If her Medicaid application was submitted, it can still be processed even if she dies. Medicaid takes 3-5 mos to get done. Medicaid will be paying the room & board aspect of her stay at the NH. Hospice does not cover this but does 100% pay for all hospice related care via Medicare. And all those months R&B once approved will be paid retroactively by the State to the NH. So it’s worthwhile to do the follow thru no matter whether dead or alive. If not, the NH room&board bill is still there and they will attempt to get paid by someone, anyone they can contact in her family. If you or another family member signed off to be financially responsible, they will try to get you to pay and at private pay rates for her stay. Not the lower Medicaid rate but private pay.
now mom does need to pay or set aside her monthly income required by Medicaid for her copay to the NH less whatever is the amount of her PNA aka personal needs allowance is. Unless your state specifically has it where the NH cannot accept the copay until Medicaid eligibility clears, she needs to have that money copay paid to the NH ea mo.
Say her SS is $ 1789.00 a mo, and her states Pna is $60, then she owes the NH $1729.00 ea mo. If she filed for Medicaid Sept 20, she owes 11 days copay for Sept. or $57.63 x 11 = $ 633.97
Hospice is a 100% MediCARE benefit. There is no copay for hospice.
the NH should have a list of documents needed in order to process her application. If you do not have this, ask billing or social worker at the NH for it. It could be quite a bit of paperwork. Try to find all and submit in 1 giant xeroxed stack. Clearly ask if it’s given to the admissions/ billing at the NH and then they in turn submit all the info along with their bill OR if whomever is POA needs to submit to the casework for mom’s application. States each run their Medicaid program uniquely.
My MIL died before the LTC NH medicaid eligibility was granted. She had 2 hospitalizations for 2 different issues and each time got discharged from hospital to the NH for rehab… all of which (rehab) is a MediCARE benefit. So her Medicaid application #1 started and stopped maybe 4 weeks in as she got hospitalized. Then she was in the hospital for like 2 mos then back to NH on rehab for weeks (Medicare again) then reapplied for LTC Medicaid once out of rehab. Maybe 4 months on LTC Medicaid and again back into the hospital. Her applications had glitches due to checks she had written for cash or to a State paid caregiver when she lived in a other part of the state ($ was all about buying alcohol, she was a most difficult person). Her last hospitalization was cause she had gotten pneumonia in the NH and then became severely septic while hospitalized; was discharged NOT back to the NH but to in-unit free standing hospice (MediCARE) where she died within 3 weeks. My BIL & SIL just dogged getting her application through, took about 10 months. Lots of foot dragging by the old NH on their paperwork and delays in getting old paperwork from old community based services & worker who got the checks. The NH sent bills to all the sons, but all lived out of state so really zero could happen there as they knew to never ever do anything to have themselves financially liable for their mom.
My point is, yes even if she passes away, her Medicaid application can still get processed & retro’d back to DOD to pay the NH. The application process can be quite overwhelming and if your grieving at the same tine, it will be very stressful. Hospice does provide bereavement benefit for family which is billed to the deceased old Medicare benefit. Very worthwhile.
And all those months R&B once approved will be paid retroactively by the State to the NH. So it’s worthwhile to do the follow thru no matter whether dead or alive. If not, the NH room&board bill is still there and they will attempt to get paid by someone, anyone they can contact in her family. If you or another family member signed off to be financially responsible, they will try to get you to pay and at private pay rates for her stay. Not the lower Medicaid rate but private pay.
now mom does need to pay or set aside her monthly income required by Medicaid for her copay to the NH less whatever is the amount of her PNA aka personal needs allowance is. Unless your state specifically has it where the NH cannot accept the copay until Medicaid eligibility clears, she needs to have that money copay paid to the NH ea mo.
Say her SS is $ 1789.00 a mo, and her states Pna is $60, then she owes the NH $1729.00 ea mo. If she filed for Medicaid Sept 20, she owes 11 days copay for Sept. or $57.63 x 11 = $ 633.97
Hospice is a 100% MediCARE benefit. There is no copay for hospice.
the NH should have a list of documents needed in order to process her application. If you do not have this, ask billing or social worker at the NH for it. It could be quite a bit of paperwork. Try to find all and submit in 1 giant xeroxed stack. Clearly ask if it’s given to the admissions/ billing at the NH and then they in turn submit all the info along with their bill OR if whomever is POA needs to submit to the casework for mom’s application. States each run their Medicaid program uniquely.
My MIL died before the LTC NH medicaid eligibility was granted. She had 2 hospitalizations for 2 different issues and each time got discharged from hospital to the NH for rehab… all of which (rehab) is a MediCARE benefit. So her Medicaid application #1 started and stopped maybe 4 weeks in as she got hospitalized. Then she was in the hospital for like 2 mos then back to NH on rehab for weeks (Medicare again) then reapplied for LTC Medicaid once out of rehab. Maybe 4 months on LTC Medicaid and again back into the hospital. Her applications had glitches due to checks she had written for cash or to a State paid caregiver when she lived in a other part of the state ($ was all about buying alcohol, she was a most difficult person). Her last hospitalization was cause she had gotten pneumonia in the NH and then became severely septic while hospitalized; was discharged NOT back to the NH but to in-unit free standing hospice (MediCARE) where she died within 3 weeks. My BIL & SIL just dogged getting her application through, took about 10 months. Lots of foot dragging by the old NH on their paperwork and delays in getting old paperwork from old community based services & worker who got the checks. The NH sent bills to all the sons, but all lived out of state so really zero could happen there as they knew to never ever do anything to have themselves financially liable for their mom.
My point is, yes even if she passes away, her Medicaid application can still get processed & retro’d back to DOD to pay the NH. The application process can be quite overwhelming and if your grieving at the same tine, it will be very stressful. Hospice does provide bereavement benefit for family which is billed to the deceased old Medicare benefit. Very worthwhile.