By Jane M. McNamara, Elder Rights Attorney
If you are elderly, have a history of hospitalizations, have Alzheimer’s/dementia, or stroke related issues, you may require future care in a skilled nursing facility. Your choice of Medicare plans is extremely important, as the skilled nursing facility available will be dependant upon your chosen insurance plan. Choices are limited because the skilled nursing facility must have a contract with your insurance plan. You may not like the ones available to you under your Medicare Advantage plan.
Choose your plan (and supplement) wisely, and don’t be swayed by the very slick TV advertisements. We often see seniors with original Medicare and a great supplement switch to an very limiting Medicare Advantage Plan during the annual open enrollment period Although people believe they have made a cost-effective choice, they later are surprised by their limited facility choices when skilled nursing care is needed. This is very important, as the quality of the care facility can often make a “life or death” difference, and at a minimum, affect your quality of life.
You must be informed, and contact the plan BEFORE enrollment. Ask what facilities are within their network and/or plan. Does the plan pay for co-payments if skilled nursing is needed? Although no one wants to receive care in a skilled nursing facility, seniors and the elderly must be realistic and objective about their health care needs.
Jane M. McNamara is the principal attorney of the McNamara Law Firm, PC located in Valencia, California. The Law Firm handles Elder Law issues, including Medi-Cal for long-term care, asset protection, and incapacity issues. (661) 287-3260; www.theMcNamaraLawFirm.com.