My sister has blue cross blue shield insurance and is in a nursing home she is not happy with. How can I transfer her?


She will go on medicare in June as her primary insurance and blue cross will become her secondary

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Nobody is "happy" about being in a nursing home. The only thing that would make them happy is to be about 30 years younger. Mom was unhappy at home, only briefly happy at AL and finally at the nursing home she had no idea where she was at all.
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Any new facility must be Medicare approved because any insurance becomes secondary after you reach 65 and are eligible.
Are her reasons for not being happy specific to the home she is currently in? If not she probably won't be happy in a new place either. That is just the nature of the beast.
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Coleman, I don't have an answer specific to transferring someone not on Medicare, but I'll share what I do know about transfers.

First, is she in a rehab facility, IL, AL, SNF - what kind of facility? "Nursing home" is often used to refer to any kind of facility regardless of whether it provides high, medium or low levels of medical/nursing care.

Did she enter voluntarily, or on referral from a doctor? Was she in a hospital prior to that? Is it expected that she will be in the facility for some time, i.e., several months?

If Medicare were involved, the ideal method of transferring would be to get a statement or letter from the physician who treated her prior to the placement, reaffirming the need for care, and referencing the fact that she wishes to find another facility. I don't recall without checking my copy of our letter whether or not it was stated that the existing facility was subpar and did not meet acceptable standards.

We got the letter, based on advice from our orthopedic's doctor's nurse practitioner. It was a caution since the NP had raised the issue that Medicare sometimes might not pay if a patient transfers to another rehab facility. So our "bases were covered" and there was no reimbursement interruption. No issues at all.

Since BCBS is primary, I would contact them and ask what they require in terms of documentation; then confirm it either by e-mail or letter before making the transfer.
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