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My sister, a schizophrenic, has been deemed unable to live independently. She presently has a "Gold-Advantage level Humana policy, but her case worker suggested we'd be better off letting the Humana lapse and relying upon Medicaid. True? What coverage would my sister get while she lives in this facility?

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Yes, I agree. Medicare will possible pay for the first 90 days and then you will be responsible unless Medicaid is an option. I would also suggest you get with your care worker and inquire about her eligibility. You need to apply as soon as possible. I am not sure about other states but in TN if she owns a home as someone stated above she would not qualify for Medicaid.
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Whoa-- MediCare never covers Assisted Living! It only covers rehab or Skilled Nursing Facility, and only very limited stay, and only if they were inpatient in hospital for 3 days (and not for "observation"). Medicare NEVER pays Assisted Living.
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Thank you, both! You've been very helpful. I had so much trouble deciphering the "jungle" of websites out there. We will follow your advice.
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If your mom has no assets I would check on Medicaid. They would probably take her Social Security check and the balance would be paid by Medicaid. Medicare would only cover the first 90 days.
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This health plan should be supplemental. Medicare will only cover 80% in many cases and stops coverage once a patient plateaus. Would a ALF accept Medicare as payment for a long placement? Check on that. :)
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Sorry. I meant Medicare. And, she has absolutely no assets beyond Social Security. She is enrolled in Humana Gold as a supplement to Medicare, but the caseworker has suggested it might be easier and more efficient to deal only with Medicare. Thanks!
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First of all, you have to apply for Medicaid (takes a longgggg time), and then you have to spend down all her assets except for something like $1200. There's a lot more to it than this but gives you an idea of what is involved. And there's the 5-year look back. Also make sure the ALF takes Medicaid, some may not. She can keep a house and a car, and a small amount of life insurance. Do some research before you let the insurance lapse and consult an attorney for sure. Best of luck. :)

-SS
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