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Dad has moderate Alzheimer's. Mom is mentally fine but has degenerative neuropathy and getting weaker. We are all together outside San Antonio. I'm POA and they say they love my help.... Mom wants to downsize and leave their large house/property. Can't find a budget friendly place in town. I offered to have them build a guest home on our land, mom now wants to move to ARIZONA with her sister. I think she's running away from problems/denial about dad/her own health, but that's besides the point. I think if we create pros/cons of both locations she'll reconsider... So I was wondering if moving away would mean setting up Social Security and Medicare again or how that works. Thanks

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97 said it well.

If your parents have a Medicare Advantage that will be a problem. Look up the word "Medicare Advantage". The word "Medicare" is deceiving. Medicare allows these insurance co. to contract them out. They are suppose to carry out Medicare guidelines. With straight Medicare you can go to any doctor u wish that takes Medicare with no referrals, not so with an Advantage plan. You need to go to doctors in their network and need referrals. The big problem is, Advantage plans don't go from state to state. Straight Medicare does. So if parents have an Advantage plan, you will either have to get them a new plan in the new state or take them back to straight Medicare with a supplimental.

Advantage plans have their advantages. Most include part D, prescriptions. Supplimentals not always. There are other perks, like paying Medicare part B. You have to weigh pros and cons and the needs of your parents. I choose not to have a MA because my DHs union pays for everything, supplimental, vision, prescriptions, and dental. Charging me a small amount a month.

Where ever u land, the County Office Office of Aging can help you with which health insurance companies are allowed to write policies in ur State.
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momvet207 Mar 2021
This is also very helpful. I know very little about Medicare so thank you for breaking that down. They also have Tricare which I think is from Dad being in the military.
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There are many repercussions from taxes, cost of living and etc. Not only a move to another state, but area of state. My bro in ALF paid 4,095 for two beautiful rooms and level one care in Palm Springs; same care in my own San Francisco would be twice that easily. So mainly cost of living. Other considerations such as Social Security and Medicare, that being a federal program don't figure. There is no problem or change involved. There is a great problem with change in medicaid as application in new state starts over and this being a joint state-federal program, the benefits change a whole lot. Then there is insurance. For instance, I am a Kaiser member. To be frank I think I would no longer move anywhere I could not get Kaiser at this point late in life.
So many things to consider. Pros and cons will be more easily known with a visit. And the rest of it is you and your favorite search engine. Sure wish you good luck.
I will tell you that moving AWAY from a supportive daughter at a certain age would be something I wouldn't do. I never want to live with or be a burden to my children, but I don't live in their states. If I did, this is not the point I would be moving away from them with an also aging sister (if I had one). That would be what would stop me at the ripe old age of pushing 79 pretty hard.
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momvet207 Mar 2021
Thank you. I think she doesn't want to be a burden, but it will be so much harder to maintain being POA if they move away... Or maybe she's not wanting to admit they need the help. Both are entirely within her personality. Pros/cons to be reviewed this weekend. I hope she reconsiders...
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1. What does the sister think about this plan?! Such a huge responsibility.

2. SS no problem. All can be managed online. Might want to look at Rep Payee information for both. Dad because he might not be able to give permission much longer and mom due to mobility issues. POAs are not recognized by SS.

3. Traditional Medicare no problem. Medicare Advantage Plans are usually regional and would need to be researched.

4. Medicaid could be in any elders future who outlive their assets. Medicaid benefits are different in different states.

5. Senior services can be perused by looking at the Area Agency on Aging for each location. Every county in the US has an office/website.

Housing, Transportation, medical care, caregivers all are important.

If their plan is to utilize family for transportation and caregiving that’s a big ask regardless of the state. Good that your mom is willing to relocate if necessary and to downsize.

The book “Being Mortal” by Atul Gawande might be of benefit as you help your parents navigate this stage of life.

Whatever they decide, everyone’s life must be considered. Both of their conditions will require more and more assistance.
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momvet207 Mar 2021
The sister is in full support but I think she doesn't realize what she's in for either. She's 2 years older but healthier (for now). Her husband has COPD. Mom and my aunt vacationed together in previous years but that's not what this is. I plan to go through pros and cons this weekend. I just don't understand why she's against moving onto our property. I need her to explain that. Thank you for all the things to think about, is very helpful.
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