Money Rehab with Nicole Lapin - "I Can't Afford My Father- In-Law's Healthcare Costs. What Can I Do?" (Listener Intervention)

Episode Date: June 28, 2024

A listener wrote to Nicole asking for advice: her father-in-law has high medical bills that he can't afford, and he can't get additional assistance from Medicare— which means his healthcare costs will fall to her. How can she stay afloat? Nicole walks her through the options she has to shoulder the financial burden.

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To get started, visit bofa.com slash newprosmedia. That's B-O-F-A dot com slash N-E-W pros, P-R-O-S, media. Bofa.com slash newprosmedia. I'm Nicole Lappin, the only financial expert you don't need a dictionary to understand. It's time for some money rehab. Oh, the financial community loves their buzzwords from technical terms like ROI or return on investment to sexier terms like passive income stream. Talking about money and the economy can quickly get bogged down with these insider terms. But the benefit of these words is that they can take a complex idea and label it so that we can discuss it. Lately, one phrase that's been gaining a lot of traction is sandwich

caregiving or sandwich generation. These terms refer to people who are taking care of their children and their parents or their grandparents. And yes, these buzzwords exist because it's such a common experience. In fact, it's the exact predicament that today's money rehab caller is in herself, and she wants to remain anonymous. So our producer Morgan is going to read the question. Hi, Nicole. My father-in-law has been in the hospital for over a month and most of the time in the ICU. And now we're looking into different rehab facilities to send him to next. The thing is that several ones of them want us to pay for what the insurance will not cover in advance. He is on Medicare Advantage plan and they say his income from Social Security is too high for low income support.

But his Social Security and insurance is far from covering his care. So the financial burden is on us. What options do we have and where can we get help with the different Medicare alternatives? We have a family with a baby to support and paying this out of pocket would be a huge financial strain for us. Thank you. So first, as always, I want to thank you for reaching out. I know you want to remain anonymous, so I'm going to call you Molly. You're in a difficult position, Molly. You're trying to do the right thing, and the right thing is really expensive. Before we dig into your specific

situation, I want to do a little primer on Medicare because the system can be so difficult and confusing to navigate, and I'm sure you're not the only money rehabber trying to navigate the system with a parent or an in-law. Medicare and Medicaid are different. Medicare provides insurance coverage to people 65 or older. Medicaid provides insurance coverage for low-income people. There are different types of Medicare plans, which are labeled as Medicare A through Medicare D. Medicare A is hospital insurance. Medicare B is medical insurance. And that coverage can be supplemented with Medicare D, and that's D for drugs because Medicare D is drug coverage.

Our listener's father-in-law has Medicare Advantage, which is Medicare C. These are Medicare plans offered by private companies. Depending on the provider and the location of the insured, there can be a variation between plans and exactly how they're structured. So today we're going to talk about generalities, things that are going to be true for anyone using these types of plans and in a similar situation. And that brings me to my first tip. For anyone dealing with Medicare, this stuff is complicated, and I'd recommend you talk to someone in your state to navigate the specifics, starting with a case manager. Most Medicare Advantage plans will provide one, and Molly, your father-in-law, may already have one assigned.

A great case manager will help you facilitate the flow of information between the different facilities caring for your father-in-law. They can also explain to you what your father-in-law's plan does and does not cover, and they basically act as the point of contact between your family and the insurance company. Now, if possible, you might want to bring your father-in-law's primary care physician into these conversations too. This is one of those times when having a longstanding relationship with one provider can actually be a huge benefit. A doctor who is on your side and willing to work with you and your care plan could help your father-in-law establish eligibility for more coverage. And finally, I want

you to reach out to the Social Security Administration. You can do that over the phone or you can find a local office. The fact that you're ineligible for financial assistance because of Social Security goes against what Social Security aims to do, and you're certainly not the only person who's having this problem. So ask them for their advice. I find that there's always a workaround that you really have to, though, dig to find. Next, you want to explore your state's resources that support caregivers and Medicare recipients. Florida, as the leading destination for retirees, has a super strong organization called Shine run by the Department of Aging Affairs. This organization provides free resources to help older Floridians and their caregivers navigate

