My mother is currently in the hospital and will be discharged this week for rehab at a SNF. She is unable to take care of herself and will need long term care from this point on. I know Medicare pays for up to 20 days and there is a copay for days 21-100. How much is this copay and what if she can't pay it? She has no income other than her monthly social security. I will be applying for Medicaid for her because she is not going to be able to come home from this SNF. At what point do I apply for the Medicaid? While she's in Days 1-20? I know Medicaid won't kick in that quickly so what happens to the money owed for Medicare copays for Days 21-100? I hope I'm making sense as I'm very new to all of this and very stressed about the whole thing.
Please be aware that if you move her to long term care, and she owns her home, medicaid may force you to sell her home and use the money earned from the sale to cover her expenses, and once that money is spent down to less than $2,000 medicaid will then begin paying for her long term care. Hopefully she has already placed her house in a trust so that it won't have to be sold. However if she did not, I believe it would have to be sold and spent down in order to qualify her for medicaid. This is how it works in my state, you may want to consult an elder care attorney to verify your state's rules and regulations.
So, start looking for a long term care SNF now and plan on moving her as soon as possible! If she will not be returning home again, sell the home or stop paying rent and move her out. Her SS income will need to go toward her Medicaid "spend-down". That, and any assets, like a home, will have to be used to pay her medical expenses before Medicaid will pay.
Medicare does not pay for long term care in skilled nursing. Medicare only pays for short-term rehab as a recovery after a hospital stay, with the expectation that the patient will recover and resume their activities of daily living at home.
Your mothers insurance details the amount of copay for SNF. Also, she may be at her cap for out of pocket expenses depending on other medical expenses. Her insurance should have that amount also.
When in the Mediciad application process she will be in a pending phase until approval with the specific NAMI Mediciad amount she will be required to pay monthly. During the pending phase you will need to pay her entire income she receives monthly less Personal allowance fund to the nursing home. The facilities Social Worker and Business Office can provide you with guidance. If your mother has a lot of assets like a home, car, savings account, stocks it would be best to consult with an attorney.
It is very stressful, but remember that the SNF is not allowed to discharge your mom to home if it is unsafe, which it is not. Keep us posted.