She has only been there a couple of weeks.

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If it’s that she’s in rehab following a hospitalization, she likely is on MediCARE rehab benefit. MediCARE will cover her rehab, room&board usually for 20/21 days at 100% coverage. Then if she is still progressing in her rehab and her health chart clearly shows she needs beyond the initial 20/21 days, Medicare will do up to 100 days coverage at 80%. The 20% will need to be paid though.

Usually their secondary insurer will pay the 20%. But sometimes if they have an MediCARE Advantage plan, it won’t as NH and PT, OT will not be in-network for Advantage vendors / providers. So it’s private pay the 20%. It’s a fixed amount, I think like $170 a day.

While on MediCARE, her SS income is not affected.

Its if & when she applies for LTC NH Medicaid, that the required copay of her SS or any other monthly income has to be paid. This copay or SOC (share of cost) is required by Medicaid? Unless there’s a spouse or preexisting legal dependent, it has to be paid. Like say next Monday, Grannie is evaluated to be no longer progressing in rehab, she transitions from being a rehab patient to now becoming a LTC resident. So if she wants to stay in the NH & applies for LTC Medicaid, she will need to pay the NH this months SS income prorated by # of days.

Medicare does not pay for room&board, but Medicaid will if she’s “at need” for however Medicaid eligibility runs for your state. Either admissions or SW at the NH can discuss all this with you & the DPOA. There will be a whole bunch of items needed to accompany the Medicaid application. If you know she’s staying in the NH, & not returning to her home/apt/old life, even if she has few more days or weeks MediCARE rehab, I’d really really suggest you all speak with admissions as to this ASAP and get a jump on the paperwork needed. Depending on her assets, it could be quite alot of items & depending on how organized her life is could be lots of detective work to find stuff. Good luck & try not to get too overwhelmed.

oh also clearly ask if the NH accepts her as “Medicaid Pending”, not all do. If not, she’s private pay till she clears Medicaid eligibility &/or family will have to sign off a financial responsibility contact with the NH.
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Geaton777 Nov 2019
I keep forgetting how often people confuse Medicare with Medicaid...thanks, Igloo!
A rehab facility is usually a temporary location. Also, your grandmother's Medicare (and supplemental insurance, if she has it) should cover some/most of the cost for that (not sure how much).

After her covered time in rehab she will be released (with doctor's approval or insurance stops paying for it). Where was she living prior? Was she by herself in a home? Or in a NH facility? If you are concerned about her running out of money and not having enough for post-rehab care, then she will need to apply for Medicaid. She can do this by calling her county's Department of Health and Human Services, or finding it online. She can also contact her area's Local Agency on Aging for info about resources or what to do.
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