the Medicare system. But searching for your, quote, area agency on aging, say that 10 times fast, will help you connect with your local state-designated organization that helps connect older people with services. This is an all-hands-on-deck situation, so if your father-in-law belongs to a church or a synagogue, talk to your priest or rabbi about available aid as well. If your father-in-law was a member of a union or professional organization, check with them too. Your support network is here for you in ways you might not even be aware of, but you have to reach out and ask for help. They may be able to offer you support in the form of legal advice, financial assistance, or simply someone who can sit with

your father-in-law at the rehabilitation center. And now that you have your crack team assembled, get an itemized bill from each of the places your father-in-law is receiving care. That alone may help knock down some of the cost because it will help you spot any errors that might exist in bills. But it will also help you see where the money is going. Is the rehab facility trying to place your father-in-law in a private room even though the coverage will only pay for a shared room? Does the cost include an out-of-network provider at in-network rehab? Really dig into these numbers and see what the biggest expenses are. Next, take those numbers and run them by your support team. Is everything you're being asked to pay for correct? Medicare

Advantage plans can't charge more for certain services, including skilled nursing facilities, than original Medicare. Can your team help you find a better price on anything? If a big percentage of your overall health care cost is coming from medication, you can try to reach out directly to the pharmaceutical company to see if your father-in-law qualifies under the patient assistant program. These programs can provide financial aid to qualifying patients, and they often work with Medicare patients specifically. Now that you have that itemized list, you can attempt to negotiate with the rehab centers directly. I always encourage everyone to negotiate everything for better prices. But unfortunately, this is one area and one situation where I wouldn't pin all your hopes on a negotiation. However, with that list in hand

and an understanding of what your father-in-law's plan will cover, you can work with the rehab facilities to try and streamline his care to what will be covered. Finally, find out what the yearly limit on out-of-pocket expenses is on your father-in-law's plan. Every Medicare Advantage plan has a limit. While it can be lower, the maximum that any patient in any plan can be expected to pay out-of-pocket in a single year is $8,300. How much has your father-in-law paid out this year? It's already the 11th month of the year and he's been in the hospital, so he may be close to hitting the limit. Hopefully with your team and research, you can knock a big chunk off this price, but there will be some costs associated with your father-in-law's care. You're going to need

to work out a payment plan with the rehab facility directly. This is where the team does come in handy. I know that they're pressuring you to prepay, but please resist that. And definitely do not prepay using a credit card. Medical bills are usually interest-free and credit cards generally are not. So if for some reason you can't negotiate a payment plan, then look into zero interest rate credit cards or shop around for the lowest available interest rate personal loan. But I would focus on trimming the costs from that bill, getting support from your community, and creating a payment plan. I know this is a lot, but you got

this, Molly. You and your husband are going to work together to take care of financial challenges. And just like you reached out to me for help, you're going to reach out for help from all the resources I gave you today. I know it's not easy, but with a little help on your side, you can honestly tackle anything. For today's tip, you can take straight to the bank. Medical care can be crushingly expensive in old age. One of the best ways to keep costs low is to obtain long-term care coverage. I know you don't wanna think about this, but when you need it, it is too late and you can't get it. This insurance is only available to people in decent health

between 55 and 65. So if you don't wanna be in the same position as our listener, then talk to your parents about their long-term care plans today. Money Rehab is a production of Money News Network. I'm your host, Nicole Lappin. Money Rehab's executive producer is Morgan Lavoie. Our researcher is Emily Holmes. Do you need some money rehab? And let's be honest, we all do. So email us your money questions, moneyrehab at moneynewsnetwork.com to potentially have your questions answered on the show or even have a

one-on-one intervention with me. And follow us on Instagram at Money News and TikTok at Money News Network for exclusive video content. And lastly, thank you. No, seriously, thank you. Thank you for listening and for investing in yourself, which is the most important investment you can make.