Having a horrible time navigating Medicare Advantage
Like a lot of you here, I'm really struggling. My parents were very "we have great insurance and a Long-Term Care plan" for decades and wouldn't share the details. Now that my dad cannot care for himself, it seems like they overstated their planning.
My dad is 90 y/o and has Parkinson's disease. His gait has gotten progressively worse over the last couple of months, leading to several falls and spinal fractures. After the most recent fall, he's lost his ability to transfer i.e. bed to sitting up, sitting up to standing, standing to sitting, without almost total assistance. He lives with my mother, who is independent herself, but can't lift him or help him up due to a stroke. She isn't comfortable taking care of him at home.
We tried to get placement in a skilled nursing facility, but his insurance denied him because he "doesn't have any medical needs." My dad wants to go home with 24/7 care but that isn't in their budget. He would be willing to go to a facility, and that's my mom's preference. His insurance approved Home Health, but I suspect they will only stop by for a few hours a day. They have long-term insurance that will cover 6 hours a day of a home health aid, but that probably still leaves 16 hours a day where he's just sort of stuck in bed with his incontinence. They have Medicare Advantage. I'm looking at changing them over to traditional Medicare and maybe adding a Medigap plan that would cover skilled nursing, but I don't really understand how those interact. His insurance company is horrible to deal with, and I'm struggling to find a good resource to help point me in the right direction. Has anyone dealt with this successfully?