Ms. Toni:
My 86-year-old mother with Alzheimer’s needs 24-hour care and lives in a local personal care home. She is enrolled in a Medicare Advantage HMO and taking her to the doctor is quite an ordeal.
Friends have suggested that I disenroll my mother from this HMO and return her to Medicare, then use a “House Call doctor”. Financially, it is costing over $4,000 per month for her personal care home and what happens if my mother does not qualify for a Medicare Supplement due to her Alzheimer’s and other health issues.
How do I find a doctor that makes house calls like Dr. Welby did in the “good old days”? Is this something that Medicare or Medicare Advantage plan will pay for it?
Thanks,
Trish from Crowley, LA
Trish:
I have good news for you because the Dr. Welby days are back for those on “Original Medicare” and for Medicare Advantage plans. Doctors are now making “old fashion” house calls to keep the sick from having readmissions back to the hospital.
My advice to you, Trish and the Toni Says® readers is to ask your family member’s primary care doctor or specific healthcare provider about which “House Call” or “Visiting Physician” organization that their office is contracted with, whether your family member has “Original Medicare with or without a Medicare Supplement, a retiree group medical plan or a Medicare Advantage plan.
A house call visit can help keep those who are having a minor ailment turn into a major illness situation and helps Medicare or the Medicare Advantage plan from paying for an expensive hospital stay.
Doctor or medical provider visits at home or at a long-term care facility such as assisted living, personal care home or nursing home are being accepted and paid for by Original Medicare, Original Medicare with a Medicare supplement and Medicare Advantage plans (depending on your house call provider being in the Medicare Advantage plan’s network).
House call doctors are generally board certified and the providers consist of doctors, physician assistants and nurse practitioners. The patient does not have to be home bound to qualify. The house call doctor can schedule regular appointments, especially if there is a chronic illness or you can schedule appointments as needed.
In 2018, who would believe that doctors making house calls would be making such a comeback? You might not see a doctor show up in a horse and buggy or even carrying an old black medical bag…but today the new house call doctors are coming to your home with many of today’s modern marvels such as X-rays, ultra-sound machines, physical therapist and even a hypodermic needle to draw blood.
Not only are doctors making house calls, but dentists, eye doctors and even mobile x-ray/ultra-sound machines with technicians are visiting homes, assisted living facilities, nursing homes and personal care homes such as what your mother lives in.
Trish, you are wise to examine your mother’s options regarding disenrolling from her current Medicare Advantage plan with her serious health situations. One must qualify with medical underwriting for a Medicare Supplement which helps to pay Original Medicare Part A(Hospital) and Part B (Medical) out of pocket. If she does not qualify, then she will be responsible to pay the Medicare out of pocket costs herself.
Therefore, it is vitally important to look over all of one’s Medicare plan options because no one knows when their health will begin to deteriorate and then they cannot change Medicare plan options.
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