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My mom has both a heart condition, previous strokes and mild dementia, stage 1. She uses Medicare and may be moving into our home. If so, I want to get her set up with a primary care physician and services for her stroke condition. She is currently in a stroke club. Etc. Can anyone speak about what it was like to get a new medical team set up and the time it took? Thanks, Newdawn

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I'm going the simple route here. When my parents moved in with us, I called MY family Dr, who is an aging care specialist, and asked if he would take them on. I explained all their issues, and he was on board and said he could handle all thier current needs except the eye specialist and dentist. What a blessing for us as it cut thier apointments WAY down! And they had great care with a Dr and practice I knew and trusted. When dad had to go to MC they were great about helping and we got him admitted in 3 days! As Moms need got more, we were able to get referals to any one we needed, and he still dealt with the rest. Sometimes simple is the best for everyone.
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Cashew Feb 2022
I did the same with my doctor and an added benefit, they allow me to bring my Mom into MY appointments so I don't have the extra caregiver charges.
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I didn't move my Mom in with me but to a different nursing home closer to me.

The nursing home had a doctor on site so that wasn’t anything difficult to deal with, but know that there is a cut-off date each month with insurance companies if you want to make any changes, and you have to let them know before that date in order for their insurance to start up the following month.

For example, we moved my mother on July 5, but I made the decision about a week before, in late June. It was too late to get her insurance switched over to start at the new location for July, so we had to pay out of pocket for July and then her insurance picked up again in August with the new changes.

This was because she moved to a different county and also changed doctors. I was surprised to find out that the new county had better benefits than the old one, such as a $100 copay for an ambulance rather than $200 in her old location. She moved a whole 30 miles away, but there were quite a few changes.

I’d advise that you check with her insurance if she has a Medicare supplement policy to see what that cut-off date is for changing doctors. In my mom’s case, the cut-off was the 20th of the previous month, so I missed that cut-off by about five days.
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Isthisrealyreal Feb 2022
If it is a supplemental with standard Medicare there is not a cut off. You can see any doctor you want anytime you want, as long as they accept Medicare.
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I had to take my dad to the hospital to get him specialists.

My husband and I both called for 3 days trying to find doctors, with no luck, my doctor said take him to the ER. That got him all the doctors he needed.

If your mom has a Medicare advantage plan it will not cross county or state lines. (County only if the services are not available in the county of residence.) We found this out when my dad was hospitalized and had no insurance.

One benefit of moving out of the service area of an advantage plan is that they cancel you and then you can get into a supplemental policy and standard Medicare without any preexisting or waiting periods. It was a huge blessing for my dad.
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igloo572 Feb 2022
MediCARE Advantage plans are the devil. They are imo predatory in their marketing as most take advantage of the fact that most do not understand how Medicare runs and how participation of doctors, etc in Medicare is done & how billing happens… they see the zero copay of an Advantage Plan and think that’s for me as “I don’t wanna pay a penny for care” and it’s only when they get really sick that they find out that the clinics/ hospitals/ labs etc “in network” is new to them or miles away; that often doctors they have seen for ages are not “in network”; and if they saw anyone out of network that they are now after-the-fact facing huge out of pocket health care bills.
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Make sure to research what assisted living, memory care facillities are in your area too. Otherwise, call your local department on aging, they may have some good resources to suggest for your Mom.
When my Mom came to live with me from another state, her doctor there had already contacted the specialist she needed to see. I called Philly's department on aging, and they were excellent. The time it took for this to get everything done was about a week total.
Even though we've been here in central Pa about 8 years, my husband is in a good health care system, there are times when his care there has been not so great. Not much here for care givers. It would almost be worth moving to Philly, just to get more help.
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What type of Medicare does she have?
what does she have for her secondary health insurance?
Do you both currently live in the same state? and the same city?
Is she on any type of community based services right now… like a adult day Center? Is the stoke club within a PACE program?

the answers on these pretty much determine what needs to happen next for changing (or not) her Medicare.

