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I took mom to an eye doctor appointment because she was complaining of not seeing and having scratchy eyes. Doc put her on antibiotic and asked her to use a warm compress. But it seems Medicare and Wellmark are not paying since this service isn't covered.

Canceled.
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Reply to swmckeown76
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Only 100,
Wouldn't drop it. A friend's 90+ year old dad actually "graduated" from hospice after two six-month terms. He lived another year as a private-pay long-term care resident and then returned to hospice care. His Medicare supplement covered what traditional Medicare didn't. If she or her brother (his POA's) had dropped his Medicare supplement, he'd have had to pay more out-of-pocket for his long-term care and doctor visits (they drove him there).
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Reply to swmckeown76
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Vision is not covered by all Medicaid plans. Look at her plan to see if vision, dental and hearing are covered for her. If not, there are plans that do cover these needs as well as supplemental insurance to cover these. It will not work retroactively for the eye doctor you just took her to, but you can have lower costs in the future.
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Reply to Taarna
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You've got some great ideas here.
I myself would take a hard and fast list of assets and income and go to an elder law attorney. I think they are best at guiding you how to proceed and how to arrange the assets to be paid directly for her care, with the rest of the care picked up by Medicaid once she qualifies for needing care.
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Reply to AlvaDeer
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Only100: Check with her Medicare Supplemental insurance plan.
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Reply to Llamalover47
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Hospice can / will (and should) explain all this.
In addition, contact Medi-care and ask them.

Generally, once in Hospice, they handle / direct all medical care - which is for COMFORT CARE only.

These services mentioned may not be paid by Medicare or Wellmark in any case. You need to ask them why they didn't / aren't paying.

Gena / Touch Matters
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Reply to TouchMatters
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So, the first thing hospice told me is to keep paying the medical premiums, just incase. I had Mom hospitalized when I discovered she had covid19 and everything was covered. She got it from the facility and with her Afib I got terribly worried. She was in hospice care and if it weren't for the premiums it would've cost quite a bit. Yes,most don't cover vision and dental but at that age you can't take them to Dr either because of inability to treat them properly. My mother had oral issues that hospice did treat with prescription mouthwash. I'm glad that paying the premiums was worth it. An ounce of prevention.... as they say.
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Reply to JuliaH
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Sounds like you need a more detailed explanation. Medicare typically covers medically necessary treatments like eye infections, so there may have been a misunderstanding or a specific reason why your mom’s treatment wasn’t covered, such as an issue with documentation or how the provider billed Medicare. Wellmark (as a Medicare Advantage plan or Medicare Supplement) could also have different rules, so it’s important you contact both Medicare and Wellmark to clarify why your mom’s treatment was denied and whether it can be appealed.

Medicare covers hospice services under Medicare Part A. If your mother is enrolled in hospice, Medicare will continue to cover hospice services, such as pain relief, symptom management, medical and nursing services, and support for both the patient and family. Medicare coverage may shift to focus on comfort care rather than curative treatments once hospice begins. It’s important you speak with the hospice provider to understand exactly what will be covered.
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Reply to HaveYourBack
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Does your mom have dental, vision and hearing? Or a supplemental plan? Her regular insurance should cover this, since it's not an eye exam for glasses. Medicare will cover hospice care after her doctor's recommendation.
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Reply to Onlychild2024
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This is a multi-part question/conversation that has many nuances, some having nothing to do with hospice.

1. Does your mom’s original Medicare policies cover the eye treatments she requires?

https://www.medicare.gov/coverage/eyeglasses-contact-lenses

The above link may help you better understand what is covered. Many factors are involved including does the doctor she is going to accept Medicare insurance?
Doctors offices usually know right away if your insurance will pay for the treatment you are requesting or they are recommending. But if you are unsure, call Medicare or look on the Medicare.gov website.

There is a search available on the above link that allows you to input your test and see if it’s covered.


