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Over the last 6 months my Mother has been in and out of the hospital with Sepsis. She first entered in early October for one week. Medicare covered the costs, and she was discharged and sent to a skilled nursing facility. She remained there for 100 days, received not only medical care but physical therapy as well which got her walking again. But 100 days is the maximum AARP would pay and thus she was discharged. But instead of going home to her house which was not conducive to recovery, I brought her to my house.



AARP's plan operates in "benefit periods". When a patient leaves a hospital or SNF, they evidently have to be out for 60 contiguous days. 30 days at one point + 30 days at another point during the same calendar year does not cut it! And that's where we are having the problem. My Mother was out of the SNF for 45 days, and she had to return to the hospital for repeat Sepsis. But AARP would not cover a second round of Rehab care, so I brought her back to my home again. . . . . . the problem is, I am not a medical professional. We have occasional visiting nurses or doctors stop by the house, but what she really needs is more IV antibiotics and a hospital bed, neither of which I have. So after exactly 30 days out of the hospital, the sepsis is returning, and by Monday I expect to be sending her back to the hospital for the third time. This could have been avoided had she been treated in a SNF. But the stupid AARP insurance policy won't allow it even though she's been out of the hospital for a total of 75 days in 2022 ! Well above the 60 day requirement . . . . .just not consecutive days.

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Larry, seriously consider getting another plan.   A Medigap plan might work, as it covers the 20% that Medicare doesn't cover.    My father and I each had one; when he was nearing the end of his life he had literally back to back hospitalizations, being home less than a week before needing another hospitalization.

Between Medicare and Medigap, all bills were covered except for one doctor's care during the Palliative Care period.   If I remember correctly it was around $95.  

Personally, I'm not impressed either with AARP or Advantage plans. 
We had AARP Dental cover through Delta Dental, and it was good, but severely limited.   Our Medigap coverage was through BCBSM, although it has changed and terms and coverage are different. 

Despite's AARP's claims of help, I haven't found them to be that cooperative in terms of insurance.   I considered switching car insurance, spoke with a rep, who e-mailed forms to complete.   They were in such poor condition that I couldn't read the terms, either in the e-mail or when printed out.  Even after explaining to them that I needed readable copies, the request and ticket information on that request was cancelled the next day.   So I got insurance elsewhere.   I would never again waste time with AARP's insurance offers.
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I agree your problem is Medicare. A suppliment pays what Medicare doesn't, it does not determine how long the subscriber can stay in the hospital or the amount of days in between.

Medicare Advantages are different. Medicare contracts out to these insurance companies. They are suppose to abide by Medicare rules but may not. A friend dropped her MA and went back to straight Medicare with a suppliment.
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AARP or any other supplement only pays when Medicare pays. Your problem is with the Medicare benefits. Like any insurance policy, there are limits to what medicare pays. There are also appeals procedures though I am skeptical that she would prevail in this situation.

Does she see a specialist outside the hospital?
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I assume the cause of sepsis is UTI ?? If not, ignore my post ..

My mom had chronic UTI ‘s . You should take your mother to a urologist.
The reason my moms UTI’s kept reoccurring was A. She ignored her symptoms as long as she could, I lived out of state B. from scar tissue pockets where bacteria could get into. I’m sorry I don’t remember the medication name my mom had, but it was taken in conjunction with vitamin c to make it work.

hopefully you can get down to the nitty gritty of the UTI.
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From your profile: "I travel frequently for work and cannot watch over her all the time."

As Barb wrote, is it time for a facility?

Don't jeopardize your job. How did she come to stay with you? Are you an only child? What are your mother's finances?
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That's a Medicare reg, not an AARP reg.

Perhaps it's time for your mom to become a permanent resident of a skilled nursing facility, because she needs medical oversight every day to prevent further infections. Long Term Care in a SNF can be either private pay or you can apply for Medicaid on her behalf.
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