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Not sure I’m in the right place but was discussing this with someone and one of us is clearly under informed. For reference, my mom is in a NH and pays for her stay. Since she has MC Part D the NH orders her prescriptions from the pharmacy and I get billed her copay/co-insurance. The dr that sees her there submits his bill and gets reimbursed directly from MC and her supplement. They also order non medical supplies (diapers, shampoo, soap, gloves, daily vitamins, etc) and bill me. They do her laundry (she pays $1 a day for this).
An acquaintance has her mom there as well. She’s about to qualify for Medicaid. She states everything will be covered. Shampoo, laundry, vitamins, etc.
My mom has money for about another year to live there so I’m starting to inquire. Can’t get a straight answer from anyone in her place. One person says yes, another says no and a third admitted she had no idea. Is there a link somewhere anyone knows of? Tried to find some info and having trouble.
I was the guardian for a friend in a nursing home and it paid part of her room and board. They determined how much we could afford to pay. They don’t cover anything else. Not sure if it varies by state.
I know that in my mom's case she had pressure sores and needed a special inflatable mattress with pump, A MEDICAL NECESSITY to prevent the sores from getting worse, and CA medicaid would not pay for it in the NH. We paid out of pocket for the rental of that piece of equipment. I don't see how they would pay for anything but the bare minimum of personal care items.
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
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We are in WA state, but when my MIL was on medicaid they would only pay for prescription items, not over-the-counter. We had to pay for things like vitamins and Boost, but shampoo and soap were provided by the adult family home operators.
I really hope diapers are included as they’re a major expense for my mother. What happens to people that have no money and no relatives to pay for these things?
I really hope diapers are included as they’re a major expense for my mother. What happens to people that have no money and no relatives to pay for these things?
My brother is in a nursing home, and I asked their business office how bills get paid when he has no money. She just shrugged!!!!
It's important for people to realize before they get there that Medicare does NOT pay for long-term care in either a nursing home (NH) or assisted living facility (ALF). For specialist and related care, Medicare becomes the primary payer and Medicaid becomes the secondary payer (I'm not sure if or how diapers are included under this, but, suspect they are).
Most states will pay for limited "Institutional Care" under Medicaid, which covers room, board and basic nursing care. However, one can have only a bare minimum income and virtually no assets (such as not owning a home). There is also a 5-year 'look-back' window to ensure that people are not simply transferring or dumping assets to qualify. 'Shared spousal assets' are also closely examined.
Finally, not all NH's accept Medicaid and those that do typically have a limited number of beds for Medicaid patients and often have a waiting list for those. Those that do accept Medicaid are subject to Federal guidelines and regular inspections.
Your question about what happens to people with no money or relatives to pay for these things, is a good one - and there is no clear answer. I've known a number of 'street' people who wind-up living in HUD housing and later, even they, may/may not qualify for Institutional nursing home care under Medicaid.
I tried to find and answer to this before too and if memory serves they pay for very little something like 70% of the daily room rate for shared room. . . Not much help I know.
COnsult an elder care attorney who knows the laws of your state.
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