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Wow...back in August I was contacted by the VA. I was told that my Dad was eligible for in home primary care. Due both to his extreme age and his war time service in WWII. After some fuss, Dad agreed to this. It was a good thing for him. The ordeal of getting him to a doctor visit at the VA was getting to be much too much. And the number of time the Cab company employees ripped him off was just awful! So, over the course of the next two months (August and September) he had OT, PT, nursing, and dietary visits. He passed away on Sept 26. So..now I am getting HUGE bills for these services!!! Medicare will not pay...in home service not covered. Dads Medicare plan F will not pay....in home service not covered. OH GEEZ. Why was I led to believe that this was a wonderful service offered by the VA? This is well over $20,000 in bills!!!!! What can I do about this? This will bankrupt my Mom.

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KK, google "colorado family purpose doctrine". If the VA turns debts over to collections, there may be a way they can come after the surviving spouse for debts. Please consider talking with a lawyer about this as you want to make sure this doesn't show up as a surprise later for you and your mom since I trust a VA financial person's comments not in writing as far as I can throw a Bradley tank.
...this comment is copied from a lawyer website, but I saw it repeated over and over.
"The family purpose doctrine states that the expenses of the family and the education of the children are chargeable upon the property of both husband and wife, or either of them, and in relation thereto they may be sued jointly or separately. In simple English, this means that both husband and wife are responsible for the grocery bill regardless of who went to the store.
At first glance, this seems like a good rule and perhaps it is. The concept is that if the family unit benefited from the expense, then the family unit should be responsible for the bill. The medical, dental and educational costs incurred for the benefit of the children are the debts of both the husband and wife. However, in Colorado probate matters we see more and more creditors suing the surviving spouse and using the family purpose doctrine to do so.
For example, an ill spouse may incur a large hospital bill before passing away. The Colorado probate estate may not have any assets. Many times, this debt is not covered by insurance, and the debt is several hundred thousand dollars. Through the use of the family purpose doctrine, the medical providers file suit against the surviving spouse instead of the Colorado probate estate. In many instances, this kind of debt will be a financial disaster for the surviving spouse."
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Pam....because he passed they have no recourse. The account will remain unpaid...and closed after 6 months. He has no estate so there is no way for them to collect
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Katie, step 8 just means the claim is completed. So now you compare his income to his expenses and if necessary, file the appeal. Get a local VFW or American Legion to help you.
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The billing coordinator said that depending on income (social security and pension) he was a step 8. Whatever that is. But, basically, he didn't qualify for free service. BUT, they didn't tell anyone that before delivering thousands of dollars in care. If they told Dad...well, the sidewalk outside would have just as much understanding. Seems like they should have known they were taking advantage of a guy that didn't understand what was going on...after all, the first time they came out he locked the doors and refused admittance because the were aliens taking over the VA
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Katiekate, well, I'm very glad your mother isn't left with your dad's large medical bills to pay. My dad never had a copay for any of the home nurses ordered by his VA doctors. I wonder why it is that your dad's case was different?
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Well.. Here is the update

Medicare does not pay for in home health care delivery. The secondary insurance (plan F) does not pay for in home health care either. So....

I had a long talk with the person who deals with VA billing here. Yes, they charge a per visit co-pay. Now..on any given day my Dad had a nurse, and a therapist (different ones on different days) plus all the hospital visits they set up...like cardio, lab, X-ray, etc. on many days there would be 3 or more people in the home from VA.

If anyone had told my Dad that this was going to cost him $20 to $60 PER DAY he would have told them what to do with their so called "wonderful benefit". But..he had dementia, there wasn't any way he was going to understand that.

If anyone had told me the cost of the great benefit they offered...I would have refused more than one or two visits a week...not allowing 2 or more visits per day!

BUT...here is the kick. Because he passed away without any estate..there isn't anything they can do to collect. They can't garnish his social security..it has stopped. The lady at the VA told me they will monitor the courts for the next 6 months to be sure there isn't any probate court proceedings, then they will just close the account.

So, beware. If you allow this benefit for your elderly veteran parent...you could be setting them up for HUGE bills!

Some benefit...eh?
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Katie, I hope the contact to VA goes well and you can get some answers. Also, there are Patient Advocates at every VA location and their job duties are to help you resolve your issues. If you have problems getting things sorted out -- in my experience, sometimes VAs can be a disconnected system, right hand doesn't know what left is doing sort-of-thing -- seek out a Patient Advocate. They've been very helpful to me in the past. Please follow up with what you are able to find out. I'm interested why this happened and could be helpful for others/me to learn from. Thank you and good luck.
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AliBoBali, thank you for all the detail information!

I will be calling the coordinator at the VA and see if she can tell me who to contact over there next. Thank you for all the help!
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My father received some in home care that was paid by the VA. This was arranged through his doctor at VA. A doctor had to order the in home care.

Who is billing you, the home agency? They should have had doctors' orders to begin any kind of in home care. They should be following proper channels of billing to VA *if* this service was ordered by VA. If for some reason it wasn't, and home service got a little ahead of itself and did the visits w/o proper order in place, they are to blame, not your family.

How, exactly, were you led to believe VA would pay for this? I don't believe your family is liable for the bill, but if you want to give more details, it might help sort out which party screwed up.

And mostly - I'm very sorry for your loss. Condolences on the passing of your father. I wish you and your family peace and comfort. (((hugs)))
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Katiekat, I think that I might have a starting point for you. Medicare should not have been billed. These services should have been submitted through the VA for payment.
Found this on VA website http://www.va.gov/geriatrics/Guide/LongTermCare/Home_Based_Primary_Care.asp#
Since Home Based Primary Care is part of the VHA Standard Medical Benefits Package, all enrolled Veterans are eligible IF they meet the clinical need for the service and it is available.
A copay for Home Based Primary Care may be charged based on your VA service-connected disability status and financial information. You may have a basic copay each time a VA staff team member comes to your home for a medical visit (the same as if you went to a VA clinic). Contact your VA social worker/case manager to complete the Application for Extended Care Benefits (VA Form 10-10EC) to learn the amount of your copay.
Did you fill out the paperwork VA Form? If the providers were billing Medicare and it was approved through VA, no wonder Medicare is rejecting. Please try calling the VA worker that got your Dad approved for services and get them to tell you how to get billing corrected and resubmitted. So sorry for your Dad's loss, and my family's thanks for his service. My nephew is overseas now.
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Wasn't he getting checks for Aid and Attendance, about $2600 a month? AND where were the bills submitted? Plan F should cover the home services. Read the plan itself, find the details. Sounds like a billing error.
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Have you contacted the VA? Isn't it VA that said they were paying for/providing these services?

I'm so sorry for your loss, K. Please let us know how this is going.
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