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I used his last VA money and social security to pay the opening of grave costs for $1700...….the NH bill was for additional 680.oo, which I just paid from my money, even though he was released from NH on the 21st of month, and they were paid for entire month...1850.00


Then another bill just arrived for $3000.00 which is the uncovered daily rate, without a supplement, after Medicare stops, 20 days and there is a daily rate fee......while waiting for Medicaid. Pending and creating a Funeral Trust with the 10,000 in Dads account...………...

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Athena- if your dad was in a NH and getting VA Aide& Attendance paid to him and also getting Medicaid LTC paid to the facility, VA will want the A&A $ repaid. It sounds like this is the situation, is that right???
Once Medicaid becomes available, A&A will need to get suspended. VA will attempt a clawback of the overage from whatever bank account the VA $ was direct deposited into. If you did the VA application, the requirement for notification (of another payer) is within the application.

You may not be aware of it as there will be a lag time, till the $ surfaces. But eventually it will.
Clawbacks done routinely. For SSA, they are pretty efficient, usually within 3 weeks. For federal / civil service retirees, a bit longer maybe 2-3 mos. For my mom, who died almost EOM, SSA paid the next month but did clawback within days of that $ being direct deposited; for my mom’s civil service spouse retirement (dad was a fed, & would be one of those required to work w/out pay during this current shutdown), they paid 2 more mos after death and did the clawback almost 3 mos to her DOD. But clawback was done, I just left the $ in mom’s old checking account untouched. VA seems to move glacially, so could be 3-6 mos+ before the clawback will be done. But it is supposed to be repaid.

The double support $ is not supposed to happen. Medicaid LTC is viewed as the preferred payout as it will pay all room&board costs and then between Medicare and Medicaid all of his health care costs are covered as he’s a “dual”. Once Medicaid step in, VA A&A stops as the M&Ms now pay all. A&A is a great program but it’s best use is to fill in the gaps between their SS and other retirements income for paying for inhome care, or AL rent or to stretch out spend down period (like to get house sold or settlement done on annuity) to get them impoverished before submitting the LTC Medicaid application. A&A with just SS $ will never pay the 6k-15k NH costs, so going Medicaid LTC is better.

Once LTC Medicaid coverage available, VA in theory switches from A&A $1500-$2500 a mo to instead be only a $90.00 / Ninety Dollar monthly resource allowance. VA will want any overlap/dupe months $$ repaid. Clawback from the account VA $ direct deposited into is what is attempted first. If acct has been closed out, VA will then go to whomever was his designated contact for VA to seek recovery. The conditions on A&A and primary / secondary payor are within the A&A application.

if this is possibly what you could be facing, to me, you need to stop spending any of the $ till you find out exactly what VA wants repaid.
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Reply to igloo572
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Was the VA money Aid and Attendance? Not sure if this should have been used to open the grave. Its for his care. May want to check that out with the VA.

If Dad was released on the 21st and you paid the month, you are due money back. They can only bill for days in the facility. Medicare didn't stop, only the 100%. They pay 50% for the next 21 to 100 days. Suppliment may pick up some of the cost.

You don't say how many total days Dad was in? I think you need to sit down with the billing department and have them explain what you are being billed for. Until you do, you can't and shouldn't pay a thing. Contact Medicaid, they may pay for the time Dad was in since you had filed. When all is said and done, there is no money in his estate and you r not liable. By law, they have to bill the supplimental.
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athena1234 Jan 13, 2019
Jo Ann I have paid the 3 thousand that I owed for the days that converted to a daily rate, as Dad had no supplement and Medicaid only covered the rest
as Dad had 10,000 in his account when he entered the NH in March as I did not understand the spend down, and I did buy a Funeral Trust with that money but Medicaid informed me that they would not pay for the dailyrate
after Medicare 20 days stops paying..so for Dads 43/4 mos the bill was 30,000 …ten thousand from Medicaid, 10 from Dad, and around 6 from myself his daughter.and by the way you can use aid and attendance money for whatever you want....the Veterans do not monitor use of the funds which is the soc and A&A as Medicaid does..why not use the
last payment in his bank account for the funeral?the NH charged me even after I had paid full month as Dad left on the 21st as well as Medicaid stops...…...frankly the NH is expensive and its a real dilemma as the room is small and shared quarters,food is not fed to Patient immidiatly..I was there everyday...better in your home with proper bed and attendants......if you can...…..Dad madeit to 97 with my caretaker Brother.So Supplements are the caveat in this scenario, the NH said only certain supplements pay the daily rate,expensive ones,250 per month, I dobt seriously that a person getting 800 per month can part with 250 extra and A&A started at 95 yrs old at 900 permo. much less as dad had all 5 adls but maybe it was held down to get Medicaid and I could have gotten the supplement paid for by the Veterans Administration but I did not know protocal and was happy to get some help for the family as brother took care of Mom who died at 90 and Dad who died at 98 so their combinied income was only 1250.00 per month.
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Don't pay your dad's bills with your money. You need your money! If Medicaid is pending, don't pay the bill you just received. Wait to see if Medicaid is approved. It can be retroactive.
I found the people at the nursing home in the billing department were very nice and kept us informed of the Medicaid application. I think there was also a representative from Medicaid we could have spoken to. But we didn't have to. The bill was paid in full by Medicaid.
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Reply to Marcia7321
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If you can have it, what does the contract say, it should spell out all fees.
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