Questions About Paying for Health Care

  1. If you're refused medical care, what’s next?

    Question - I understand that you have concern for your neighbor's health, but I think that there is more going on here than what she is telling you. For her to have 2 different doctors refuse to help her says alot. In the medical profession, you need to have a really good reason to terminate a patient relationship, or you can be fined for patient abandonment...
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  2. Do I have coverage from Medicare when traveling to Canada?

    Question - Medicare doesn't normally cover regular or emergency medical care in Canada, whether you're living or vacationing there. Medicare can cover medical care in Canada in a few very limited circumstances. They are: (1) If you're in the U.S. when an emergency arises but a Canadian emergency room is closer than any in the U...
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  3. How do I find the coverage details for hearing aids with Medicare and Medicaid in Ohio?

    Question - Unfortunately, Medicare does not cover hearing aids, in Ohio or anywhere else. However, it appears that Ohio's Medicaid program does cover at least "conventional" hearing aids, for both ears; if you require special hearing aids, Medicaid may cover it if you (through your doctor) demonstrate a "special...
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  4. Will my mother be covered by Medicare for one day stay in hospital?

    Question - Sounds like someone at the hospital or rehab center is misinterpreting the rules about Medicare Part A hospital coverage. Whether Medicare Part A pays for your mother’s hospital or rehab center stay, and how much it pays, is measured by what's called a "benefit period" or "spell of illne...
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  5. Can my dad get help to pay for shots after chemo?

    Question - One of the big loopholes in Medicare Part B medical coverage is for outpatient hospital or clinic bills. If your dad is getting shots at a hospital or clinic as an outpatient, they can charge him personally for the entire amount of their bill above what Medicare pays them...
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  6. Is a spouse responsible for medical bills?

    Question - Your instincts and advice to your mother to proceed slowly and cautiously in paying your father’s final medical bills were sound.A recent study revealed the scary statistic that about 90% of hospital bills contain errors, mostly in the hospital's fav...
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  7. What is a durable power of attorney?

    Question - There are two types of powers of attorney: one that pertains to finances, and the other to medical care.
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  8. Which forms do insurance companies and Medicare require in order for me to become a Patient Advocate for my elderly father?

    Question - You might need a real hodge-podge of forms, depending on the requirements of specific agencies, medical offices, insurance companies and the like. These forms are in two categories: financial and medical.
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  9. Will Medicare pay for hearing aids?

    Question - Medicare, no, Medicaid, maybe. Medicare Part B does not cover routine hearing exams or hearing aids. Medicaid , however, may cover some of the cost of hearing aids, depending on the state you live in. That's because each state operates its own Medicaid program, and each program has slightly different rules and coverage...
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  10. Will Medicare Parts A and B pay for treatment in a psychiatric hospital?

    Question - Yes, Medicare Part A can cover the inpatient costs for her care in a psychiatric hospital -- meaning a hospital that accepts patients only for mental health care. Medicare can also cover her inpatient psychiatric care in a general hospital. The rules of payment are the same for either type of hospital, but the total amount of coverage is different...
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  11. Are accidents in a foreign country covered by Medicare?

    Question - Original Medicare (Part A and Part B) doesn't cover any medical care in Europe, but a Medicare Part C Medicare Advantage plan or a Medigap supplemental insurance policy might.
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  12. How much will Medicare cost me?

    Question - Medicare Part A is free for most people. If you're 65 or over and eligible for Social Security, Railroad Retirement or civil service retirement, or dependents or survivors benefits, you're also eligible for Medicare Part A without paying any premium...
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  13. Does Medicare Cover Vision Care?

    Question - Coverage of vision care by Medicare Part B is limited to treatment of medical conditions, and only treatment provided by a medical doctor. It does not normally include vision examinations, eyeglasses, or contact lenses.
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  14. If a Medicare patient is readmitted to the hospital, does she have to be discharged from PT/OT?

    Question - If a patient is receiving outpatient PT and gets admitted to the hospital then the PT must write a D/C note and discharge that patient from therapy because the patient's status has changed. Once the patient is discharged from the hospital and if they require continued outpatient therapy--they must get...
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  15. How can you pay for care when your assets are too high for Medicaid?

