In need of medical professionals that help family sort thru the maze of Medicaid and private insurance. Any suggestions?

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Joehowie58 Asked August 2019

In need of medical professionals that help family sort thru the maze of Medicaid and private insurance. Any suggestions?

Are there professionals or companies that can help the family with health insurance, Medicaid, and disability services. I am in a nursing Home and soon to run out of money. I need physical therapy services which Medicaid will not cover in Illinois, private insurance Medicare, disability benefits it is all very confusing as to what are the beat choices for an individual. I am soon to have a spinal surgery which will be covered by my insurance and will return to a NH for rehab and medical recovery but eventually private insurance will stop paying for these services, maybe I will have 60 days , but I will still need to be here as I am 75% dependent for daily living. I am eligible for Medicare in 6 months and will need another surgery assuming the first one is successful. Eventually I hope to be able to be less dependent and move to an assisted living home assuming I can afford one.

Where does the family get the help to sort thru all these medical options ??

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score 0 · Answer 1

Your nursing home should have a social worker on site that can help you with all of this. Your county sept of social services or it may be called health & human services or something similar, also has caseworkers that are trained to determine eligibility for state and county programs. Since you are soon to run out of money, hiring a consultant probably isn’t an option and as I said.../:your county social services office provides it for free anyway.

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score 0 · Answer 2

You need to talk to the Social Worker at your facility.

Or call Office of Aging in your County. If you are already collecting SS then Medicare A and B are automatic at 65. A deduction for B will be taken out of ur SS check. Unless, Medicaid will cover it if u qualify for health insurance thru them. This is what O of A can help u with. Actually, I would go with them first before a SW.

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score 0 · Answer 3

Thank you , stepping back and tackling one item at a time was good advice. It is manageable , and not so overwhelming.

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score 2 · Answer 4

You may try to find a geriatric consultant in your area (there aren't that many but I do know of my fried who hired one and really liked the help).

Geriatric consultants are professionals who provide seniors and their families with assistance in finding appropriate resources in the community to address needs related to aging and physical disabilities.

Start by researching online. Good luck!

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score 2 · Answer 5

We've always done our own research, but it can be very confusing.   I would ask the social worker at the facility if there are any resources available on site, or if he/she has any knowledge to share, or if he/she can recommend companies and contacts to call to get information on your own.

Are you comfortable doing research for these issues online?

I'm not sure what you mean by "private insurance Medicare."

I think you might want to start with the most important coverage first to help establish a baseline, then consider what else you might need, research those resources and make a decision, then move to another issue.

E.g., after getting Medicare coverage, I researched Medigap and other policies to supplement Medicare.    I also separately researched dental policies.

I think it's very easy to become completely confused and overwhelmed with the whole issue.

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In need of medical professionals that help family sort thru the maze of Medicaid and private insurance. Any suggestions?

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