Nursing home stay with a transition to Assisted Living while on Medicaid. What am I missing? - AgingCare.com

Nursing home stay with a transition to Assisted Living while on Medicaid. What am I missing?

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My mother was in a nursing home and on Medicaid. She has a higher income than most--in tax exempt status she brings home ~$3400/month. Her share of cost to the nursing home was $2879. She recently moved into assisted living. I received a Notice of Action from Medicaid and they are stating she needs to pay her share of cost of $2179 PLUS the facility's room and board so the combined total is more than she had to pay in the nursing home. I'm confused as the social worker told me since she would have sufficient funds to pay the entire amount in assisted living, she may go off Medicaid. What am I missing here?

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What Jeanne says is correct. You need information specific to your mom's State and her financial situation. I would request a sit-down with the facility social worker and business office to sort out whether it's better for your mom to continue with Medicaid at this time. It may be that paying the cost of the AL is less expensive than dancing with Medicaid, but only the facility can tell you that.
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The over-all cost for NH is higher than ALs, but in NH the "room and board" charge is covered, but in AL "room and board" is not covered.

Make sense? I don't think so, either, but Medicaid is strange and wondrous. It is also a godsend. Not all states cover AL at all, and some have Elderly Waiver programs that do not separate out room and board, and not all ALs accept Medicaid even if the state allows it, so maybe we should just be happy Mom is getting the coverage she is.
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