    Question - There are a couple of different ways your brother-in-law may be able to qualify for Medicaid even though his assets are over the usual allowable limit. Depending on the rules of the state where he lives, he might qualify for Medicaid if he's considered "medically needy." More than half the states have this category...
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  16. Does Medicare cover glasses to correct double vision?

    Question - Probably not. Generally, Medicare Part B pays for eyeglasses only following cataract surgery in which a new lens is implanted in the eye. If you have any other kind of eye problem, Medicare does not pay for glasses. If you are treated by an eye specialist physician -- as opposed...
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  17. Can refusing some treatments invalidate Medicare?

    Question - A patient (who is competent to make decisions) always has a right to refuse treatment. It sounds like what the doctor is doing is simply protecting himself or herself against a liability claim by getting written documentation that your husband's failure to follow a particular course of treatment is contrary to the doctor's medical advice...
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  18. Will Medicaid pay for an electric wheelchair?

    Question - Both Medicare and Medicaid can help pay for an electric wheelchair, with Medicaid paying the portion of the costs that Medicare doesn't. Medicare Part B can pay either to rent or buy a power wheelchair if prescribed by your father's doctor and if medically necessary for him to get around (not just going outside, but to get around the house, too)...
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  19. Will medicare pay for dental implants?

    Question - Probably not. The only way that Medicare might pay for dental implants was if they were part of a larger reconstruction of the mouth or jaw, following an injury or disease to the tissue or bones of the mouth or jaw. If it's simply the replacement of bad or lost teeth, then Medicare will not pay anything...
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  20. Will Medicaid pay for a wheelchair or scooter?

    Question - Both Medicare and Medicaid can pay for a wheelchair or scooter. If you are enrolled in both programs and eligible for coverage of a wheelchair or scooter, Medicaid will pay the portion of the costs that Medicare doesn't.
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  21. Can I get medicare to pay for both a scooter and a wheelchair?

    Question - Medicare Part B will pay for the use of a power wheelchair or power scooter, if medically necessary, but not both. The fact that one or the other device can't be used in some places doesn't change this rule.
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  22. Will my Medicare cover a deviated septum?

    Question - A deviated septum is a medical condition that can interfere with breathing and with the ability to taste, and may require treatment. Both Medicare Part A (for hospital costs) and Medicare Part B (for doctor and other outpatient costs) could cover that treatment, but only if your doctor determines that...
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  23. If covered, how do I get Medicaid hearing aids?

    Question - About two-thirds of state Medicaid programs cover some or all of the cost of a hearing aid. States also put different conditions on eligibility for hearing aid coverage. These conditions may include one or more of the following:
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  24. Does power of attorney make me responsible for medical bills?

    Question - Having your mother execute a power of attorney for health care allows you to make decisions for her about her medical care, but doesn't make you financially responsible for her medical or long-term care. To lawfully execute the document, your mother must be mentally competent and her signature should be notarized...
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  25. How many days is considered in a "benefit period" ?

    Question - Under Medicare Part A , you begin an entirely new, full benefit period as soon as you have been out of the hospital and a skilled nursing or rehabilitation facility for 60 consecutive days. For each new benefit period, you pay a hospital deductible of $1,024 (in 2008)...
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  26. Does Medicare cover cataract surgery and implants?

    Question - Yes, it does. Because cataract surgery is performed by a physician rather than an optometrist, Medicare Part B covers the surgery, including lens implants. And following that surgery, it can pay its share for one pair of eyeglasses. How much it pays for the glasses depends on whether you get new frames, and if so how much they cost...
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  27. I have a 98-year-old father who can still get around; however...

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  28. Will medicare pay for an oral surgeon consultation?

    Question - That may depend on the kind of work the oral surgeon does, and perhaps on whether the surgeon is a physician (M.D.) or a dentist. If the oral surgeon is a physician, Medicare Part B will almost certainly cover the care. If the oral surgeon is not a physician, it depends on the kind of consultation and follow-up services the surgeon performs...
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  29. If I have a Medicare Advantage (Plan C) managed care plan, can I switch back to regular Medicare Parts A and B?

    Question - You can leave your Medicare Advantage plan and return to traditional Medicare Part A (hospital insurance) and Part B (medical insurance) at any time. Just give your managed care plan 30 days written notice, and they will notify Medicare.
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  30. Should I Enroll in Medicare Part D?

