Managing Long Distance Care

There are two growing trends in senior care management:

  • The increasing number of seniors who travel between multiple homes and/or decide to move their primary residence outside of the New York area to be closer to loved ones.
  • The need to sift through health care policies and determine the differences in requirements and benefits from state to state when these moves occur. State laws and insurance policies vary widely nationwide even within the same insurance provider.

Eddy & Schein has extended services for seniors whose needs encompass areas outside of the New York Tri-State. We help to manage and organize personal, financial, legal, and health insurance matters in multiple states.

Re-creating a Care Team in another Part of the Country – A Client’s Story

George was 91 years old and had been splitting his time between an apartment in an assisted living facility in Tucson, Arizona and an apartment in New York City. Following the death of his wife, he spent more and more time in Tucson. During that same period, his health declined substantially and he needed 24/7 care from competent and trusted aides. For two years his aides from New York City were able to travel with him to Tucson. Since he had some good Tucson physicians and the regular team of aides from New York City, the “short-term” visits were relatively easy. The major transition that had to be solved was the management of his finances, legal affairs, and insurances. Here is where the team concept Eddy & Schein uses translated well. We worked together with his attorneys, accountant, and assisted living staff to create a plan whereby the bills that arrived in Tucson would be forwarded to New York and we could pay and track his expenses.

For two years the system proved successful until one November as George was preparing for his winter trip. His aides declared that they could not go with him again. He was, however, determined to get back to Tucson, as he said, “whether to live or to die.” Since his health was a greater issue than during previous flights, the first problem was getting George to Tucson. There were no direct flights to Tucson and given his care needs, changing flights and going unsupervised was impossible. Fortunately, he had the means to travel by air ambulance accompanied by Gideon Schein. It was clear that transportation was only the beginning of the problem. The well-functioning team of medical physicians and aides that had served him in New York would have to be re-created in Tucson. Together, with information from the National Association of Geriatric Care Managers’ website and the assistance of local geriatric care managers, Gideon and his accountant in Tucson were able to find a wonderful care manager who set up a system as strong and caring as the one George had in New York. She was also a phenomenal co-ordinator and kept everyone informed all across the country.

By the time George got to Tucson, a system was in place that included all the members of his team – his physicians, the geriatric care manager, his lawyer, accountant, and Gideon as his financial organizer. Until George's death, because of his team, he was able to live as good and fulfilling a life in Tucscon as he had in New York.

Managing Health Insurance across State Lines – A Client’s Story

Debbie is a physician who lived most of her professional life in New York, but as a result of a difficult divorce, a career opportunity, and suffering from multiple sclerosis, she decided she would be better working in Madison, Wisconsin. She was referred to us by her financial advisor because Debbie had a problem figuring out what to do about her health insurance, which included the complex terms of her COBRA coverage. The challenge to Eddy & Schein was to learn about the differences in laws that governed the two states. Gideon worked with her attorney, Medicare, her previous supplemental insurance company, and her ex-husband’s firm to determine what benefits she was eligible for. It became clear that her COBRA had expired, but that under New York law, she still had over a month left to transition into a new supplemental policy and establish Medicare as her primary insurance. However, when Gideon contacted Empire Blue Cross in Wisconsin (since that is what she had in New York), to see what they had to offer he was informed that the laws were different in Wisconsin and that she had only three days left to make the change without being subject to the pre-existing condition clauses of any “new” insurance. By that time she was bedridden due to MS and could not get to the insurance office in time.

After several urgent calls, one of the Blue Cross managers in Madison offered to have his sales rep drive 45 minutes to her. He did so and three hours later Debbie was covered.

Recently, the disease has worsened and she is no longer able to manage her own financial affairs. Her lawyer, financial advisor, and son, who lives in Minnesota, have joined with Gideon to help set up a new system. Currently they are contacting AADMM (American Association of Daily Money Managers) and NAPO (National Association of Professional Organizers) and other New York colleagues to search for someone in her area to coordinate her daily financial and health insurance needs.

More and more the traditional caregiver model is undergoing change. Just as it has become clear that there is a need to support and care for seniors who don’t have local families, friends, or relatives, it is equally clear that the problem becomes more acute as our clients transition to other parts of the country. In our local area, the need to build a “team” to support seniors is vital to the breadth of their care. And it is equally helpful to build a comparable local team when the senior transitions to a new locale.

Nationwide Resources

American Association of Daily Money Managers (http://www.aadmm.com/)
National Association of Geriatric Care Managers (http://www.caremanager.org/)
National Academy of Elder Law Attorneys (http://www.naela.org/)
National Association of Professional Organizers (http://www.napo.net/)
Medicare (http://www.medicare.gov/)

October 2009 - FEATURE
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