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Thread: Too rich, too poor...how do you pay for it?

  1. #11
    Senior Member willingtocope's Avatar
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    Quote Originally Posted by RJC View Post
    "Welcome to Walmart"
    One of the plus sides to living in small town iowa is the cost of living is really low. Would you beleive that food prices at our local Fareway and HyVee are lower than the local Walmart? Brand new 4000 sqft homes go for $275,000. Life here is cheap. But...our income still doesn't include money for a live in caretaker.

  2. #12
    Quote Originally Posted by willingtocope View Post
    One of the plus sides to living in small town iowa is the cost of living is really low. Would you beleive that food prices at our local Fareway and HyVee are lower than the local Walmart? Brand new 4000 sqft homes go for $275,000. Life here is cheap. But...our income still doesn't include money for a live in caretaker.

    That is relatively cheap, but you are right - it is still expensive to live retired with a chronic medical problem. No doubt.

    A live in student sounds like your best bet, unless moving in with family is an option.

    It is very hard when you fall in the interface... not enough $ to pay for what you need privately, but too much $ to qualify for Medicaid home care services. I understand that completely. It is very frustrating.

  3. #13
    he doesn't need medicaid, he has medicare and private insurance, get part "B" medicare and everything will be paid for 100% w/private insurance.......or did i read the OP wrong......

  4. #14
    Senior Member willingtocope's Avatar
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    Make sure I understand. I've got BC/BS thru work. I've got Medicare A. If I add Medicare B, that will pay for all the home health care I need?

    Which one? BC/BS says they only pay if theapy is going on...and I thought part B followed the same rules...

  5. #15
    No, unfortunately Medicare Part B pays only for very limited SKILLED home care (ie, care that can be provided only by an RN or LVN/LPN such as complex wound care or IV medications) and does not pay for "maintenance" care such as assistance with ADLs, bathing, transfers, cooking, feeding, ROM, etc. etc. The same goes for PT or OT...there must be an expectation for realistic functional gains (ie, increase independence by you) with the therapy, and improvements would have to be shown for therapy to continue more than just a few visits.

    Even the skilled care provided under Medicare Part B has a limited number of visits. For example, you might be able to get a few weeks of skilled Medicare funded home care for doing bowel care, but the expectation would be that the nurse would be training a family member or PCA to do this and to take over (at your expense) once taught.

    Few if any private insurances cover PCA care. If you have long-term care insurance, there may be some coverage under that policy. Worker's comp is often the only coverage that includes PCA care.

    (KLD)

  6. #16
    Senior Member willingtocope's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    No, unfortunately Medicare Part B pays only for very limited SKILLED home care
    Exactly what I thought. 4 or 8 visits, then you're on your own dollar. BC/BS uses the same rules.

    Even though I'm working, the fact that I'm over 66 does mean I could apply for Social Security. I wouldn't get my full amount until I do quit working, but I could use that money to pay for HHC. And, because I'm on SS, my wife's SS (she retired at 62) would increase to 1/2 mine.

    The question is, does that increase my taxable income.

  7. #17
    they pay for a quad guy here in tennesse......he has care come in and do his bowel and bath program......i was under the impression they would do it in every state, sorry........

  8. #18
    Moderator jody's Avatar
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    do you need specialized or very personal care? if not, there must be plenty of people in your area who would love a nice part time job.

    What about a high school senior? like the local work/study program or something like that?

  9. #19
    Senior Member willingtocope's Avatar
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    We've got a friend who actually works as a caregiver at a nursing home. She will come in and do our laundry, shopping, errands, etc. She'll even help me take a shower. She knows what shes doing, and we feel safe dealing with her.

    We can make arrangements with her to visit every other day. The problems are: she has her own life, and is not always dependable; and, whatever we pay her we cannot process thru our insurance, flex account, or claim on our income tax. We figure we'd need to pay her $600-800 per month, if not more.

    So...back to my last question. Should I apply for SS now so our total income goes up, or is that going to just pay taxes?

  10. #20
    Quote Originally Posted by willingtocope View Post
    We've got a friend who actually works as a caregiver at a nursing home. She will come in and do our laundry, shopping, errands, etc. She'll even help me take a shower. She knows what shes doing, and we feel safe dealing with her.

    We can make arrangements with her to visit every other day. The problems are: she has her own life, and is not always dependable; and, whatever we pay her we cannot process thru our insurance, flex account, or claim on our income tax. We figure we'd need to pay her $600-800 per month, if not more.

    So...back to my last question. Should I apply for SS now so our total income goes up, or is that going to just pay taxes?

    Of course starting to take SS will increase your income. It does not all go to taxes. But you need to do that calculation yourself. Social security is taxed if your combined income with your wife is above a certain limit. Most people defer starting social security when they can afford not to and to increase their returns long term. But if you can't do that, you can't do that. That's ok.

    See this website:

    http://www.ssa.gov/planners/taxes.htm

    So if your joint income is above $32k, you pay tax on at least 50% of your income. If your joint income is above $44k, you pay tax on up to 85% of your income. The tax is at the going rate for that income level.

    So you need to do the calculations yourself to see what makes sense.

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