    Question - For someone who doesn't take regular prescription drugs, the answer is probably no -- especially if the premium, which averages $35 a month, is more than she typically spends on prescriptions. But she might still want to consider enrolling in a Medicare Part D plan if one is offered in her state for a very low ($5 a month or less) or no premium...
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  31. Can we insist on generic drugs?

    Question - My mother is in a nursing home suffering from stroke and dementia. They have her on Seroquel and it is costing her out of pocket over $600 a month. We have asked the psych nurse practitioner to please consider a generic, lower cost anti-psychotic drug as my mother cannot afford the Seroquel along with...
  32. Do I need Medicare Part B if I have BCBS Federal Basic Insurance?

    Question - If you are retired and have Medicare Part B as well as other insurance, Medicare would be your "primary payer," which means it would pay its full benefit amount for any covered medical service; your other insurance would be the "secondary payer," which would pay the costs that Medicare leaves unpaid...
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  33. How can I cover my medical care expenses?

    Question - Most Medicare Part D drug plans don't cover any drug costs during the program's "doughnut hole" -- when total drug expenses for the year reach $2,510 but out-of-pocket costs for the year haven't yet reached $4,050. But there are some ways to save money on out-of-pocket prescription drug costs...
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  34. Does Medicare pay for diapers or pads?

    Question - Medical supplies of all kinds are covered by Medicare Part A, but only when you are a hospital or skilled nursing facility inpatient. Medicare Part B covers outpatient care; this includes "durable" medical equipment -- such as hospital beds, wheel chairs, walkers, and oxygen systems -- but not most medical supplies like adult diapers or pads...
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  35. Who has authority to make medical or financial decisions if no power of attorney has been assigned?

    Question - Your situation underscores the importance of having a signed power of attorney or advance directive in place and the confusion and hurt that can occur without one. But you know that—and the best we may be able to do is take a lesson for ourselves and be prepared.
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  36. Does Medicare pay a MRI? If so, how many MRIs will Medicare cover in a year?

    Question - There is no special Medicare rule limiting the number of MRI exams it will cover for a patient in one year. Whether Medicare Part B medical insurance will pay for any MRI – or for any other medical service -- depends on Medicare's determination that it is "medically necessa...
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  37. How can I talk to my Mother in Law about the decisions being made on her behalf that I disagree with?

    Question - I’m very glad you took the time to write in. My hunch is that many readers can relate to the myriad of family dynamics you describe and I have several thoughts on things you might try:
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  38. Does any part of a VA widows pension amount have to be repaid under current laws?

    Question - If she provided her correct Social Security number and filled out the VA forms correctly, she shouldn't worry about the money she has already received. But there is no guaranty that she will continue receiving the VA pension amount, even though no new law affects these particular pension rules.
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  39. Does medicare cover Chiropractic care and services?

    Question - Mostly no, but Medicare Part B can cover some chiropractic care in certain, very limited circumstances. The only chiropractic treatment Medicare Part B covers is manipulation of the spine to correct a subluxation (a bone in your spine out of position). The treatment must be considered medically necessary, and formally prescribed, by a physician...
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  40. Can my mother continue to see her current physical therapist if she isn't Medicare certified?

    Question - The question is not really whether your mother can continue to be treated by this physical therapist but whether Medicare will pay for it if she does. Your mother is always free to get treatment from anyone she wants. But if Medicare does not pay for it, she will have to pay for it herself, or with other insurance...
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  41. Does Medicare cover wheelchairs and transport chairs?

    Question - Medicare Part B covers what is called durable medical equipment, which includes wheelchairs and walkers, if prescribed by a doctor. For wheelchairs, Medicare pays to rent the chair for up to 13 months. By that time, you will own the wheelchair outright, but Medicare will continue to pay for the chair's maintenance and repair...
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  42. Can my parents access a nursing home without a hospital stay?

    Question - check again with the source where you heard that, because Medicare Part A coverage for inpatient skilled nursing or rehabilitation facility care has strict rules requiring a prior hospital stay. In order for Medicare to cover an inpatient stay in a skilled nursing or rehabilitation facility, admission...
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  43. Does Medicare pay anything for emergency air flights?

