Follow
Share

We receive a bill from MassHealth for $110,000.00 for the services that my mom receive from meals on wheels, personal attendants during the day for a few hours & doctor visits, she cold not be alone so we took care of her. She fell twice, fracture her arm & her hip. After hospital stay she went to Rehab at a nursing home & then home. Is there any way we can have the bill waived or reduced?

This question has been closed for answers. Ask a New Question.
E - my point is that Meals is getting funding and there are strings attached in some way. Someone whether it's a foundation, city agency, church group, private organization or state program is underwriting the costs for Meals. I'd bet that if state Medicaid pays for Nightingale's mom's Meals program, they (Meals) in turn have to be able to show they bill someone in order to be within compliance for getting Medicaid funding. This is along the lines of what Medicaid has to do with home ownership and the MERP (after death estate recovery) program. MERP comes into play by placing a claim or lien on the property after death. Not all states have a organized MERP program but all states are required to have something in place to be within compliance to participate and get federal funding for Medicaid which each state then administers. MERP issues on this site are usually about "momma's house" type of ? but MERP can place a claim or lien on the property for getting benefits from other type of Medicaid payments - like the Star Plus program or other programs which get Medicaid funding. I think only WIC programs are excluded from recovery though. So if Meals got Medicaid $ then the state could have this billed for and included in the person's MERP tally. If they have no assets after death, then MERP doesn't matter. But if they have a house, then MERP can make a claim or lien even years and years later.

NIGHTINGALE - as others have said, look to see just exactly what the statement is. If it is a bill, well, first of all, you personally are not responsible for paying it; but if you are mom's MPOA, DPOA then you have to do your best to make sure that her insurance companies are billed for any & all services. Look to see, if there is a category that states - insurance anticipated. Whatever that amount leaves out is what mom's secondary policy should pay. And then whatever is left after that is what she is personally responsible for. This could be quite alot or nothing. Depends on what her coverage is. If she saw out-of-network or non participating
providers then there often is NO payment and NO deduction and the costs could be staggering. Keep in mind that most bankruptcy in the US is due to health care bills. So if you find that mom is going to be personally responsible for the bills, you are not alone. Not that this makes it better - it's a real nightmare to deal with. Keep in mind that providers use billing agencies and most take the route that any bill without insurance on file is due 90 days and then turned over for collection. If you think (horrors!!!) that mom might be responsible for 110large, then you need to get letters to each provider that you get a bill from requesting the validilty and details on the billed services. Make sure it reads as written by mom and her address (or if you think this is going to be a real problem, then get a post office box or other private mail box so all things 110large go to this address so you can keep better track of stuff.) Letters get sent certified mail with a return registered receipt card (the green card at the postoffice). This doesn't make the $ go away per se but makes the provider have to provide lots and lots of paperwork and it buys mom (you) time to figure out what to do.

If she was on MediCARE, then Medicare should have taken care of 80% of the hospitalization stay and 100% of the "rehab" room & boards costs at the NH for 21 or 28 days. Now Medicare cover most but not all medical expenses. Her secondary policy (like Blue Cross traditional style polices or a good senior policy like from Humana) usually pays for most of the other expenses at whatever their negotiated rate is with the provider. If she had Medicaid, then there should be no billing or costs to her - Medicaid means zero due. You have no say in what the negotiated fee and deduction is - that is determined by the providers and insurers. The provider can bill you for whatever is left after - except if it was paid by Medicaid (that is zero). Good luck and let us know what happens.
Helpful Answer (0)
Report

Is Meals on Wheels billed according to state? My dad had Meals on Wheels but we didn't have to pay for it. We're in MO.

And I was thinking the same thing. Maybe it's not a bill but a statement of services provided. I get what looks like a bill every month for prescriptions, it has a dollar amount on it and everything but it's just kind of an FYI for what I save with prescription insurance.
Helpful Answer (0)
Report

Meals isn't free as there is funding coming from something to pay for it. If the local Meals on Wheels is getting funding that comes from a grant or is in a line item in the states various programs within Medicaid, then it can get tacked on. Some states have all Medicaid programs - exempt WIC one's - done so they are billable and recoverable.
Helpful Answer (0)
Report

I understand that MassHealth is the state's program that administers Medicaid.

What is the nature of the statement you received? Is it really a bill, or a summary of services provided?

Had your mother qualified for MassHealth before these services were provided? Is she now approved for the program?
Helpful Answer (0)
Report

If I saw a $110,000 bill I think I would faint dead away.

Meals on Wheels is free and your mom should not be billed for that service.

Is the rest of the bill itemized? Because if someone is trying to bill you for Meals on Wheels I would question the entire bill. How often did she have caregivers? How many Dr.'s visits were there?

Does your mom not have any insurance? A bill this size for Meals on Wheels (which is a free service), caregivers a few hours a day and Dr. visits does not seem possible. When you arranged to have caregivers come in and care for your mom what kind of financial arrangements were made? An agency won't commit and send out caregivers if they don't think they're going to get paid. Usually someone will either send a check to the agency when billed or their long term care insurance pays for the caregivers. Did your mom send the home health agency a check at any time?

And while she was in the rehab and then the nursing home didn't your mom's insurance cover that?
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter