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Thread: Home supplies and help!

  1. #1

    Angry Home supplies and help!

    Question...Noone has told me yet...we are just 3 weeks into rehab. Do most insurances or the VA help pay for supplies such as depends, catheters...etc. Not even sure yet what supplies I will need when I take my husband home in October...I guess the best thing is to call my insurance, huh and find out what they cover. I know I have 180 days of home health a year..but I don't know if that means an aid would come to the house and help take care of him or what?? Anyone know?? The SC
    I nurse KLD may know what the VA provides as far as home care and the costs to us. I need help...I will be the primary care-giver but have to work as well and I really don't have a back-up other than a couple relatives that also have full time jobs. Starting to panic!!
    Brenda
    Brenda

  2. #2
    Moderator Obieone's Avatar
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    Welcome to CC Brenda ...... I can't be much help to your question since I'm up way here in the great white north but I'm sure KLD or someone will be able to answer your questions. With our health system here most of my husbands supplies are provided including home care .... we are very fortunate!

    Try not to panic we'll help you through this process as best we can ..... its a brave new world you've entered and we're in it together. Ask any question .... vent as necessary ...... share the happy times too (there will be some I promise) ! I wish you all the best !

    Obieone
    ~ Be the change you wish to see in the world ~ Mahatma Gandi


    " calling all Angels ...... calling all Angels ....walk me through this one .. don't leave me alone .... calling all Angels .... calling all Angels .... we're tryin' and we're hopin' cause we're not sure how ....... this .... goes ..."
    Jane Siberry

  3. #3
    You need to talk to your insurance about the home health coverage. Often it covers ONLY "skilled" care, which does not generally include ADLs, transfers, ROM, dressing, bathing, etc. as this is considered aide/unskilled maintenance care. It may include bowel care, but not always, and generally it does not cover catheterization other than changing of indwelling catheters if there are no other options for doing this. Daily PCA (personal care attendant) care is rarely if ever covered under private insurance. If they use Medicare criteria for home care (such as requiring homebound status) or limit the number of visits for specific purposes, you may not see anywhere near 180 visits a year. Many people with SCI who are low income and qualify for Medicaid can get some attendant care from the state, but that is unlikely to apply in your case. Most people with more assets must private pay, and find and train their own PCAs. There is an excellent book on PCA management that you can purchase from the PVA here: http://www.pva.org/site/News2?page=NewsArticle&id=8115 If he has already joined the PVA, he is entitled to one free copy.

    I would also strongly urge you to NOT be the primary caregiver, esp. for bowel and bladder care. It is very difficult to maintain your spouse/lover roll when doing this, and it often interferes a lot with the sexual relationship. Some can carry it off, but it is incredibly stressful, and I have seen it destroy many marriages. My dad used to be my mother's caregiver and they are so much happier now that I finally was able to convince him that the money spent to hire a private PCA was well worth the money. You trying to continue to work AND be his caregiver would be especially hard.

    He may or may not be eligible for some limited home care through the VA if he is getting his care at the VA. You should inquire about fee-basis bowel and bladder care. Some VAs only provide his for low income and service connected SCI veterans, while others are more liberal, and the availability of this varies. The social worker there should be able to help you determine if he might be eligible for this, but he would first need to be getting his care through the VA.

    His case manager at MetroHealth should be clarifying what is covered or not for home care with your private insurance as far as equipment and supplies for bladder, bowel and skin care. Wondering why he needs Depends??? I can't think of the last time we needed to order these for a new injury patient completing rehab at our place. These are rarely covered. Most insurances use Medicare guidelines for what is and is not covered, and that includes incontinence products like padding (diapers), although external condom catheters may be covered.

    If he chooses to get his care at the VA, he is eligible for medications and supplies such as catheters, gloves, Chux, lubricant, wound care products, etc. as well as durable medical equipment such as wheelchairs, commodes, shower chairs, grab bars, reachers, and ADL adaptive equipment, but only with a prescription from a VA physician, and there is a set amount available of each monthly, as well as only specific approved products. If you have a co-payment, that is currently $11 per prescription. Most prescriptions (except for controlled drugs) are good for 1 year at which time he would need to be seen for his annual VA SCI evaluation and have all of this renewed. Supplies for the VA are mailed out from a national distribution center. You don't find your own vendor or get reimbursed for things you choose to purchase yourself, although some of that might be covered under your private insurance as long as he is covered (I assume this is your insurance plan, not his???).

    (KLD)

  4. #4
    Senior Member dizzal's Avatar
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    ty for the info KDL i will have to start looking into someone else doing her bp in the future.

  5. #5
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    One thing that really helped me me in the transition from rehab to home was a sympathetic nurse that ordered a ton of supplies to get us started. In the helter-skelter of newness it was heaven sent. Also, a simple calender was helpful, kept out of sight of visitors, it marked bowel program progress, catheter changes, medication alerts, skin changes. Another calender for insurance calls, etc would have been helpful in hindsight. Everything will become second nature but those first months are a flurry of activity and change. Deb

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