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TYoung79 Asked January 2020

Just found out yesterday that my father's insurance will stop paying for his rehab stay on Friday...any advice on what our options are?

He went from the hospital to a rehab facility in Tenn and has not been able physically to benefit from the rehab. We have filed for "Tenncare" Medicaid, he has been approved physically but the financial side hasn't been approved. We have no idea what to do.

JoAnn29 Jan 2020
Yes, confusing. Was Dad living in a NH prior to the hospital stay and rehab? If so, how was his care being paid for? Private or Medicaid.

With rehab there comes a point when the person plateau and rehab can no longer help. Medicare will no longer pay. Or, he has hit his 100 days and Medicare will stop payment? Is the NH going to be a permanent thing? Please realize that therapy can only do so much. You may feel Dad needs more but more is not going to solve the problem.

Isthisrealyreal Jan 2020
You can appeal the insurances decision to release him.

Your profile says he lives in a nursing home, did they fill his bed or what? Or was that based on rehab?

When my dad was being released from a SNF that said he was good to go because he could get from a wheelchair to a bed and back again I found a different rehab facility that I knew would get him to the best point he could be. He was walking the day he went to the hospital, I was not willingly bringing him home without all efforts to get him back on his feet.

If you think that he can improve to pre hospital stay fight for the help.

Best of luck, such a difficult time.

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Geaton777 Jan 2020
TY, can you clarify what "been approved physically but the financial side hasn't" means" ? Are you saying they've acknowledged his physical need but you are waiting to hear if it will be approved for coverage? Or was he financially rejected? Every state's Medicaid program operates a little differently. If you have submitted the application to qualify, here in my state (MN) once you are approved for Medicaid you can submit medical bills that were incurred in the 3-months leading up to qualification. If you weren't approved there is a "spend down" period and amount to bring your dad to the point where he will qualify. It is sort of confusing so you should call their offices and get clarity on this. I'm sorry for your dad's health issues...wishing you all the best as you move forward and help him.

BarbBrooklyn Jan 2020
If he is NOT approved for Tennesee Medicaid, you find out if he can spend down his assets as a private pay patient until he is eligible. Does he have a spouse? If there is, you need an eldercare attorney to assure that she is not impoverished.

BarbBrooklyn Jan 2020
You need to find out if he can stay in the facility "Medicaid Pending". Get the social worker on the phone right away. If the answer is know, ask for her help in finding him a facility that WILL accept him "Medicaid pending".

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