But I’m more concerned about the feasibility of your mom moving in with you. What is her currently living situation and why the need to move right now? Has she had a needs assessment done? What are her capabilities right now….. can she select her clothes and get dressed on her own? Can she transition from her bed to walk to the bathroom and toilet on her own? Ditto for bathing? How much support do you - you not her - have with others to come in on a regular basis to provide caregiving for her? Or is this move planned as you being the 24/7 oversight for your mom in your home?
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No offense here to any older physicians, but when I had to "take on" helping my mom with her health I wanted to line her up with younger physicians (under 70) who would be around for a while as the few she had been seeing were in the process of retiring/getting ready to retire. Also, also wanted a more modern "group practice" for her general care which had things such as "on-line" scheduling, a health portal to review lab reports, ability to email the MD and health care team, ability to do video apts and part of a larger group in the event the one MD was not available there were others if needed. Her prior (nice guy) was a "pen and paper" type, solo practice. Could not find the paper records of when her last EKG was and she has heart issues, like OMG the paper file is missing somewhere, that was the last straw for me. No she did not have a cardiologist, again OMG. She had picked her prior GP because "he dressed nice" and she could drive up and park right in front of his townhouse office, only 10 steps from the car to the office door.

The new practice is part of a GP group tied to a large known and high quality hospital system, with a teaching hospital too. So if any specialists are required, it is a simple referral from her GP. And importantly, since the use the EPIC electronic health record system ANYONE in their system can see all her records across doctor office, outpatient, inpatient, etc.

This fluid access to all her records was very helpful when she had a 2-week hospital stay AND all those hospital records, tests, Rx, etc reports all all in that same record now. Obviates her having to remember what Rx, what doses, when was last EKG, etc. And easy for me to track it too.

All to say, perhaps look for a GP practice that is part of a larger and quality hospital system near you and get her plugged into that system. All major hospital systems accept Medicare so should not be an issue.
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JColl7 Feb 2022
I agree with you. Having a doctor who is up to date with technology (instead of paper files) makes a difference. My DH’s former doctor only did paper. It was a hassle and inconvenience to run to her office to pick up referrals (if he needed one). Being on an on-line system made a difference when he had to go to the
hospital and various specialists. Also I could access his lab reports when needed. Recently I had to find a new doctor since my doctor of over 20 years retired. I found a younger one who hopefully won’t retire on me because it was a pain trying to find a new one that I liked.
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It wasn't hard at all. Mom moved here from another county. I simply called her Medicare Advantage plan and updated them. They changed her to a plan in this area. (Thank Heavens for Medicare Advantage plans, they are amazing by the way.)
I got a new list of Doctors, checked them out online. Found a great Family Practitioner nearby, which she used until she became completely bed-bound. Easily transferred her prescriptions to a local pharmacy. It was all very simple and uncomplicated.

The big issue arrived when she became bed-bound. Took awhile to work it all out, to find a Doctor's office in the area who sent a NP to make house calls, and to find a lab that made house calls. And found a Medical Transport company to take her to Specialists.

My biggest shock - and a shock that would have made me choose another county to live in had I known... was that Medics here charge $175 for lift assists, and $200 ~ if they make a call for service and the patient declines hospitalization. It's the things like this that are the tricky issues. The insurance updates & changes, and finding Doctors was the easy part.
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You received some good advice already so I won't duplicate efforts. My experience in Florida's healthcare system (several locations) is that the wait to see a primary care physician or specialist can be 2-3 months. You'll be told to go to the ER if you have an emergency and cannot wait for treatment. So once you decide whether or not she's moving in with you, immediately proceed to assemble her medical team to avoid a gap in care.
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My mom moved from Illinois to Florida and she is on Medicare. It might be easier to switch when "the open season" for Medicare occurs in the Fall. Once you switch her plan, you can then look for doctors in the network in your area. Look up reputations of doctors in the network online. Then call and ask if doctor(s) is accepting new patients and how long to usually wait for appointments. Schedule a "check-up" with the new doctor(s) to get her care started. Local hospitals are probably your best source to find out about "clubs" or support groups based on diagnosis.
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