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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.

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Luckily she will be staying in the same facility as she is in now for her short term rehab. Can the nursing home social worker help me get started applying for Medicaid or do I need to do that all on my own? Will I be assigned an actual Medicaid caseworker that will help and answer any questions I have? Also at what point will her Social Security be signed over to the nursing home? Is that after she is approved for Medicaid? We are in WV and I don't think they can make us sell the house before getting Medicaid. They will place a lien on the property. Thank you all for your help.
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Reply to MegKelly50
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Hi there! You should apply immediately! When the Medicaid is approved, it will be approved retroactively for the day you applied forward. In other words, if your mom is approved for medicaid, her bills will be covered from the day she applies forward.
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.
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Reply to ClaraKate
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Apply for Medicaid now. If she is approved, they will pay retroactively, although there are conditions to paying for Rehab at an SNF. She must continue to show improvement and become more independent or Rehab can't bill for services.

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.
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Reply to CaringWifeAZ
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After day 20 the copay is 50% out of pocket. You can appeal to Medicare if she is deemed not progressing and that allows some time to get the Mediciad application started. You will apply for Mediciad at the time she has spent down all assets to the States threshold (Most cases approx. $2,000).

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.
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Reply to AMZebbC
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21 to 100 days Medicare only pays 50%. So, I would tell Rehab that there is no money passed the 20 days. If they have Longterm care in the same building, that would make an easy transition for you. Get the Medicaid ball rolling now. In my State you have 90 days to spend down, get info requested back to them and find a place for Mom. I would contact Sovial Services and speak to a Medicaid caseworker. I worked with Medivcaid the LTC facility worked with me.
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Reply to JoAnn29
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Thank you Midwest, I will definitely speak to the social worker.
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Reply to MegKelly50
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Others here likely know the specifics, but my recommendation is to speak with the SNF social worker as soon as possible and explain the situation. They should be able to guide you through. Let them know that you are not able to care for your mom and need to find placement.

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.
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Reply to MidwestOT
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