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Mom has metastatic cancer and an estimated 3-6 months left. She wants to be with family and be here with me. She has turned down hospice until we get her moved. We are working as fast as we can, but the missing link is how do we make sure of continuity of care while we are moving her here?

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Not to be harsh, but I think y’all may want to rethink rejecting hospice where she is now.

Heres why, hospice is very much a defined Medicare benefit. So if she can become a client of a hospice agency that is in BOTH States, it might be a way to get a lot of her health care info and care plan done within a centralized system AND MAYBE use this as a way to transfer her care plan to the new State. VITAS and Compassus are big national hospice groups. And both - depending on the city/region - also have freestanding hospice should really truly end of life days become more than can be done in home. If she’s on hospice the medical director MD of the agency becomes her primary physician. This May be a way to manage this…… it crazy unwieldy to try to do a State switch for healthy folks, will be a beast to get it done for someone in end of life phase.

The freestanding hospice places tend to be under the radar to find out about. They are similar to LTACH aka long term acute care hospitals, in that both need a referral to get into….. we cannot enter off the street, For the hospice ones it’s the medical director of the hospice group that writes order for this, for the LTACHs it’s the hospitalist MD in charge of her care in the hospital. My MiL went into a LTACH and it was overwhelmingly end stage cancer patients (she wasn’t, she was very septic and cascading organ failure, the LTACH was amazing).

if she currently has a Medicare Advantage Plan, those are very very narrow and designed to be used in a fixed city/region and with specific vendors. She or you will basically have to shop around for a new Advantage Plan in the new state and find those who have oncologists and other specialists for her specific cancer and treatment, & good luck on that. If she’s remained Original Medicare and has a supplemental, that’s going to be easier shopping / comparison.

Here’s my suggestion: get the 2023 and the 2024 Medicare and You for your State and hers for 2023 and then do a comparison of what her current insurance is and try to get a match up. It just came out in September and everyone on Medicare gets mailed a State specific copy. CMS product # 10050-17. Libraries carry it too. It’s open season on switching so why mailed out now.

if you are Texas, the Medicare & You book is frickin huge. All have the contact # for the SHIP program for the States as well. Once ya have a better idea of what type of services she needs, then call the SHIP.

also remember she needs to change her SSA and any retirement info to the new address. Try to do this asap as they both will be snail mailing out the 2024 “awards letters” like in Nov. fwiw the awards letter mucho importante if, IF, she should be able to get eligible for a program that is income based.
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There will BE no continuity of care; she is LEAVING her caregivers. I would begin now to look for a good palliative care MD who may accept her into care if you are able.

Are you already certain her insurance will not travel with her? Are you speaking of her supplemental? Most will travel with her. Time to call them to check. Then just be certain you are not cancelling one policy before the other is fully in effect, even if you are paying double for one or more months.
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