Does Medicare Discriminate Against Certain Elders?
Published: Fri, 01/24/14
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Ask the Expert: Your Elder Law Questions Answered by Evan H. Farr, CELA |
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Does Medicare Discriminate Against Certain Elders?
If you cannot view the image below, please read the article on our blog.
 Q. My mother, Sally, is 67 and has chronic depression and is in the early stages of Alzheimer's. In the past, Medicare only covered 50% of the costs of her psychological treatment for her depression. I feel like this is discrimination, since mental health treatment covered by Medicare is not on equal footing with other medical and surgical services. I hear, however, that the amount covered has gone up. How much does Medicare cover now for mental health outpatient services and what services are covered? Also, does Medicare pay for the care that is needed by people suffering from chronic illnesses, such as Alzheimer's disease or other types of dementia? A. For decades, Medicare has effectively discriminated against older adults with psychological conditions, such as depression and anxiety, because these conditions have received unequal treatment under Medicare. Medicare has paid a smaller share of the bill for therapy from psychiatrists, psychologists or clinical social workers than it did for medical services and has imposed strict lifetime limits on psychiatric hospital stays. In 2008, Medicare covered 50% of the cost of psychological treatment, while in 2013, it covered 65%. Beginning in 2014, Medicare will pay 80% of its approved amount for certain outpatient mental health services. Payment kicks in once someone exhausts an annual deductible of $147 per year. Covered services include:
Medicare will pay for the services of medical doctors (such as psychiatrists) who do not take Medicare (non-participating providers), but these doctors can charge you up to 15% above Medicare's approved amount. Some states have stricter limits on how much doctors can charge. Find out more about Medicare's Mental Health benefits on the Medicare.gov website. Since its inception, Medicare has also effectively discriminated against older adults in that Medicare does not pay for the type of care that is needed by people suffering with certain diseases; specifically, Medicare (and, for that matter, private health insurance) does not pay for the care that is needed by people suffering from chronic illnesses such as Alzheimer's disease or other types of dementia, or other brain diseases that cause a diminished ability to function without assistance from others. When a family has a loved one with one of these "wrong types of diseases," that family must become officially "impoverished" under federal and state Medicaid rules in order to gain access to basic long-term care. It is a tremendous shame that our country's social policy essentially discriminates against those who get these "wrong types" of diseases. I submit that it is unfair for Medicare to provide full coverage for most diseases but force those with the "wrong type" of disease to go broke financially in order to gain access to the basic care needed - care which our society calls "long-term care" instead of "health care." It should be no surprise to anyone that most knowledgeable families seek legal methods to preserve the efforts of a lifetime in order to protect themselves from our country's unfair social policy.
If you have a loved one who is nearing the need for long-term care or already receiving long-term care, please contact The Law Firm of Evan H. Farr, P.C. as soon as possible at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to schedule your appointment for our no-cost consultation. ------
 Should Mom Bring Her Cat to Assisted Living?
 Dear Saki and Alley, My mom visited the Farr Law Firm recently and enjoyed meeting you and the other pets (and Evan and the staff, as well). My mom is in the early stages of Alzheimer's and will be moving to assisted living soon. I read somewhere that pets are good for seniors. She would really love to bring her small Calico cat, Itty Bitty Kitty, with her. If the facility accepts pets, do you think it is a good idea for her to bring Itty? Thanks!
Sheila Oves-Hercatt -----
Dear Sheila,
We completely understand why your mother would want to bring her cat with her. How could anyone have it any other way? In some assisted living communities, cats (and dogs too) can accompany their owners, and sometimes there are pets in assisted living communities (and in nursing homes) that are owned by the facility and enjoyed by the residents. A growing consensus among assisted living residents and staff alike is that pets bring health, connection, and a sense of home.
Not every assisted living community has a pet program, but they're growing in popularity at a rapid rate, and for good reason. Studies show that when seniors interact with pets, depression and loneliness decrease while socialization and conversation rise. Part of the reason is that pets are not judgmental and they don't see age or disability. In addition to offering unconditional love, lowering blood pressure, helping fight depression and loneliness, and easing loss, pets in assisted living communities keep seniors active.
Consider these statistics from the Pets for the Elderly Foundation:
"Taking care of a pet is a way to engage residents," says Paul Kelley, senior director of Operations for Sunrise Senior Living. "Many stay active by filling water bowls and taking trips to a pet store for treats. Sharing care can also be a bonding opportunity for residents and staff alike. And for residents who are used to being cared for, it's a nice change for them to step into a caregiver role as they become responsible for an animal's well-being."
It has also been shown that pets are good for Alzheimer's patients. They, too, need to belong, love and be accepted. Pets give unconditional love. Alzheimer's patients say the most incredible things in the presence of a pet.
There are common challenges with animals in any community living situation, however, including allergies or just a lack of affinity for dogs or cats. Whatever the potential challenges, the upsides seem to far outweigh the downsides. For some residents, time with their own pet, daily rounds from a community dog or cat, or weekly therapy visits can be the highlight of their day.
Do you have a loved one who is nearing the need for long-term care or already receiving long-term care? Whether you are looking for a facility that allows pets or not, if you have not done Long-Term Care Planning, Estate Planning or Incapacity Planning (or had your Planning documents reviewed in the past several years), now is the time. Please call The Fairfax Medicaid Asset Protection Law Firm of Evan H. Farr, P.C. at 703-691-1888 to make an appointment for a no-cost consultation. While you are here, you will have the opportunity to meet our delightful Siamese cats, bunny, and African dwarf frogs!
P.S. Don't forget about your pet! Read our recent post about Pet Trusts and be sure to include them in your planning.
Purrs, Saki and Alley About Saki and Alley: Saki and Alley are nine year old Siamese cats that belong to Jeannie and Evan Farr and live here at the Farr Law Firm. They are very sweet and smart and love all the attention they get from staff and friendly clients at the firm. We encourage you to visit us and meet these extraordinary Siamese cats! |
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