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A good friend just informed me that his mother (CA 87 y/o) had fallen while going up stairs, and turned out to have both broken and dislocated her elbow. She is now in the hospital to reset the bones and must have surgery. She has minimal assets, and he, his sister, and the sister's son all live in a rather small house with his mother near Cleveland, OH. He is worried that his mother might require extended rehabilitation in a facility until her arm heals. I explained the 20 day/80 day support Medicare would provide, but even the copays for more than a few days 21+ would present a financial challenge. He wondered if he should ask about Medicaid. I assume it would be difficult to get it on such short notice, but I suggested that after discharge from the hospital perhaps rehabilitation could take place at home with a physical therapist visiting (which I believe Medicare would cover). I suggested talking to a social worker at the hospital, but I'm wondering if anyone can suggest an appropriate course of action. Should he be "pro-active" in investigating Medicaid, or should he simply wait to be told what the prognosis is, and what recommended care plan is suggested and then go from there? His mother (whom I've met) seems fine mentally and is in reasonably good health otherwise although he said she is beginning to rely on a walker.

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I really can't see why she would need any rehab while the arm is broken. Maybe afterwards if there is a problem with it. My Mom had a broken shoulder that couldn't be cast. She had PT but at her home. It had to be done after it healed.
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Thanks, JoAnn29; I was thinking the same thing about a broken arm. I figure she'll end up in a cast for a certain length of time, and she'll have to make periodic visits to check her progress in healing. I would expect that she wouldn't need 20 days in rehab--perhaps just a couple to make sure there are no complications. My friend was new to all of this and knew I had parents in a nursing home plus I'm now enrolled in Medicare while his mother was still at home and he's still a decade away from Medicare.

I wasn't sure if Medicaid could be obtained that quickly in case she had to stay past 20 days. So far I haven't gotten any emails since the initial one telling me about her fall even though I've sent a few.

BTW I've seen your conversations here about NJ--I grew up in the NE part of the state (Union Twp), but have lived in 5 other states since then.

I guess I hit the wrong button, so this looks like an original comment as opposed to a reply--sorry! (I doubt the edit feature--which is great to have--allows me to change this.)
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Mom was in rehab 2x. Both times, she had a balance owed of $150 a day after the initial 20 day stay. My Mom had Medigap the second time.

When the mother is admitted to rehab, she will be asked to sign paperwork saying she is responsible for any balance left after Medicare and supplimental pays. If she cannot afford PT after the 20 days Medicare pays 100%, she needs to tell them then so the facility can apply for Medicaid on her behalf. That or ask the hospital if PT can be done at home because she can't afford rehab care past the 20 days. Really, how much therapy can they do with a broken arm.
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My dad just completed rehab after a hospital stay. He does rehab after most hospital stays. They are set up by the hospital social worker and paid by Medicare. This time he also has extended in home therapy paid by Medicare also set up by social worker. The social worker is your best ally in getting this going, and they often know of services and ways of payment you may not be familiar with
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jacobsonbob Dec 6, 2018
Thanks, Daughterof1930. As I just responded to Ahmijoy, I don't know if his mother has a Medigap or Advantage plan, but I see many of these plans cover the copay. I haven't received any updates on their situation, but I will pass this information along. Maybe by now he has contacted the social worker in the hospital. I also emailed a link to this website.

It's always good to hear from people who have "been through" the situation!
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If he does not already have at least financial POA, he needs to have that. I have always relied on the social services department at whichever facility my husband or mother was at. That does not mean he should be uninvolved—he needs to make sure all is progressing on his mother's behalf. But most social workers and financial departments at facilities are pretty good at applying to agencies who will get their statements paid
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jacobsonbob Dec 6, 2018
Thanks, Ahmijoy. I don't know if he has financial POA, but I will mention it to him. It's possible his mother still manages her own finances, but at that age it certainly doesn't hurt to get this matter taken care of because the time will come when she can't if she lives much longer.

After I posted my question, I realized I didn't know whether his mother has a Medigap plan or an Advantage plan (or perhaps neither). However, I just checked and it appears many Medigap plans cover the copay for days 21-100 (I assume recovery in this case would require much less than 100 days!)
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