My grandmother is in an assisted living facility and was quite independent up to a week ago. Her respiratory disease has recently affected her mental processes and is now in need of more individualized attention. My assumption is that a hospice program may be the only way she can stay in that setting (avoiding a nursing home). With this assumption and goal in mind... My question is regarding medicare supplemental and medicare advantage plans. She currently has Medicare Part A and B and a Rx drug plan through Part D. 2 weeks ago (as she requested) I enrolled her in a Part C Medicare Advantage Plan which is scheduled to be in effect August 1st (in 3 days). (Question 1) Should I cancel the enrollment (which is allowed prior to Aug 1st) and keep her with Medicare and add a supplemental insurance for her. (Question 2) Should I allow her Medicare Advantage Plan to kick in Aug 1st so not cancel the enrollment? (Questions 3) How much does supplemental insurance cost - I might not be able to afford it? (Questions 4) The only Medicaid benefit she has is the "Medically Needy" benefit. Which is Medicaid with a $1,500 monthly deductible. How can I use this benefit in combination with a supplemental insurance?
Medicare.gov has information on the different supplemental plans that are available in your area, what they cover and contact information. Just do a supplemental plan search on their sight. It will take you several days to do the research but some insurers let you have a retroactive start day. Most are issue-age rated. Meaning they base their premium on the age you are on the day you signed up. There are different plan options including plan F (the Cadillac plan), plan G (covers everything except her part B deductible of $166), plan N ( covers everything except part B deductible, $20 office visit, $50 ER unless admitted). Everything else is not worth looking at because they only pay portions of Hospice and other services. These plans go from most expensive to least ranging from $140-$270/month based on who you call.
Your grandmother might not qualify for anything else but the. Cadillac plan F because plan G &N require a health questionnaire for eligibility. If she answers yes to being bedridden, wheel chair, chronic pulmonary disorder, CPOD, Parkinson's, osteoporosis with fractures, dementia, AIDS, diabetes, if you'd been advised you will need surgery in the next 12 months, among others- she will not be eligible for any other plan but F. The most expensive premium that runs from $212-$270/month based on my research. Sometimes Medicaid covers premiums for supplemental insurance depending on what she has. You would have to contact Medicaid or ask when you speak to supplemental insurance companies.
All this takes time and you don't have much. If you want hospice coverage for your grandmother, the best thing to do is not move forward with Part C.
Good luck!
Moriama - she's in an AL & till the incident was very independent, good on her ADL's, right? I'd suggest you clearly find out IF as she now needs & can qualify for medicare covered hospice level care that she can continue to live at the AL. AL may require residents to be good on their ADLs and someone on hospice, needing specialized nursing care & perhaps bedfast, may not meet that requirement. It may well be a NH is where she would be best at.