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I know in the state of MO Medicaid does not pay for rehab therapy even in the hospital for adults.
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Reply to Horseshoemama6
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Thank you all for your advise!
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Reply to Tovarivka
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Tovarivka: Go to Medicaid.gov and Medicare.gov.
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Reply to Llamalover47
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Medicaid may not “take over”. What can happen depends on your eligibility.

Rehab is paid by health insurance. For most over 65, they are using Medicare as their primary and then have a secondary or supplemental or gap health insurance to go with their Medicare. For most, the Medicare Part A premium is free and their Part B is taken from their SS income. The secondary will be something like BCBS, Humana, United.

Only if they are low income or a specific disease can they apply to have Medicaid as their secondary health insurance. You need to go onto your States Medicaid as health insurance site to see what is needed for you to be eligible for Medicaid as health insurance. If you do both Medicare and Medicaid as health insurance., you are considered a “dual” for health insurance billing . In theory if you are a dual, all costs covered for things billable to health insurance as long as your providers take both Medicare and Medicaid.

Now if they left Original Medicare to go onto a Medicare Advantage Plan, how they pay and deal with cost totally depends on the Plan. There are Advantage Plans set up for “duals”.

Neither MediCARE or MedicAID as health insurance will cover custodial and residential costs. This is done by the LTC Medicaid program as it is a separate program that will cover and pay the room&board residential cost for a facility like a NH. This is a different program, application and eligibility than Medicaid as health insurance. It is not automatic eligibility if you are on Medicaid for health insurance coverage to also be eligible for LTC Medicaid.

LTC Medicaid has both financial AND medical “at need” requirements. Eligibility is pretty narrow. For most States, income under $2901 a mo. and no more than 2K in nonexempt assets. The application has a lot of documentation required. If $ or assets gifted there will be penalties. If you are over in assets, you have to spend down till you are basically impoverished if you are an individual unmarried / or widowed applicant.

If you are a “dual” in rehab, and about to be discharged but cannot return home due to your care plan, so are now medically “at need” and also are financially “at need”, then you would apply for LTC Medicaid. It is not automatically done. Admissions at the NH should be able to help you with your application.
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Reply to igloo572
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Rosered6 Jan 5, 2026
Good explanation, igloo572!
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If rehab is finished and you want mom to stay in the long term care section of the facility, you then have to apply for Medicaid to pay the cost. Medicare pays for only the rehab portion.
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Reply to lealonnie1
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Rehab is covered, almost always, by Medicare. The number of days is limited per protocols that are spelled out in the Medicare sites. Medicaid will come to the fore if there is more therapy needed as an outpatient, or if it deemed and diagnosed as something that would be helpful.

Each case is different.
You don't here give us any information, which limits our ability to help you.
So I will tell you that if you have a loved one currently getting rehab as this question and all others of the Social Workers and Discharge Planners involved. If you are MPOA this will be expedited. If you are otherwise the nearest next of kin this will be expedited. You will be included in care plans and discharge plans FROM THE BEGINNING of the rehab situation.

I wish you the best.
If you want more specific answers from us then the situation should be explained to us in some detail, but your best answers will come from the current medical team involved.
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Reply to AlvaDeer
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