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Medicare covers spectrum of care

If there is one message that Brendan Weidler, regional vice president for Caring Edge, the sister company to Edgewood, would like to convey to seniors, it is this: “You pay into Medicare your entire life. You should utilize it to ensure you stay actively independent for as long as possible.”

Weidler knows from a personal experience over the past two years.

Last October, Weidler had learned that his grandfather Harry, now 92 years old, had taken a couple of falls, had limited mobility and wasn’t leaving home much.

“He was really lacking confidence,” Weidler said. “After a couple of falls, he didn’t want to leave home.”

Weidler visited his grandfather, a retired farmer living south of Velva, he brought along information on possibly staying at Edgewood for a time while he received therapy to improve his mobility. Weidler pointed out to his grandfather that home health care was covered by traditional Medicare at no cost.

“My pitch was ‘promise me six weeks, but if you hate it, you can leave after one,'” Weidler said. He wasn’t terribly optimistic. He’d spoken to Harry’s children, including Weidler’s father, and while they supported the idea, they didn’t think Harry would agree. “It was hard to ask. He’d lived on the farm for so many years and it was only the second place he’d ever lived.”

The next day, Harry agreed. He moved into a short-term stay room and began working with therapists. By the end of February, 2019, Harry showed significant improvement and met his goal of being able to walk from his apartment to Weidler’s office on the far side of the building. Improved, he was offered outpatient therapy while remaining in short-term stay accommodations.

“Outpatient therapy is covered by Medicare Part B, but there is a co-pay unless you have a supplement, which he did and it was very useful,” Weidler said.

By June, Harry was routinely walking to his grandson’s office and asked Weidler if he thought they were going to “kick him out.”

“I told him he could stay as long as he wanted. By then he’d made friends and really enjoyed the social environment. He decided to become a resident and has been here since. We went back to the farm to visit and I realized one of the reasons he hadn’t wanted to leave home was that there were two steps. That wasn’t a problem.”

While Medicare doesn’t cover assisted living, Weidler pointed out that long-term care insurance often does and that Medicaid covers some of a resident’s stay.

Although Harry isn’t eligible for it at this point, Weidler said the last line of service CaringEdge provides is hospice care, which he says is underutilized in North Dakota. Hospice is covered 100 percent by traditional Medicare.

“The benefit is really designed to be a six-month program offering a multitude of services,” Weidler said. “We find that people wait too long and don’t get the full benefit of the program.”

Across the spectrum of care, seniors have opportunities provided by Medicare and as Weidler reiterated, people pay for it and should utilize it to maintain their independence and well-being for as long as they can.

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