Long-term financial planning is important for everyone -- but it is essential if you are coping with the expense of a chronic illness, such as Parkinson's disease.
This article offers some basic information on how to handle your finances while living with Parkinson's disease.
Develop a Financial Plan
Dealing with a chronic illness is unpredictable, there is no way to know how you will feel or what you will be able to do days, months, or years from now. But, for your own security and that of your family, you need to plan ahead, and assume that Parkinson's will lead to increasing disability. There are professional financial managers and medical lawyers that deal with financial planning for people with chronic illnesses. Ask your doctor for a referral, or speak with a national association or support group to find a reputable professional in this area.
Consider Your Medical Coverage Options
Employee Insurance. If you are insured, either through your employer or a retirement policy, read all of the policies pertaining to chronic illness. If you are unsure about the language or terminology, contact the personnel department or your financial planner.
It is important that your insurance agree to provide for a referral to a specialist in Parkinson's disease in the event that you should need one now or in the future. Not every neurologist is a specialist in Parkinson's disease. To be a specialist, neurologists undergo further training in movement disorders.
Private Insurance. If you are unemployed and you do not have coverage, you should look for the highest level of coverage that you can afford.
Medicare. If you are 65 or over, you will qualify for Medicare. You can supplement this insurance with a "Medigap" policy available through a private insurer. Note also that many states have prescription assistance/reimbursement programs for low-income senior citizens.
If you are disabled but too young to qualify for Social Security, you may be eligible to receive a form of Medicare for the disabled.
Medicaid. If you cannot get insurance and your income is low, you may qualify for Medicaid, a government "safety net" program that pays for medical costs that exceed a person's ability to pay.
Investigate Long- and Short-Term Disability Insurance
If you are employed:
- Check to see if your employer has a private disability insurance plan and contact your human resources department to investigate your eligibility, the cost of enrolling, and how much of your salary it will cover.
If you are unable to continue working:
- And you are too young to qualify for Social Security, consider state-run disability programs, unless you were enrolled in your employer's disability coverage.
- And if your total income is below a certain level, you may qualify for federally subsidized Supplemental Security Income (SSI). If you collect SSI, regardless of your age, you are a candidate for Medicaid.
Medicare and Medicaid
What Is Medicare?
Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over, as well as some disabled individuals under age 65. Eligibility for Medicare is linked to Social Security and railroad retirement benefits.
Medicare has co-payments and deductibles. A deductible is an initial amount you are responsible for paying before Medicare coverage begins. A co-payment is a percentage of the amount of covered expense you are required to pay.
What Are Medicare's Coverage Options?
Medicare has two parts: Part A (hospital insurance) and Part B (medical insurance).
Part A Medicare coverage includes:
- All normal hospital services
- Skilled nursing facility care
- Some home health services
- Medical supplies
- Hospice services
Part B Medicare coverage includes:
- 80% of reasonable charges from doctors and other health care professionals (after the annual deductible is met)
- Medically necessary ambulance services
- Physical, speech, and occupational therapy
- Some home health care services (doctor certification is necessary)
- Medical supplies and equipment
- Transfusion of blood and blood components provided on an outpatient basis
- Out-patient surgery
Part B Medicare benefits require that you pay a monthly premium. You must also be entitled to Part A benefits to receive Part B benefits.
Medicare Coverage of Skilled Nursing Care Facilities
In order to receive care in a nursing home under Medicare:
- You must have had a three-day hospital stay prior to admission into the skilled nursing facility.
- You must be admitted into the skilled nursing facility within 30 days of discharge from the hospital.
- You must enter the skilled nursing facility for treatment of the same condition that you were hospitalized for.
- You must require daily skilled care.
- The condition must be one that can be improved.
- The facility must be Medicare-certified.
- Your doctor must write a care plan. The care plan must be carried out by the skilled nursing facility. (Once the skilled needs are met, Medicare will no longer pay for services.)
Medicare Coverage of Home Care
In order to receive home care under Medicare:
- You must be home-bound.
- Your doctor must certify a plan of care.
- Care must be needed on an intermittent (not continuous) basis.
- Care cannot exceed 35-hours per week or eight hours per day.
- Physical or speech therapy must be provided on a "necessary and reasonable" basis. There are restrictions on the number of days or hours per week of these therapies.
- If you qualify for home health care, you are entitled to a home health aide to provide some personal care.
What Is Medicaid?
Medicaid is a joint federal-state health insurance program providing medical assistance primarily to low-income Americans. It also is available to people under 65 if they are blind or disabled.
The purpose of Medicaid is to provide preventive, therapeutic, and remedial health services and supplies that are essential to attain an optimum level of well-being.
How Do People Receive Medicaid Benefits?
Medicaid eligibility requirements depend on financial need, low income, and low assets. In determining Medicaid eligibility, officials do not review rent, car payments, or food costs. They only review medical expenses. Medical expenses include:
- Care from hospitals, doctors, clinics, nurses, dentists, podiatrists, and chiropractors
- Medical supplies and equipment
- Health insurance premiums
- Transportation to get medical care
The four eligibility tests required to receive Medicaid include:
- Categorical. You must be age 65, blind, or disabled.
- Non-Financial. You must be a U.S. citizen and a state resident. You also must have a social security number.
- Financial. Your total gross income, personal assets, and property will be evaluated and must meet a certain standard. This amount varies from state to state.
- Procedural. You must complete and sign an application and have a personal interview with a Medicaid official.
Each eligible Medicaid recipient receives a monthly medical identification card. The card is valid for one month only.
Medicaid coverage varies from state to state. For specific coverage guidelines, contact your state's Department of Human Services. Generally, Medicaid benefits include:
- Ambulance services when other means of transportation are detrimental to the patient's health
- Transportation to and from the hospital at time of admission or discharge when required by the patient's condition
- Transportation to and from a hospital, outpatient clinic, doctor's office or other facility when the doctor certifies the need for this service
Ambulatory health care centers are private corporations or public agencies that are not part of a hospital. They provide preventive, diagnostic, therapeutic, and rehabilitative services under the direction of a doctor. Ambulatory services covered by Medicaid include dental, pharmaceutical, diagnostic, and vision care.
- Inpatient hospital care up to 60 days for an illness
- Private hospital rooms only when the illness requires the patient to be isolated for his or her own health or the health of others
- Outpatient preventive, therapeutic, and rehabilitative services
- Professional and technical laboratory and radiologic services
Medical Supplies and Medication
- General medical supplies (when prescribed by a doctor)
- Durable medical equipment (such as hospital beds, wheelchairs, side rails, oxygen administration apparatus, special safety aids, etc.)
- Medications prescribed by a doctor, dentist, or podiatrist
Home Health Care
- Visiting nurse
- Home health aide
- Physical therapist
Skilled Nursing Facilities
Skilled nursing facilities and intermediate care facilities (providing short-term care for a patient whose condition is stable or reversible) are covered through Medicaid with a doctor's authorization.