    Question - In some limited circumstances, it can. Medicare Part B can cover most of the cost of an ambulance -- including an air ambulance in very limited circumstances -- if you have a medical emergency that puts your health in serious danger and that needs immediate medical attention...
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  44. How can I reconcile the debt of my late father?

    Question - Tthe key thing to know is that you, as an individual, have no personal responsibility to pay for your father's final debts.
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  45. Who owns a patients medical records, the doctor or the patient?

    Question - Medical records are the comprehensive documentation of a patient's medical history and care. They are legal documents, which means they subject to the laws of the state in which they are made. They are also protected under federal law by HIPPA (Health Insurance Portability and Privacy Act), which sets strict guidelines to keep them private...
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  46. Will I be responsible for my husband's bills if he cannot afford his medical care?

    Question - My husband is a diabetic and unable to get long term care insurance. He has not done a good job in maintaining his health and watching his sugar levels. The home is in my name only. I have long term care insurance and have diligently saved for retirement over the years. He has not. He is getting some income but saving little...
  47. Should I delay getting medical attention for lumps in my groin?

    Question - Do not wait for the appointment in 3 months. Call and request an appointment sooner to have these lumps that you found evaluated. Since you don't mention if the lumps are painful, they may be nothing (like cysts), but I think you should be checked out just to be sure. Good luck!
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  48. Does Medicare cover Thyrogen injections for Radiation Ablation Uptake?

    Question - I called Medicare regarding coverage for Thyrogen and my call was referred to a person in specialty medications. I was told it was covered under Medical Part B. When I discovered that Thyrogen was available from my secondary insurance, Cigna Health Plan, I told the radiation oncologist that Cigna had...
  49. Will Medicare pay for a medical alert system?

    Question - Will medicare pay for a medical alert system?
  50. How to obtain coverage for hearing aid equimpement?

    Question - what medicare plan cover hearing aids equipment
  51. Will Medicare cover hospitalization after oral surgery?

    Question - As you realize from what you say in your question, Medicare does not normally cover oral surgery unless it involves bones, the jaw, or facial nerves rather than simply teeth, and is the kind of procedure than an MD (medical doctor) would perform, rather than a dentist or non-physician oral surgeon...
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  52. Who is responsible for paying for my husband's medical bill?

    Question - First, I would encourage you to not use the term "husband" to refer to your partner. He is not your husband, and especially in this context, you don't want to lead anyone to think that you have a legal relationship with him. This is one time when not being married could be very beneficial to you financially...
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  53. Does Medicare cover preventative services?

    Question - For helpful information about preventative care, including a prevention checklist for those over 50, go to Ask Medicare and click on “Caregiver Topics,” then “Care Options,” then “Services,” and “Get tips on staying healthy.”
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  54. Can the hosptial provide paperwork to prove my dad is incapacitated?

    Question - Your question about whether the hospital can provide paperwork for the bank to prove that your father is incapacitated has a long and a short answer. The short answer is "no".
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  55. Is a nursing home the best option for my sister who's partially paralyzed?

    Question - A nursing home for your sister is probably the best option for both you and your sister. Your sister's paralysis causes her to have physical needs that require assistance from someone. If she gets that care in a nursing home, then you will be able to provide other kinds of care.
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  56. Is it legal to purchase additional coverage and have three forms of coverage?

    Question - I am 62; retired military and my wife will be 65 in March 2011. We currently have Tricare Standard as our primary health insurance and a supplemental policy with ASI. Both insurances have deductibles that must be met prior to all bills being taken care of. i.e., TS = Individual $150 and Family $150 and ASI = Individual $100 and Family $200...
  57. My grandparents need help but are stubborn!

    Question - Your question raises a number of problems, among them the issue of your grandparents needing care but not wanting it. What can be done depends on quite a number of factors.
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  58. I am a Nurse of 35 years RN, and wondered if any one thought...

    Question - I am a Nurse of 35 years RN, and wondered if any one thought that if you had someone come into their facility maybe once a month month for those families that are not there to visit and check up on them. This would include making sure all meds are taken, checking for skin integrity or any falls with pictures, etc...
  59. Does Medicaid cover hearing aids in Kansas?

