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I live with both my grandparents. My grandpa just got out of hip surgery and he can't walk or do anything on his own and always needs help. My grandma is too weak to take care of him, and I am always either at school or work. We really need a care provider to come about 3 times a week but insurance doesn't cover it, and we simply can't afford it. What can we do?

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Jazz - for advanced elderly in their mid 80's and 90's, the HMO style of Medicare plans aren't best. HMO's are best for healthy & active elders as the plans are designed to pay for "maintenance & preventative" needs rather than in hospital stays and extended rehab. That is why HMO Medicare plans often have a lower or no premium. I'd bet grandparents just looked at the $ cost rather than benefits coverage.

Advanced elderly or those with chronic diseases are better off having original (sometimes called traditional) Medicare. The Medicare system is set up to allow without penalty a change on enrollment of plans in Nov & Dec, but they can change after a major event. If you can try to see if grandpa can change out of the HMO to original Medicare.

So your 17? If so, really dear, you need to have your mom, dad, an aunt, uncle be the point person in dealing with grandparents. One ofthem needs to be the DPOA and be the point peron for your grandarents. You aren't legal age to sign off on anything to start with. But imho also you need to have your own life and not be saddled with elder caregiving no matter how much you love them.
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Aaaphx.org is your local agency. Good website. Check back in with us and let us know how this is going.
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As someone noted above, this might be a situation in which grandpa is in a medicare hmo and may need to switch to straight medicare.

Is grandma clearheaded enough to be handling all this? Can you get on the phone with her and grandpa's doctors office to see him more homecare can be had?

You also can look up your local area agency on aging and call them to see what help is available.
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Okay, Jazz, here's the thing. MEDICARE covers 21 days at full cost, and thr next 80 days IF the patient is progressing. A supplemental policy ( does gramps have one) would have picked up the copay on that. So the qustions are 1. Was he still progressing 2. Do they have a medicare supplement, 3. Does grandma understand all this? Does anyone have poa?
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I'm only 17 years old. he was put in a rehab facility after his surgery but their insurance only covered it for 21 days and then they discharged him and was sent back home. the occupational therapist/physical was allowed 3 visits, the nurse is allowed 3 also because that's all their insurance can cover.
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I am going to assume that there are no other people to help you that live in the home. So please follow all those above suggestions . Asking the doctor for some rehab assistance for Grandpa is also necessary for his welfare. Some hospitals also have care co-ordinations to helpp put together a plan for Grandpas next few weeks.Is there someone assigned to be the power of attorney , called POA? Are you aware of that position? If so, that person should also be involved. If no one is this position you will have more responsibility than you might be able to handle.Do they have Social Security? You do not say how old you are but you should investigate Medicaid and the VA benefits also . Please keep the forum informed so they keep encouraging you.
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I meant from an HMO to regular MEDICARE! (sorry)
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I was in your position, and it took me a while to find help because my mom had too much money for Medicaid, but not enough to pay any Medicare co-pays, or for private care.
All of the above answers have worked for me -- rehab, in-home pt, and help through area council on aging. It took a long time to find the right information -- don't give up!
My mom had to change her insurance from an HMO to regular Medicaid to get into a good rehab, but I was able to do that and it's working out great. Then I found out from the Alzheimer's Association (which also helps people with any kind of dementia, including memory loss, which also took me a while to find out) that NY state now has Medicaid "pooled trusts" for exactly people in my mom's financial position -- even with a free lawyer, it is taking months to get that straight, but at some point when she comes home from the rehab she will be able to get a LOT of long-term help at home because of this....
Don't lose faith. The help is out there if you need it. And don't let any social worker from the hospital or anywhere else tell you otherwise -- you just keep telling them and calling helper agencies that he NEEDS HELP, and you CANNOT do it. And good for you for posting here! That is a good step.
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Is he still in the hospital? If so, you talk to the discharge folks about rehab.
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Why wasn't he sent to a rehab facility? Ask the doctor who performed the surgery to write a script for home care, including PT.

If your grandparents have Medicare, I don't understand why this wouldn't be covered. Check with the surgeon's office.
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