in her 80s showing signs of Dementia and if she got cancer she had already said she was going to do nothing about it. She was tired of being poked and prodded.
Who has notified you of injury or concern re Dad's shoulder?
The facility may have an arrangement for nurse practitioner to oversee residents care. If your dad normally is managed by a Dr outside of his facility, his care gets transferred over. This is the most streamlined way . My moms care was handled this way and I didn’t regret it..
So if the doctor at the facility determines he has a broken bone, torn ligament or whatever is bothering his shoulder and needs to have something done what do they do? Do they take him to a hospital or a specialist?
Does Medicare/Medicaid pay for all of that?