Medicare Calls the Shots

An elderly gentleman I know suffered a stroke last December.  It has affected him more physically than mentally and though unable to speak well, he is fully cognizant of all that is going on around him.  He has made some improvement over time, but is still confined to a nursing home.

Therein lies the problem.  Medicare!  Now I am not so familiar with Medicare's rules and provisions...yet...so I am a little disconcerted by some of the things going on with him.  I knew Medicare only paid for so much, just the first 100 days of nursing home care, but they also don't seem to pay for continued therapy or much of anything else.  I know this man has a supplement, but not sure what this will pay.  It's not really any of my business.

What is my business is that Medicare decides what level of care he gets.  Since he is not fully recovered after 100 plus days, they stop most of the therapy.  How is he supposed to continue to get better?  Or do they just not care much when you are 87?  I guess he could get more intensive therapy if he paid for it himself.  Pretty hard for that to happen for most of us.  So instead of a doctor directing his care, Medicare is.

I guess I knew some of this, but as I get closer to that point myself, it's a little scary to discover that you really are not in charge of your health care.  Not unless you are Bill Gates or Warren Buffet and can pay for whatever you need, however long you need it.  I've had to purchase individual health insurance for the last several years and it is VERY expensive!  And they raise your rates constantly and you are just kind of stuck with that.  But at least it is like the regular insurance people have from employers.  You can get the care your doctor says you need.  I thought when I got on Medicare, my premiums would go down and my worries would be over.  Silly me.

I guess worries are never over and it's just one more thing that I thought I knew but I really didn't.  I'm ready to start knowing what I know and having that be the facts!  If anybody knows more about his than I do, please add your two cents to this discussion.  Thanks....

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