Wow...back in August I was contacted by the VA. I was told that my Dad was eligible for in home primary care. Due both to his extreme age and his war time service in WWII. After some fuss, Dad agreed to this. It was a good thing for him. The ordeal of getting him to a doctor visit at the VA was getting to be much too much. And the number of time the Cab company employees ripped him off was just awful! So, over the course of the next two months (August and September) he had OT, PT, nursing, and dietary visits. He passed away on Sept 26. So..now I am getting HUGE bills for these services!!! Medicare will not pay...in home service not covered. Dads Medicare plan F will not pay....in home service not covered. OH GEEZ. Why was I led to believe that this was a wonderful service offered by the VA? This is well over $20,000 in bills!!!!! What can I do about this? This will bankrupt my Mom.
I'm so sorry for your loss, K. Please let us know how this is going.
Found this on VA website http://www.va.gov/geriatrics/Guide/LongTermCare/Home_Based_Primary_Care.asp#
Since Home Based Primary Care is part of the VHA Standard Medical Benefits Package, all enrolled Veterans are eligible IF they meet the clinical need for the service and it is available.
A copay for Home Based Primary Care may be charged based on your VA service-connected disability status and financial information. You may have a basic copay each time a VA staff team member comes to your home for a medical visit (the same as if you went to a VA clinic). Contact your VA social worker/case manager to complete the Application for Extended Care Benefits (VA Form 10-10EC) to learn the amount of your copay.
Did you fill out the paperwork VA Form? If the providers were billing Medicare and it was approved through VA, no wonder Medicare is rejecting. Please try calling the VA worker that got your Dad approved for services and get them to tell you how to get billing corrected and resubmitted. So sorry for your Dad's loss, and my family's thanks for his service. My nephew is overseas now.
Who is billing you, the home agency? They should have had doctors' orders to begin any kind of in home care. They should be following proper channels of billing to VA *if* this service was ordered by VA. If for some reason it wasn't, and home service got a little ahead of itself and did the visits w/o proper order in place, they are to blame, not your family.
How, exactly, were you led to believe VA would pay for this? I don't believe your family is liable for the bill, but if you want to give more details, it might help sort out which party screwed up.
And mostly - I'm very sorry for your loss. Condolences on the passing of your father. I wish you and your family peace and comfort. (((hugs)))
I will be calling the coordinator at the VA and see if she can tell me who to contact over there next. Thank you for all the help!
Medicare does not pay for in home health care delivery. The secondary insurance (plan F) does not pay for in home health care either. So....
I had a long talk with the person who deals with VA billing here. Yes, they charge a per visit co-pay. Now..on any given day my Dad had a nurse, and a therapist (different ones on different days) plus all the hospital visits they set up...like cardio, lab, X-ray, etc. on many days there would be 3 or more people in the home from VA.
If anyone had told my Dad that this was going to cost him $20 to $60 PER DAY he would have told them what to do with their so called "wonderful benefit". But..he had dementia, there wasn't any way he was going to understand that.
If anyone had told me the cost of the great benefit they offered...I would have refused more than one or two visits a week...not allowing 2 or more visits per day!
BUT...here is the kick. Because he passed away without any estate..there isn't anything they can do to collect. They can't garnish his social security..it has stopped. The lady at the VA told me they will monitor the courts for the next 6 months to be sure there isn't any probate court proceedings, then they will just close the account.
So, beware. If you allow this benefit for your elderly veteran parent...you could be setting them up for HUGE bills!
Some benefit...eh?
...this comment is copied from a lawyer website, but I saw it repeated over and over.
"The family purpose doctrine states that the expenses of the family and the education of the children are chargeable upon the property of both husband and wife, or either of them, and in relation thereto they may be sued jointly or separately. In simple English, this means that both husband and wife are responsible for the grocery bill regardless of who went to the store.
At first glance, this seems like a good rule and perhaps it is. The concept is that if the family unit benefited from the expense, then the family unit should be responsible for the bill. The medical, dental and educational costs incurred for the benefit of the children are the debts of both the husband and wife. However, in Colorado probate matters we see more and more creditors suing the surviving spouse and using the family purpose doctrine to do so.
For example, an ill spouse may incur a large hospital bill before passing away. The Colorado probate estate may not have any assets. Many times, this debt is not covered by insurance, and the debt is several hundred thousand dollars. Through the use of the family purpose doctrine, the medical providers file suit against the surviving spouse instead of the Colorado probate estate. In many instances, this kind of debt will be a financial disaster for the surviving spouse."