2. Does her supplement cover the eye treatments your mom requires?

The supplement only pays if Medicare pays. The purpose of the supplement is to pay all or part of the 20% that Medicare doesn’t pay. There is no need to call the supplement to see if it pays. They will tell you only if Medicare has paid on the bill. Some treatments are completely covered by Medicare and then the supplement doesn’t pay because there is nothing left owing. But of course you can call them and they will explain to you how they pay.

3. Many of the medications for the eyes are very expensive.

Part D pays for medications and that depends on the plan that is chosen. We are reminded to be sure to compare our Part D this fall to make sure the meds we need are covered by the plan we choose.
4. Does your mom’s original Medicare Part A, part B and part D and supplement still pay when mom is on hospice?

It will continue to pay as it would have before going on hospice if used for something it covers.

It isn’t clear if mom is on hospice at this time. If she goes on hospice it will be for a specific reason.
Let’s use as an example cancer as the reason one might go on hospice.
If a person is told they have an incurable cancer and no more curative treatment will be given, then the patient has the option of going on hospice for additional care, supplies, equipment and stronger meds to control pain or to keep her comfortable.
One can keep their existing health insurance and use it for other issues that might occur that have nothing to do with the reason they are on hospice.

So if your mom is on hospice, you need to understand what hospice used as the reason she qualified at this time.

This is a choice of whether or not to keep the insurance she already has in place. It is not required to keep in order to have hospice but it is still useful if curative treatment is sought for other issues that the person chooses to treat. Not everyone who is on hospice is actively dying.

All of the comments I have made are for Original Medicare. There are many different Advantage plans. If a person has one of those, they need to call the number on their insurance card and ask their questions.

Your headline question was “Will mom’s Medicare and Supplement policy benefits end when she goes into hospice?”

No, they won’t end unless you cancel her policies. Even then Part A will stay in effect. The caveat is you can’t use hospice and Medicare plans to treat the same issue. One is for end of life care (hospice) and the other is health insurance for curative care. A supplement never pays unless Medicare pays first.
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Reply to 97yroldmom
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Traditional Medicare does not cover eyecare. Suppliments usually don't either thats why you need separate coverage. Thats why people like Medicare Advantages because they provide everything in one package. But they have their pitfalls so I stay with Traditional Medicare.

Hospice does not allow Doctor or Hospital visits. Its end of life care. Some life saving measures are discontinued. Like chemo and dialysis. Its comfort care.
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Reply to JoAnn29
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LakeErie Sep 26, 2024
I have a Medicare Supplemental and it covers dental and vision too.
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Time to call supplemental to learn about the coverage plan mom has, I think.
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Reply to AlvaDeer
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97yroldmom Sep 22, 2024
Alva
The supplement is to “supplement” what Medicare DOES pay for. If Medicare (original Medicare) does not pay on the doctors bill, then neither will the supplement.
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Hospice only covers end of life treatments, not any outside eye care. However you can drop hospice if you're wanting your mom to continue to be treated for other issues she may have, and then down the road when needed she can go back under hospice care, and then her Medicare will continue to cover these eye treatments and others if included in her supplement.
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Reply to funkygrandma59
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AlvaDeer Sep 21, 2024
Mom is, I think keeping supplemental insurance. This should pay for all eye care to maintain vision while she lives. Not certain whether this insurance covers this particular med. Our OP should call the "horse's mouth" here I think.
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When mom goes under hospice care, all other providers will no longer be required. Hospice replaces those providers and Medicare picks up the cost for hospice entirely. If you decide to discontinue hospice care and send mom to the hospital to get care again, Medicare will pay for those costs, less your deductible.

My mother's Medicare plan and supplement paid for no eye doctors. My plan, which is Kaiser, pays for both Optometrist and Opthamologist services within the Kaiser organization. You should check your supplemental plan to see what they do and do not cover.
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Reply to lealonnie1
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Only100 Sep 22, 2024
Thanks for this most helpful answer. What are your thoughts regarding dropping her supplemental Wellmark insurance? I'm wondering if I need to keep paying for that while she is in hospice.
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