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I didn't receive any statements from the facility during my mom's time in rehab until the time came that she had to cover the copay out of pocket, and then that bill didn't come until months after the fact. However, I did receive statements from Medicare that showed what was paid. I also received statements from her private insurance since they paid the 20% copay for a short time when that kicked in. I remember being surprised that the daily room rate didn't cover any of the therapy. They were all separate charges, but were covered.
Now that she is private pay and in long-term care there, I get a monthly bill broken down as follows:
1 - Incidental charges for the previous month, ie and broken down - incontinence care $/day, TV $/month, laundry $/day - hairdresser $/month) - wound care $/month.
2 - Advance room charges for the following month.
I had to make some calls about a few of the incidental charges as some aren't very specific (ie, wound care).
I have not received anything about prescription charges though, and she's been there 7 months and has lots of scripts. I do receive a list of them at every care plan meeting though. No prices, just the dosage, when they were started/ended. They use a pharmaceutical company to take care of the meds and billing for that. As a matter of fact, that company called and left a message for me about my mom's "overdue" prescription bill. I called and informed them we had never received a bill, if they would send one, I'd be happy to pay it. They then asked about insurance, and I told them she had Medicare and gave them the name of her seondary insurance, told them they should contact the facility if they needed further info like policy numbers. This was at least 2 mos ago and I still haven't received anything, maybe they worked it out.
I can only surmise that they only send statements when they need me to send $ (ie, if Medicare/insurance doesn't cover the "ALLOWED" amount).
That's why you need to see an Eldercare Attorney who specializes in Medicaid preparation. Especially the house (if the elder owns a home) and keeping it out of probate after they pass. Do not use an ordinary quick deed--they will be seen as gifting and Medicaid will penalize.
To me, bigger issue for families who have parents who want to keep their home is more initial problems (not Estate Recovery) in they:
- are not in synch / agreement on how to pay to keep it OR
- have no interest in the home & perhaps....
in dealing with anything to do with elder much less old house
- cannot afford home for unknown period of time.
Did you find this on your own or did the NH or Medicaid caseworker tell you about it? We have United thru hubs employer and I’ve seen zero on anything on this type of supplemental in the raft of mailings and email from United. When hubs retires for real, we can do a 1 time only opt in for United retiree policy which pulls premium from his pension. But it’s somewhat pricey compared to most gap policies. Although I think will be what we do as gives us more across state lines options for MDs.
Bet you spilled your coffee when you opened that $12,500 mo. bill!!
My DH has UHC Supplemental F Plan, and although it’s pricy he pays $0 copays, which he loves to remind me about.
If they are on Medicaid, it’s going to be how your state requires medicaid to run. Between my mom & MIL we had 1/2 dz different facilities in 3 states and never saw a Medicaid bill or breakdown of what Medicaid paid for while they were alive. The Medicaid tally was sent out only after death within the estate recovery MERP paperwork.
Now any costs being paid by Medicare, CMS would send out a payment report within 2 weeks of any bills that CMS paid through Medicare. & within the CMS statement would be the possible copay due $ amount.