HomeCaregiversHow to navigate the healthcare maze?Navigating the Healthcare Maze

5.1. Navigating the Healthcare Maze

Navigating the Healthcare Maze from Family Caregiving 101

Most people - whether as patients, family caregivers, or health professionals - do not have a good idea of what medical insurance (assuming the patient has some) will pay for until the need arises. Family members and patients are often shocked to find that insurance will not pay for many services and items needed at home that are routinely paid for in the hospital. Unless your relative has specific long-term care insurance (and very few people do at this point), many home care needs, especially home care aides or attendants, will not be covered at all or beyond an initial short-term period.

HELP: Communicating Effectively with Insurance Company Personnel
HELP: Communicating Effectively in the Hospital Setting

Know What Your Insurance or Managed Care Company Is Responsible for Covering

Identify and Use All Available Resources

Be Assertive About Your Rights

Recognize How the System Can Work Against You

If someone tells you "Medicare (or another insurance) won't pay for it," don't stop there. Check it out yourself through your State Health Insurance Assistance Program, the Medicare Rights Center at (212) 869-3850 or online at www.medicarerights.org, or through another independent source.

Contributed by Carol Levine, Director, Families & Health Care Project, United Hospital Fund

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