Money and Love

valentinesmoney.jpg

The next hit I am taking is not medical—it’s financial. I had hoped to leave Orchard Creek by Friday, and the staff here was scurrying around, trying to get prescriptions ordered and home health care arranged. I am feeling much better, and I was feeling guilty taking up a room at OC, when I could basically take care of myself, except for the antibiotic IV feed. The therapy staff was ordering a wheelchair and a few other things I would need, and I was feeling like this was a good choice—I love my house, I could do my income tax, and I could retrieve my dogs from Canine Camp (Diana’s boarding kennel).

But then, suddenly, Beth the Social Worker at OC, was standing in my doorway, her blue eyes wide and slightly teary. “I thought I’d better talk to you before I go any further,” she said. “This is not particularly good news.”

“Let me have it,” I said.

And then she told me: Medicare would not pay for the antibiotic and the equipment to administer it, if I received it at home. I would be personally responsible for that cost, which would likely be in excess of $4,000 before much time had elapsed and I could go back to Munson for the hip replacement.

I called Munson to corroborate this news, and the woman there was most helpful and thorough in explaining the Medicare “gap” and its effect on my pocket book. “However, if you get the meds while at Orchard Creek, Medicare will continue to pay until you have utilized your allotted number of days.”

“You mean, Medicare will pay for my medicine, bed, board and physical therapy if I am at Orchard Creek, but not for the meds and pump if I am at home? One is going to cost significantly more than the other.”

“That’s it in a nutshell,” said Sharon of the pleasant voice.

“Well, phooey (not the exact word I used, as I recall), I guess that makes the choice rather easy. You are recommending that I stay at Orchard Creek, right?’

“Oh, I can’t RECOMMEND anything,” she replied. “But if it were MY mother, that’s what I’d tell her.”

Now you may recall, Dear Reader, that I previously mentioned that I hired a carpenter to put in a wheelchair ramp and a step-in shower—that project is all finished. But on Monday, Delightful Don the builder called to inform me that the heat wasn’t on in my house, though the thermostat was set at 60 degrees. The bottom line: a new furnace, which is being installed even as we speak. And of course if you live in an area where the temperature hasn’t been above 30 degrees F. since shortly after Christmas, heating is a necessity. So I’d already spent in excess of what my Medicare bill was going to be…making the extension of my stay at OC a no-brainer.

Again, nothing here that could be prevented, and there’s nothing to rage about. In my new-found skill of conserving my personal resources and applying them to a healthier body, I am not fighting this battle. To begin with, to fight would be like banging my head against the Great Wall of China. My other reason for sharing this story is to point out that the decisions I see in progress every day by the residents of Orchard Creek are not just about health, or age, or whether the cook can cook. These decisions are also about financial resources. Marion, my friend who moved into an extended care apartment here at OC so she could be near her husband (also at OC) gasped when she saw her month’s rent that her children would have to pay. For several weeks Irene and her single-parenting daughter have been searching for a rental which they can afford. And here at OC, valentines with a piece of candy are available to give tomorrow for the grand total of $.25 each (or one card from your bingo winnings).

It’s remarkable, I think, that the OC Valentine Store is doing such a brisk business. The $.25 is pretty dear for most of the OC residents, but everyone seems to want to say ‘thank you for caring about me—I care about you’, I am learning this lesson: Money isn’t everything, even if I can’t go home just yet.

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5 thoughts on “Money and Love

  1. Dear Gertie,
    I was thinking of saying, “It would be funny, if it weren’t true.” But you know what? I don’t think anything is funny about the truth that brought tears to your social worker’s eyes: Medicare policy encourages you to stay at OC rather than proceed with a less expensive and all-over better option for you as you improve.
    I appreciate the lesson about choosing your battles.
    Good choice to go with the flow and check out the OC Valentine Store. Please buy one for yourself from me, and send me the bill. Wait, your stamp would cost more than the amount I’d owe you. Okay, then buy yourself two valentines from me and email me the mailing address. What a deal!
    hang in there and keep getting better. Wendy

  2. Judith,

    Happy Valentine’s Day. I am sure the staff at OC is ramped up for a celebration.

    Last year I blogged about access to assistance programs that will pay for certain medications for folks who don’t have Medicare or insurance coverage to pay for it. Getting medications without charge on my Record Eagle Blog “Aging in Place.” Here’s the URL.
    http://blogs.record-eagle.com/?p=387

    You’ll find a hyperlink in my blog for Partnership for Prescription Assistance. The website has an easy-to-use online form that will tell you if the specific medication you need is available through the program and if you qualify for free distribution.

    Wouldn’t it be loverly?

    Keep smiling. Jeanne

  3. Jeanne, thanks for that helpful tip. I said in the blog that I wasn’t going to fight the US Government, but I didn’t say I was going to be helpless! This is a great source to follow up on.

    Thanks, too, for the copy of your book, “Taking Charge: Good Medical Care for the Elderly and How to Get It.” I don’t like to think of myself as ‘elderly’, but I know good advice when I see it!

  4. Pingback: Money » Money and Love

  5. Happy V.D.

    Errr Valentine’s Day of course!

    Medicare does some strange things. Nan must see her diabetes doctor every three months to get her pump supplies even though the doctor only wants to see here every six months..a saving of time a dollars. Nan’s pump is out of warrantee but no one will pay for a new one until her old one is 5 years old (next summer) At that point she can get last year’s model but probably not the current one.

    But if you want my favorite medical gotcha: Hearing aids are not covered by anyone as far as I can tell.

    Pick your battles wisely and after all this is behind you let’s the three of us join grey panthers!

    Take Care,

    Chuck and Nan

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