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What If You Can't Afford To Pay For In Home Post-Operative Care?

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If you've recently had an operation or other procedure that requires extensive post-operative care -- such as a knee or hip replacement or insertion of a heart catheter or stent -- one of your primary concerns may be your ability to handle this care yourself. Although family members may gladly pitch in to help out, if you need daily care for a period of time, this could be more than even the most dedicated family is equipped to handle.

But what if you can't afford to hire a home nurse or pay for an in home care provider? Read on to learn several options that can help you receive the care you need while you recover.

Medicare coverage

If you're over age 65 and currently covered by Medicare, you may be able to access in home post-operative care at no cost to you. Medicare coverage extends to "intermittent skilled nursing care" to help you on a temporary basis as you convalesce. This type of care can involve wound cleaning, removing and replacing gauze and bandages, or helping you to the restroom.

Medicare will not cover services like meal delivery, long-term in home care, personal support (for example, driving you to the doctor or grocery store), or housecleaning. If you do have family willing to help during your recovery, and are unable to handle any of the previously-listed tasks yourself, your best bet is likely to contact an in home care provider to handle the physical aspects of your recuperation, while family handles the logistical (meal preparation, cleaning, and grocery shopping).

Medicaid coverage

Medicaid, the government-funded healthcare program for Americans whose household income falls below a certain threshold, may be able to pay for post-operative care under specific circumstances. Unlike Medicare, which is federally governed and mandated, Medicaid policies differ from state to state. Therefore, although some states may fully cover this type of care, other states can offer no coverage at all.

However, because states are always interested in decreasing the costs associated with Medicaid, they would rather ensure you get the help you need while remaining in your home, rather than needing further hospitalization or transfer to a nursing home or other inpatient facility. For this reason, many states have opted to cover in home nursing care through Medicaid waivers. In a number of states, this coverage is more expansive than that provided by Medicare, and is not merely limited to intermittent skilled nursing care.

Respite care

If your family is able to handle the bulk of your recuperative care, but occasionally needs a break, you may be able to obtain respite care at a relatively low cost. This care is designed to relieve the obligations of the primary caregiver or caregivers and allow them to run personal errands, sleep, or simply relax while still ensuring that you have the assistance you need.

This type of care is governed by a national organization that should be able to assist you in finding respite care providers in your area.

Private health insurance

If you are too young for Medicare, make too much money for Medicaid, yet can't afford to pay for respite care out of pocket (or don't have family or friends who are able or willing to assist you), don't despair -- the answer may be no further than your own private health insurance policy. Check your coverage carefully to see whether these types of services may be covered.

Unlike Medicaid and Medicare, you will likely be responsible for costs up to your deductible or out of pocket maximum. Be sure to research the care provider you select to ensure that they are in your coverage network, as this can help you save a substantial amount on this type of care.