Is a supplemental insurance needed when a person has Medicare and Medicaid?

Mom accidentally let her supplemental insurance lapse. What I learned was that (in Massachusetts) it could be reinstated for up to 6 months after. Six months had already passed. At that time, she was not receiving Medicaid. I could, however, re-enroll her. In terms of someone already on Medicaid, not sure if anything changes, but I say, "No time like the present!" Hope that you were able to already:)

Hi all, I called mutual of Omaha headquarters here in Illinois today and they said we had 14 days to reinstate the insurance from the day we canceled. However, in the meantime, the financial office at my moms AL, called Medicaid for me and was told mom is on "full" Medicaid, therefore does not need a supplement that she has been paying on for two years.  I do a real realize that money she's been paying out goes to the  AL.  I'm wondering why no one caught this before when my mom signed up to live there ?  Very thankful for that because in the past it has always been so difficult to get help from that office. I'm just now stepping in and helping mom with her finances and learning how to navigate the system. Whew! What a mental challenge it is... not sure if I've gained or lost brain cells on this one but definitely have learned a lot of valuable information. 
My biggest beef is, is that the local insurance company here that sold her the Mutual of Omaha, told me her agent (that signed her up) a couple of years ago retired and there was no one that could answer our questions. When I finally called Mutual of Omaha headquarters yesterday, the girl that helped us was very kind and explained things so well, it was very easy actually.  My parents are divorced,  they live at the same AL ...my dad has Medicare and full Medicaid with no supplement.  Mom has Medicare, plus a pension from ex-husband and on Medicaid.  I think I see now why she was on a supplement, was it because she had that extra income and could afford it  and helps out with Medicaid part ? And I still don't understand the "full" Medicaid thing.

If I would have the POA papers already sent to Medicaid, I could have called them myself instead of driving myself nuts last week and took care of it from the beginning.  That was something I got lazy with and just didn't do because mom was doing so well for so long but now she's not.
 Save yourself some frustration and get your POA's out!!😉

 Thank you everyone for your help 💜

Bella
What happened to this post where you realized you were using the supplement?


“Went over moms EOB's from Mutual of Omaha and it has been paying pretty good on different doctor visits and procedures etc. Based on the advice given here, I want to try to get that insurance reinstated on Monday
Last Thursday is when she canceled it, I just hope it's not too late!!
Does anyone know???”

I'm sorry, I don't know what you mean??

Well maybe I read it incorrectly.
It seemed like earlier you were deciding to keep the supplement after all because you found it had paid some bills not covered by Medicaid.
Then today you found out that your mom was on full Medicaid so even though you are within the time frame to reinstate you had decided to not reinstate because she has full Medicaid.
Not all drs take Medicaid. Mom has some doctors that evidently don’t because the supplement paid.
Did I misunderstand your intentions?

They paid a portion after Medicare then Medicaid picked up the rest.
I chose not to reinstate because Medicaid told me since she's on full Medicaid it wasn't necessary
Now I'm REALLY confused

want to give up

Lol. I’m confused too. But it looks like you could go either way.
After reading on the Medicare.gov website I see that all medical claims are first paid by Medicare and the supplement before being paid by Medicaid.
So the Mutual of Omaha payments would have been paid for any dr appointments that took Medicare. It wouldn’t mean they didn’t take Medicaid. You would have to ask the doctors office.
As far as cost goes it’s the same to your mom regardless as has been discussed in the previous posts.
The only advantage to keeping the supplement would be if there was a doctor or procedure needed that Medicaid didn’t pay for but that Medicare and the supplement would. So for the same money you potentially get additional coverage. ( if I understand it correctly).
You do have the chore of paying for the supplement with the money Medicaid allowed mom to keep for that purpose.

My understanding is this. If you keep her supplemental, her PPA (patient paid amount goes down the amount of the monthly premium so that she can continue to pay the premium. In other words, it shouldn't cost her anything more. And, 97yroldmom is right, some doctors don't accept Medicaid patients....and that list is growing. I would keep the supplemental and have Medicaid Long-term care adjust the PPA. Same cost, better coverage with all three. With this set-up, Medicare is the primary coverage, her supplemental is her secondary insurance, and Medicaid is the tertiary. Generally, the cost of supplemental premiums is less than the bills your loved one will generate in any given year, especially if there is a hospitalization which is why Medicaid allows people to maintain their supplemental insurance. Why not reinstate it until you can figure out all of this to your satisfaction? I wouldn't base my decision solely on the nursing home business office:)

Is your amount in Assisted Living or Nursing Home?

AL

Regular Medicare (A/B) only pays for 'nursing homes' for medical care purposes; and it only covers short-term stays. If you want Medicare to help pay for long-term care (nursing home or 'memory care'), then a person has to have a specific supplemental policy for that. It is not included in "regular" Medicare benefits. Medicare only pays for short-term 'rehab' care (after hospitalization, etc.); after a certain number of allotted days, Medicare stops paying and a person/family has to find out how to foot the bill if more than the allotted days are needed in a care facility.
If she ends up being Medicaid eligible (qualifications differs from state to state), Medicaid will pick up the nursing home cost. However, she'd then have restricted choices of where to go, based on which facilities accept/have openings for 'Medicaid waiver' patients.
If a person is close to qualifying for Medicaid, but not quite low enough with their income/assets, then most states offer the option of having the person pay for a private insurance policy as a "spend down" to make their income limit low enough to qualify for Medicaid. That needs to be a particular kind of policy - in our state (NE), it can't be just a 'regular' medical care policy, it needs to be vision/dental/cancer care, etc. Insurance agents that help with elder care policies should know the types that qualify, as would Elder Care attorneys. Our NE state's limit to qualify for Medicaid eligibility is $1,028/mo income and not more than $2,000 in 'assets'- that includes property, life insurance policies, retirement plans, annuities, savings/checking accounts- basically everything excepts a 'special needs trust' handled by a conservator/lawyer and an 'irrevocable burial fund' directly paid to a funeral home/cemetery.
I believe that for Medicare qualification, a person can purchase a supplemental policy to 'spend down' their income to become eligible if they are close to the eligibility capped limit. I don't think those have to be a specific type of policy.
As you have unfortunately found out, sorting through options for care, cost of care, and insurance coverage gets very complicated when you're trying to figure out private pay vs. entitlements. And it is even more difficult, now that most states (NE included) have done away with dedicated case managers to cut DHHS costs. Every state or county should have an AAA Agency for Aging Assistance whose contact info could be found in the government pages of a phone book or by calling the national "211" number for local resource assistance. Hopefully, your mother's Primary Care Physician has a medical social worker at that office (likely have one if they are a hospital-based clinic). Both of these sources can be very helpful in figuring out levels of care and costs/coverage for such.