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Rileydog14 Asked May 2023

My mom is in long term care paid by Medicare for now. What happens with her social security retirement income and Medicaid?

JoAnn29 May 2023
Medicare only pays for Rehab that may share a building with Long-term care. Medicare pays 100% for the first 20 days only, 21 to 100 50%. The other 50% is paid by the patient if the supplemental insurance does not pay. So this means Moms Rehab can continue after the 20days if Medicare finds she will benefit from it. She can be discharged by Medicare at any time if its found she is not progressing or has hit a plateau. Upon discharge is when it needs to be determined if she is 24/7 care. If so, and no one is willing to care for her or can't, she can be transferred to Long-term care. At that time, its now private pay. If she cannot afford private pay, Medicaid can be applied for. At that time, the facility will ask that Social Security and any pension be turned over to them to offset Moms care. Medicaid will pay their share. Out of the SS a small amount will be withdrawn and placed into a Personal Needs acct set up by the Nursing home.

If Mom goes the whole 100 days the above scenario will happen. It will be determined if she is 24/7 care and if so if she is transferred to LTC or a family member supplies her care or 24/7 care is set up for her.

That 50% can mount up and be over 12k after 100 days if insurance does not cover. If Mom does not have this kind of money, Medicaid can be applied for to help with the cost. All this should be explained to you by the finance dept. Sign nothing saying you can be held responsible to pay anything the insurance company doesn't. If you are POA, always put POA at the end of your name.

BarbBrooklyn May 2023
Is mom in rehab right now? Medicare woukd pay for that for 20 days if she is progressing.

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Geaton777 May 2023
Usually it’s Medicaid that pays for LTC in most states. Her SS benefit will go towards paying for her LTC + Medicaid. Some SS is left for the person and this amount also varies by state. In MN it uses all but $90 of her SS every month. I think that’s on the generous side compared to other amounts I’ve read about. Others on this site will have more info to share, such as Medicaid putting a lien on the recipients home as part of recovery.

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