Mom's in rehab and her Medicare/supp ins covers 120 days. Told to leave by 100th day. Advice? -

Mom's in rehab and her Medicare/supp ins covers 120 days. Told to leave by 100th day. Advice?


She needs to be in rehab longer than 100 days & then will go to assisted living facility. Her Medicaid has not been approved yet. What can I do to keep her where she is for another 20 days?

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From their website
Looks Like Aetna and Humana - they have a report card comparing services.

If they already have Medicaid, here's the phone #'s.
Automated Phone System (open 24/7)
Call 1-877-711-3662 with your pin
Follow the steps to enroll via the Automated Phone System
Medicaid Choice Counselors are available to help you enroll in a Long-term Care (LTC) plan that best fits your needs
Speak with a choice counselor via phone at 1-877-711-3662 Monday – Thursday, 8:00am to 8:00pm and Friday 8:00am – 7:00pm
TDD users ONLY call 1-866-467-4970
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This is the portal for Palm Beach County and begins the process for finding out how to apply, what's available etc.
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Can someone please help me out.... I need a contact number to fill out the diversion program application in Palm Beach county FL. and does anyone know what Insurance Providers they are currently using. Thx
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Gail - ? For you, is the facility just rehab OR is it also a SNF (skilled nursing place aka a NH)? If its more truly a rehab facility, then they require her to be out once her rehab has stopped "progressing". This may be why she needs to move. If this place seems to have lots of residents who are trauma cases or cancer post surgery types, then it's a different type of rehab & really not designed for elderly

But whatever the case, Medicare stops paying rehab (this means paying for her room & board charges as well as all health care provider services fees) either after 21 days if they do nothing OR stop progressing anytime after the first 21 days. So say its day 70 and mom has flat platuead out in PT & OT, so in moms chart is shows no progress, then Medicare won't pay it's % anymore even if you pay the copay. She cant stay as she no longer needs rehab. Speak clearly with rehab as to where mom is in this.

About the co insurance, it may be they will pay for additional rehab but it may be paying for services done via out patient care. My mom - through her high option BCBS- had about 5 months of rehab post rotor cuff surgery years ago. But out patient therapy (it was done at a sports physical therapy place) as the co insurance will not pay for any room & board costs, only pays for direct provider costs.

If your mom is viewed as being ok to going to AL, that also is part of why she must move. Rehab means skilled care. So if she is OK for AL, then she cannot stay in skilled nursing.

Are you 100% that Medicaid will pay for her AL? That this AL accepts her a Medicaid Pending? & what that means as far as her resident contract & required copay. Medicaid is primarily designed to pay the room& board & non Medicare paid aspects of a NH stay as medicaid is designed for the neccisity of skilled nursing care. Now some states have medicaid diversion programs that will pay for AL rather than the much more expensive NH. But diversion programs seem to be more limited. Most AL is private pay with a signed contract. Be sure whats what before you do all this. Good luck.
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The DPOA for my mom was not recorded in county records. I am now thinking of resigning as DPOA to allow another family member that title and responsibility. Do I need to go to an attorney for resignation as DPOA? Since original DPOA was notarized but not recorded, do I need to record the my resignation as mom's DPOA? Thanks
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Every state is different in terms of private Medigap supplements, public Part C Medicare Advantage plans, and Medicaid so it would be very hard to answer this question without further information. Some of the key and conflicting words in the question are "rehab" and "assisted living."

Basic Original Part A Medicare pays for up to 100 days of MEDICALLY NECESSARY services (often some type of "rehab") at a skilled nursing facility or rehab hospital. The first 20 days have no co-pay and the rest have a co-pay. However, the medical necessity must be ongoing.

After that, assuming the medical necessity persists, it depends on what the supplemental policy says. But apparently the medical necessity is not persisting because you say she is ready to be moved to assisted living. That leads to the second question because I was not aware of any supplement or Medicaid program that pays for assisted living? But like I said, every state is different.
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I believe that if approved, medicaid is retroactive. Talk to the social worker at the rehab facility.
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