    Question - Hi,
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  60. Will Medicare pay for my lymphedema treatments?

    Question - I have server Lymphedema in both legs. Both feet are different sizes too. I have to buy two pairs of shoes, of different sizes. They are not very comfortable because I can not find them in 2-3 X-Wide or the top high enough to fit over the swollen feet. I am disabled receive Medicare (A)(B) & (D) and also Medicaid...
  61. Which prescriptions will Medicare Part D cover?

    Question - The specific prescription drugs a Medicare Part D plan covers depends entirely on the particular plan you enroll in (though every plan must cover at least one drug in all major therapeutic categories). Medicare's official Web site provides a simple tool called the Formulary Finder in which you just...
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  62. Is there a better medication for my Alzheimer's mother to help control her abusive behavior?

    Question - Rejection of care is quite common in individuals with advanced dementia. Your mother does not understand why the caregivers try to provide care for her and resist their care. In addition to the lack of understanding, rejection of care is often caused by depression...
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  63. He's better on the new meds; should I bring him home?

    Question - Dear anonymous-
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  64. Medicare won't pay for the hospital's error - what do we do now?

    Question - Your story is one of those outrageous ones that makes one wonder where the “care” is Medicare can be found.
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  65. Should we hire in-home care or insist on Assisted Living?

    Question - Hiring in-home help is a temporary fix for a permanent problem. Dementia is always going to progress; a person with dementia is going to become less functional and more needy over time. Getting in-home help is a band-aid on the wound, and is a great deal more expensive.
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  66. What rights do I have as a healthcare agent?

    Question - Congratulations on planning ahead. Now you need to learn what you've signed up for! If your father hasn't done so already, ask for a copy of the durable power of attorney for healthcare, naming you his healthcare agent. This document will spell out your duties. The better drafted the document, the more clearly it outlines your rights and responsibilities...
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  67. Recently, after one month in the hospital with end stage...

    Question - Once your mother and your family choose Medicare hospice care , Medicare will cover all her hospice medical treatment while she's in the nursing facility, including medications and nursing to keep her as comfortable and pain-free as possible. But Medicare hospice only covers your mother's care and comfort...
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  68. How can I ensure that my domestic partner will be empowered to handle my medical care and financial decisions?

    Question - You have taken good solid steps to ensure that your wishes are protected from a legal standpoint. Check the ownership designations on other types of property or benefits you may own. You may also be able to name your partner as immediate beneficiary of property such as pension rights and the pay-on-death...
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  69. What are the Medicare hospital stay limits?

    Question - Unfortunately, yes. In order for Medicare Part A coverage (up to another 90 days) to begin again -- for a new "benefit period," as Medicare calls it -- for a hospital stay, you must be out of the hospital and skilled nursing or rehabilitation facility for 60 days. And those days have to be consecutive...
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  70. Can a medical care team legally determine someone is unable to return to home care because they are a "threat" to society?

    Question - You can take your mother home to care for her if she’s not a danger to herself or others at the time of her discharge. If you’re capable and responsible, it’s unlikely hospital staff would prevent you from taking her, in any state in the c...
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  71. Can SSI/Medicare/Medical/Hud Section 8 look for repayments of benefits paid to date, when I am no longer eligible for benefits going forward?

    Question - You seem to be doing everything right, and there is no reason to worry about repayment to any of these agencies or programs. As long as you legitimately qualified when you were receiving assistance, there is no obligation to repay any of these programs if and when your income goes up and you no longer qualify...
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  72. Do you need a prescription for a walker?

    Question - No, you don't need a prescription for a walker, but I wouldn't recommend buying a walker on your own. An inappropriate or improperly used walker can actually contribute to a fall. It's also important to remember that some people should only use a walker with supervision. Also, people with dementia may always need reminding to use their walker...
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  73. Why do I need a living will?

    Question - You need a living will -- also called a healthcare directive, directive to physicians, or a declaration, depending on your state -- if you have strong feelings about the type of medical care you would want withheld or provided if you became unable to express those preferences...
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  74. Do I have any legal rights over my sister who is an alcoholic and neglects to eat or take her medicine for her Type 1 diabetes?

