Follow
Share

My parents are in a nursing home on Medicaid ,the pharmacy they use says I need to pay the co pays. Originally I was told to hang on to the bills, but now they say I need to pay them. If they only get $30 a month for incidentals how are they supposed to pay it. They also have Tricare which they say I should cancel. The bill is now several hundred dollars!!!! Am I legally responsible as POA?

This question has been closed for answers. Ask a New Question.
CMS, the federal govermenl agency in charge of Medicare and Medicaid says this:

Q: I have Medicare and Medicaid, both of which pay for most of my health care. But my doctor is telling me I still owe money. Is this right?

A: If you have both Medicare and Medicaid, and the service you received is covered under Medicare, your doctor's office cannot bill you for any Medicare co-pay costs. If you have Medicare Parts A and B (also known as Original Medicare) or are in a Medicare health plan, AND Medicaid helps you pay for Medicare premiums deductibles, and coinsurance, you are probably a Qualified Medicare Beneficiary (QMB).

Note: your doctor may bill you for Medicaid co-pays. Please check with your local Medicaid office to find out more about your Medicaid status, including Medicaid co-pays. If you are still being told to pay a Medicare co-pay and the service is covered by Medicare, please contact 1-800-MEDICARE to file an anonymous complaint.
Helpful Answer (0)
Report

Medicaid pays for meds. TRiCare told me that all the bills go to Medicare, TriCare and then Medicaid, so you should not have to pay anything. Hope this helps.
Helpful Answer (4)
Report

Wow, that is exactly what I went through. Fortunately, my mom had an elder-law attorney and I would highly recommend, if you can afford, to get one to assist you with Medicaid; that is what I ended up doing. Not sure how it works in your state, but our lawyer told us to hang onto the bills and not pay them as my mom was Medicaid pending. So, as far as I know, you would not have to pay those Medicaid bills as the pharmacy has to write off the rest (again, this is only as I understand it, however, would consult an attorney). Also, our lawyer told us NOT to cancel my mom's other insurance, which, as our history shows, to date, this was a good choice NOT to cancel my mom's other insurance. So, as it went, my mom had Medicare, then secondary insurance, then Medicaid and all went well. As concerning the question are you legally responsible, not according to our lawyer, as you are acting on behalf of your parents. The only time you would be responsible is if you signed as a beneficiary, which would mean, essentially, their bill is your bill. I think it is a good idea to have an elder-law attorney to help you as this is what essentially helped me through all the rough times with the nursing home/Medicaid issue. Hope this helps and good luck. It is a tough time in your life with all this going on - I know - I am living it now.
Helpful Answer (2)
Report

I am sorry to hear that both your parents are requiring some form of Nursing home facility whether its assisted living or a nursing home itself. At least they had the good insight to prepare for the Nursing home care if that truly happened, meaning that they are not spending down all their assets to pay for their assistance. In some cases you can't avoid this happening. Unfortunately, my wife (age 57) was diagnosed with early on-set Alzheimer here a year ago after having several emergency surgeries with regards to other issues. We had previously gotten her on ss disability which paid for her medicare plan B. We were getting huge medical bills regardless and I found perhaps some good info for you on the back page of the medicare handbook (Medicare and You--available on-line or at your local Social Security office.) The Agency is called (SHIP) State Health Insurance Assistance Program with a provided toll free number. Through this agency we get the vast majority of all our medications for her paid.past and present. We pay roughly 1% of the cost of the med's. They were a God send!! Hope this can give you some direction and help.
Helpful Answer (2)
Report

I am a social worker in N.Y. Most people on Meidcaid should be eligible for "extra help" through medicaid and should not have to pay a co-pay. Speak to the S.W. at the NH who should be able to direct you. Also, $30 sounds too low. I forget the exact amount, but it should be higher. Check with the SW, Medicaid or Dept. on Aging.
Helpful Answer (2)
Report

Do not cancel TriCare, find a pharmacy that accepts Tricare and have the prescriptions filled there. It will save you lots of money
Helpful Answer (1)
Report

My son is in a Nursing home & all residents have to pay a small co-pay for their meds.
I am his POA.
I'm not sure what state you are in but here in CT the patients are allowed $68./monthfrom their SS pensions.
I would want to believe that this amt. is equal, no matter where you live.
Yes, I do believe that with recieving such a small monthly stipend, there should be a fund to help pay fo rco-pays.
It seems unfair that this allowance has to be used for anything other than their own personal needs.
But then, the system is not all fair nor reasonable.
Have you checked to see if there may be other avenues of financial help, such as the Soldiers, Sailors & Marine fund ?
The Nursing home should have some info , if there is indeed any other help for the residents.
Helpful Answer (0)
Report

I would contact Tricare and Medicair as their POA and find out exactly what is what. You are not responsible for their bills, they are, you help them pay them as a POA and sign as such.
Helpful Answer (0)
Report

Oops, I mean Medicaid.
Helpful Answer (0)
Report

In WI they only get to keep $45. from their SS. but when your in the NH there is no copayments.. That is in Wisconsin
Helpful Answer (0)
Report

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