Follow
Share

My mom was recently hospitalized for the flu. Her insurance denied the claim saying she could have received in-home treatment instead. Her monthly expenses are already exceeding her income. I pay all her bills and without the financial support of my sisters and I, she wouldn’t be making the ends meet now. My sisters and I are tapped out and can’t contribute any additional money to pay the hospital bills. Her income is just over the allowable amount to receive Medicaid so that isn’t an an option. She lives in the least expensive assisted living place we could find. One of my sisters and I are on her checking account. If the bills are turned over to a collection agency, would we be liable for payment? She has no assets-house, car, or any investments that could be sold. What happens in a situation where there literally isn’t any money to pay bills?

This question has been closed for answers. Ask a New Question.
I just double-checked for North Carolina re Medicaid payment for assisted living, This is what I found:

Medicaid Coverage of Assisted Living Services in North Carolina
Assisted living facilities are generally less expensive and less medically intensive than nursing homes, but are not cheap by any means. Most North Carolina residents living in assisted living facilities pay their own costs. Generally speaking, Medicaid does not cover room and board fees in assisted living facilities. However, if you have little income and few assets, you may qualify for a program that helps pay for assisted living facilities.
Helpful Answer (0)
Report

Call the Area Agency on Aging for assistance with this or Medicaid issues.
Helpful Answer (0)
Report

File an appeal on the insurance denial IMMEDIATELY. You have 60 days. File the appeal even if they say that they're working on it so that you don't miss the deadline. And if necessary, file an appeal at the 2nd denial.
Helpful Answer (0)
Report

Sorry, one more thing. Even if you have Medicare, you can still get the Medicaid Long Term Care, that's for the services/supplies mentioned above.

Then there is the other part of Long Term Care which is called MMA, Managed Medical Assistance, which covers medical needs, dr. bills, physical therapy when needed, etc.
Helpful Answer (0)
Report

Sorry, but that is not true. If someone can qualify for Medicaid Long Term Care, they are covered for: 1. Nursing home, if the meet the level of care requirements, 2. Assisted living facility, 3. own home or apt. or mobile home or whatever - they can get personal care and homemaking services, plus incontinence supplies if needed.

Those who say get an elder care attorney are correct. It is not inexpensive to get one, but if one has no, or very little liquid assets, and within the income guidelines, they can get Medicaid Long Term Care. The area agency on aging should help, but if not, see an elder care attorney.
Helpful Answer (0)
Report

If/when your mother does become eligible for Medicaid, it would be better financially if she qualifies for nursing home/memory care as opposed to assisted living. Medicaid generally covers nursing home/memory care, but not assisted living. Of course, no one wants to be in a nursing home if she/he could manage in AL, and your mom would need to qualify for a nursing home in terms of activities of daily living to get Medicaid once she qualifies financially.
Helpful Answer (0)
Report

If/when your mother does become eligible for Medicaid, it would be better financially if she qualifies for nursing home/memory care as opposed to assisted living. Medicaid generally covers nursing home/memory care, but not assisted living. Of course, no one wants to be in a nursing home if she/he could manage in AL, and your mom would need to qualify for a nursing home in terms of activities of daily living to get Medicaid once she qualifies financially.
Helpful Answer (0)
Report

BarbBrooklyn: OP states "her income is just over the allowable amount to receive Medicaid." That's puzzling and yes, I saw your other post about the Miller Trust.
Helpful Answer (0)
Report

Creditors will come knocking. But it's still not your responsibility. They cannot force you. I read that if you pay even once, then you will be obligated. So do not pay.
Helpful Answer (1)
Report

Why is your mom not eligible for Medicaid?
Helpful Answer (1)
Report

Thank you all for your suggestions. We’re in NC and from what the woman at the Agency on Aging told me there is no assistance for my mom. She was very unhelpful. My mom has no assets and is not eligible for Medicaid. Right now I’m waiting to see what the hospital and insurance company decide. I was told that if we can’t pay the bill it would be turned over to a collection agency. It really doesn’t make a difference who comes collecting if there’s no money. The lady at the Agency on Aging suggested paying something. There literally is NO extra money to pay something. I pay her pc dr appointment bills from our income just to make sure she can see him. Thanks again for your advise and suggestions. Much better than the Agency on Aging.
Helpful Answer (3)
Report

What State do you live in? In Ohio there is a program called Passport that you can contact for services for seniors. I did this last year for my parents and was able to get a free 30 consultation with an attorney to discuss legal issues.  Check out state agencies first. Catholic Family Services was a big help in getting advice in applying for Medicaid, you don’t have to be Catholic to get help. Their doctor's practice also has an on-staff social worker to 
consult.
Helpful Answer (2)
Report

Elder law attorney is needed STAT.
Helpful Answer (3)
Report

It's my understanding that "observation" at a hospital is not covered by insurance even if the patient is there overnight. Insurance usually only covers admission and in-patient services.
Helpful Answer (4)
Report

You need to speak to a Senior Finacial Advisor. They can help turn any retirement, into an annuity. If either of you has a Durable Power of Attorney, you can spend money to pay her bills, to her down to the allowable amount to qualify for Medicaid. Once she has below the 2k mark and her SS money is going to help for the Nursing Home, you can start the Medicaid process...
Helpful Answer (2)
Report

Thank you so much for the suggestions. I haven’t received a bill from the hospital yet. The insurance company was going to work with the Hospital concerning coding, so there may be help yet. I’ll pay more attention to the reason for admission if there is a next hospital stay. I didn’t realize that there was a difference between admitting a person and admitting a person for observation. Observation would have been covered, admission was not. My knowledge is increasing all the time. Thanks again!
Helpful Answer (3)
Report

If you did not co-sign the credit card or other bills, it's not on you. Don't pay if your name is not on the account holder or co-signer or guarantor line.
Helpful Answer (5)
Report

You are not responsible for her bills? Have you gotten the final bill from the Hospital. If not, wait. Sometimes there are adjustments. If not, then call the billing office, they may have coded it wrong. If Mom was admitted then there was a reason. This years strain was deadly. Maybe Mom had a predisposition that made her case serious. You need to cover all angles before making payment. How old is Mom? A bill going to collections is not going to hurt her credit. Doubt if she will be buying a car or a house.
Helpful Answer (6)
Report

Challenge the denial. Ask her doctor to justify the reasons she needed hospitalization.

If she's over the limit for Medicaid, you go to an Eldercare attorney to create a Qualified (or Miller) income trust, which diverts her overage to a trust which reverts to the state upon death. Does the AL accept Medicaid?
Helpful Answer (8)
Report

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