Mom has Humana Medicare. In November, she spent 20 days in a skilled nursing facility. Now she had a stroke and will need extensive therapy. Any advice?
However I was told that she will have to pay $177 per day. Please help.
Yes what & when some Medicare Advantage plans begin to actually pay for can be an eye opening experience.
Its important to read the policy and any fine print in these plans. Re-read what the policy covers. Note the required member out of pocket cost that must be met by the policy holder (in this case, your mother) before the plan begins to review the claim & pay.
If the Advantage plan your mother opted to join during her eligibility period was an Advantage plan policy from Humana that then pays mother’s only the monthly part B, you may come to find that your mother has a huge out of pocket expense that needs to be met before her chosen Humana policy will cover some or all of the cost of care.
Mother will have to meet her deductible and out of pocket expenses prior to the Humana policy paying.
Realize a Medicare member is given time and resources to investigate policy costs when choosing a Medicare Supplemental plan. I am not a fan of Medicare Advantage plans but they work well for many.
I suggest reading your mother’s Humana insurance policy carefully. You should learn a pretty good inkling of what the policy covers $ wise.
You can follow the Appeal process if coverage is denied. The policy should have company Appeal process listed.
I’m not familiar with this particular plan, but I can tell you that if it’s one of those zero premium Medicare Advantage plans, it’s got a really high deductible and she will be responsible for meeting the “out of pocket” costs which can be as high as $6,000 before they’ll pay. Those plans look great at the outset, with low or zero premium payments, but I’ve heard they’re great...until you need them. Either go to the financial office at the facility, the social worker, or get out the plan book Humana sent her and find out what her coverage is. I hope you’re not sc***ed, but if it’s a high deductible Advantage Plan, you may be.
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Its important to read the policy and any fine print in these plans. Re-read what the policy covers. Note the required member out of pocket cost that must be met by the policy holder (in this case, your mother) before the plan begins to review the claim & pay.
If the Advantage plan your mother opted to join during her eligibility period was an Advantage plan policy from Humana that then pays mother’s only the monthly part B, you may come to find that your mother has a huge out of pocket expense that needs to be met before her chosen Humana policy will cover some or all of the cost of care.
Mother will have to meet her deductible and out of pocket expenses prior to the Humana policy paying.
Realize a Medicare member is given time and resources to investigate policy costs when choosing a Medicare Supplemental plan. I am not a fan of Medicare Advantage plans but they work well for many.
I suggest reading your mother’s Humana insurance policy carefully. You should learn a pretty good inkling of what the policy covers $ wise.
You can follow the Appeal process if coverage is denied. The policy should have company Appeal process listed.
I would get that clarified.
Yeah, isn't it great they sell our seniors plans that don't cost them anything, just the 134.00 that Medicare takes anyway.
I hope you find a solution.
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