    Question - hi have a nice day
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  75. Is it just because of old age that my grandmother has to get blood transfusions every three months?

    Question - No, needing regular blood transfusions is never a routine treatment for old age. Although blood transfusions aren't unusual, getting them on a regular basis is rather uncommon.
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  76. My mom recently passed away -- will I be responsible for the medical bills that were not covered by Medicare?

    Question - My mother and father signed a "Warranty Deed Reserving Life Estate" in 2004 that basically states that upon both their deaths, their home is to be sold at fair market value and divided amonst the six siblings. My question is does this suffice in lieu of a will? Their only belongings is the house. No life insurance, etc...
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  77. Should Medicare or Medicaid have paid for my mother to enter a rehab facility after brain surgery?

    Question - The decision about whether your mother should have gone into a rehabilitation facility following surgery is a medical one, made by her doctors rather than by Medicare or Medicaid. If the doctors had decided that she needed to be in a rehabilitation facility and had prescribed it, Medicaidwould have paid for it...
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  78. How Does Someone Get Coverage for a Non Formulary Drug?

    Question - If you have a prescription for a drug that isn't on your plan's formulary, there are several things you -- or a family member -- can do. First, ask your Part D plan for an exception, which -- if granted -- would mean that the plan will cover the drug...
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  79. Will my mother's final medical expenses be paid even though the coverage has been cancelled upon her death?

    Question - Yes, all medical bills incurred by your mother are covered by Medicare and by her secondary insurance, as long as her premiums were paid up to the time of her death. Also, there is no need to continue paying premiums after her death (unless there is an unpaid premium from the time your mother was alive)...
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  80. What can I do if my parent refuses to receive medical treatment?

    Question - Greetings:
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  81. How do I find someone to be my power of attorney?

    Question - While it must feel a bit lonely to be in your position, the truth is that you are far from alone: There are many people who can’t find a person they know and trust or who is willing or able or well-suited to act as a medical agent and make decisions on final medical care for them.
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  82. Is choosing another insurance company a good idea?

    Question - Many people find themselves in the same boat as you, realizing that the first Medigap insurance policy that they bought is no longer the best or most affordable for them. You always have a right to switch to a new policy, but unless you are still within six months of when you first enrolled in Medicare...
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  83. Will Medicare cover a chair lift?

    Question - Medicare probably does not cover a chair lift that moves up and down stairs. Medicare Part B covers what's called durable medical equipment. This includes "patient lifts," which are mechanical or hydraulic devices that help to safely lift a person out of or into a bed or chair. It's intended to avoid injuries to patients and caregivers alike...
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  84. Are there tax deductions for assisted living care?

    Question - Tax deductions for both caregivers and assisted living can be made under the right circumstances and with the proper documentation. It’s common knowledge that you can deduct the cost of medical expenses if they exceed 7.5% of your Adjusted Gross Inco...
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  85. Can I claim my parents as dependents on my taxes without it affecting their Medicaid eligibility?

    Question - The Medicaid program provides medical and long-term care coverage for people with very low income and few assets other than the home they live in. In most states, your parents' income of close to $4,000 -- not even considering what you contribute to their support -- would be too high to qualify for Medicaid...
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  86. Are there programs that will help with medical costs?

    Question - If you have very low savings or other assets other than the house you live in, and you have low monthly income, you might qualify for the Medicaid program in your state. If you qualify for Medicaid, the program can pay almost the full amount of all your medical bills. This would include screening for lung disease...
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  87. What type of glasses can I purchase after cataract surgery and what is covered under Medicare Plan B?

    Question - Medicare Part B can pay for one pair of eyeglasses following your cataract surgery, if you had a new lens implanted in your eye. If you have two separate cataract operations, one on each eye, Medicare will cover new glasses after each surgery. Medicare Part B will pay for the lenses and the frames, but only for a basic, low-cost frame...
    Icon-expert-hh9a0a45474a1 Expert Answer
  88. Is it possible to get around medical power of attorney to visit an unresponsive relative?

    Question - My wife's sister had a stroke, and is in an unresponsive state. The niece, who has health care power of attorney, is refusing to allow my wife to visit her sister with no apparent reason, except for being in control. My wife and her sister have been very close all through their lives and she wants desperately to see her sister...
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