We didn't get the approval letter until September. We spent all her funds on pre pay Funeral, etc so we do not have the money to pay July and August. The NH keeps sending us bills -past due for July and August.
I think you should contact the nursing home and find out if they ever billed Medicaid for those 2 months. Medicaid won’t pay if the nursing home doesn’t bill them.
Don’t let your nephew pay anything. Medicaid paid for all moms previous bills back to before the date we applied. They specifically told me not to pay any bills and submit them to my Medicaid caseworker. Paying them really complicates the account. Call the caseworker.
Contact Medicare/Medicaid Services and ask them what to do. It is still free number. Give them the Medicaid account number and just ask. They will tell you what to do.
Did you contact the department of public welfare to determine why the approval is not retroactive to the time she ran out of funds? Did you keep receipts for expenses incurred during the spend down process? Was there any unusual expenditures that are causing a penalty fee? You are not responsible for the nursing home bill. I would also contact the ombudsmen to see if they could be of assistance. If an elder attorney assisted you with the application, I would contact them as well. If an elder attorney was not used, you still may want to consult with one to see 8f they could assist you with a resolution of this matter.
My mother’s was made retroactive. She was approved in July and I didn’t even know it. Well, In November, I received the approval notice stating that she was approved effective July 1st prior and I had stopped paying and Medicaid paid the back pay. You reminded me of this. You are spot on.
This could be clerical error, such as applying the payment to the wrong account.
Make sure that they have not already been paid. You could create a situation that gets her kicked off Medicaid, if the facility has already been paid at some point that will get caught at which point they would credit her account, this would throw her over the asset limit for Medicaid. They will not just send the money back to the person that paid it.
So please don't let him pay until you find out for sure. If he is adamant ask him if he is prepared to continue to pay if she loses Medicaid because of the asset limit.
Often Medicaid can do a retroactive payment (up to 90 days) for bills incurred before Medicaid begins if the client through application can show eligibility. Copies of the bills need to be submitted so that they know about it. Coordination between the LTC business office and Medicaid is what is needed.
Bostongranny while it is truly wonderful your nephew is willing and wants to do this (and can) I would urge you to make sure it’s necessary before he does. Who did the Medicaid application? When you say she was approved the beginning of July is that when the application was put in or when you were actually told verbally it had been approved? I ask because while it’s possible it varies in some states (you may need to indicate the need on the application) my understanding has always been that Medicaid is retroactive to the application date once approved. NH often do the paperwork for their residents and have a very good idea if a patient is likely to qualify or not so plan on the retroactive payment. My guess is the retro payment comes separately from the monthly when that starts (Sept in your case it sounds like) so they are probably accounted for in different places. While they knew they would be paid, your MIL’s July and Aug bill wasn’t actually paid so they system generated bills, they have to so it may just be a clerical thing. Even if you did all the application paperwork, check with the NH before paying out of pocket, they will be able to tell you or at least track down what is happening internally and clarify things. Sometimes a place uses an outside billing service for instance but payments and Medicaid paperwork are done directly by NH office staff for instance.
That PA case is irrelevant. However, everyone needs to start now planning for old age care. States and federal government are both running deficits in the Medicaid program. Changes being planned where I live are going to make it more difficult to get Medicaid. The “free” nursing home is going to be harder to come by.
No need to worry about filial law. Your MIL is on Medicaid. And the case linked below is totally irrelevant and and not helpful all. It’s a totally diffident situation involving someone NOT on Medicaid and who left the country.
I cannot agree that it is totally irrelevant because I strongly suspect that the states more and more are going to take this type route if they can to save money.
I handled my Moms application for Medicaid. I supplied everything needed. I was given 90 days to get them info needed, spend down and pick a facility. Since Mom had enough money for 2 months private pay, she was placed in LTC May 1st. She paid May and June privately. In that time I did everything Medicaid needed. I called, verified that they had what they needed. Told the caseworker I paid 2 months, he put in for Medicaid to start July 1st.
What does the approval letter say about when her Medicaid started. If September 1st then thats when payments started. If it says July 1st, then thats when it should have started. Without seeing the letter, its hard to tell you what is what.
There should be a caseworkers name on the letter. Call them and explain u thought Mom was approved for July on. That neither she nor you have the money to pay July and August. Maybe they can do a retro payment.
Those filial laws are rarely used now most states have adopted Medicaid. The income and responsibilities of the children is taken in consideration. So don't worry about it.
Depending on what state you live in, you may be able to submit those NH invoices to Medicaid to pay. In my situation they were willing to pay the 3 months of any medical bills prior to my MIL's actual approval. You should talk to the Medicaid/social services offices to see if this is possible. Also, even though my MIL was approved the NH had no Medicaid beds and so to prevent her from being moved to another facility, we opted to pay the difference for her private room. Fortunately there were 3 families to split this with but it went on for almost a year. I hope you can resolve the issue!
it seems that some states are becoming more desperate to shift the costs unto anyone..and are using these old laws.
hey..in Massachusetts you can be jailed if you don’t take care of your parents health care bills. But, surprisingly, it is still on the books that you can be put in stockades on the town common for repeatedly breaking the local laws.
Just as and aside...most states really need to pass “sunset” laws.
Call the caseworker.
This could be clerical error, such as applying the payment to the wrong account.
Make sure that they have not already been paid. You could create a situation that gets her kicked off Medicaid, if the facility has already been paid at some point that will get caught at which point they would credit her account, this would throw her over the asset limit for Medicaid. They will not just send the money back to the person that paid it.
So please don't let him pay until you find out for sure. If he is adamant ask him if he is prepared to continue to pay if she loses Medicaid because of the asset limit.
He says he can afford it without it affecting him.
Thanks for the help. This is the best group ever!
Breathe!
I handled my Moms application for Medicaid. I supplied everything needed. I was given 90 days to get them info needed, spend down and pick a facility. Since Mom had enough money for 2 months private pay, she was placed in LTC May 1st. She paid May and June privately. In that time I did everything Medicaid needed. I called, verified that they had what they needed. Told the caseworker I paid 2 months, he put in for Medicaid to start July 1st.
What does the approval letter say about when her Medicaid started. If September 1st then thats when payments started. If it says July 1st, then thats when it should have started. Without seeing the letter, its hard to tell you what is what.
There should be a caseworkers name on the letter. Call them and explain u thought Mom was approved for July on. That neither she nor you have the money to pay July and August. Maybe they can do a retro payment.
Those filial laws are rarely used now most states have adopted Medicaid. The income and responsibilities of the children is taken in consideration. So don't worry about it.
but...there are some states that have laws making adult children responsible. Famous case in Pennsylvania a couple years back.
https://www.elderlawanswers.com/son-liable-for-moms-93000-nursing-home-bill-under-filial-responsibility-law-9873
it seems that some states are becoming more desperate to shift the costs unto anyone..and are using these old laws.
hey..in Massachusetts you can be jailed if you don’t take care of your parents health care bills. But, surprisingly, it is still on the books that you can be put in stockades on the town common for repeatedly breaking the local laws.
Just as and aside...most states really need to pass “sunset” laws.