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I don't know what that is, but I have never heard of anything like that, and I get all my Mom's bills. Can you post the link? $820 per day could be accurate as a daily rate on a subacute room, however. All facilities charge different rates though, in some that would be more than 20%, so again I'm not really sure. But in any case, if he had traditional with a supplemental policy, the supplemental would pay that $164.50 a day.
In Texas, non-seniors cannot have a supplemental plan (I think you mean medi-gap if you're talking about a plan that would pay this co-insurance). I was just posting, for clarification, what Medicare rules are on that.
Things really do differ from place to place. I am sorry for your experience, germaine. My brother has a really lucky deal at the place he goes. They have actual private rooms. I think they were built when it was more affordable somehow for people to use them? But now no one hardly can or they go to other places if they can, IDK.
But if you are short term rehab you can use the private room for the regular contracted Medicare rate for a 'double occupancy room'. It's really nice. There is even a sitting room with another TV, coffee table, couch and chairs for visitors.
He's never come in on Medicaid but I don't think there will be a problem when he does. The double occupancy part - I think most there must be on Medicaid. Medicare only pays 20 days and then you're self-pay or Medicaid.
Medicare pays 100 days of skilled nursing care (rehab/nursing home). It covers the first 20 days at 100%, the rest of the 100 days require a co-payment.
Medicare pays 100 days of skilled nursing care (rehab/nursing home). It covers the first 20 days at 100%, the rest of the 100 days require a co-payment.
Well for him it's the same amount! The co-insurance is $164/day. $160/day is what this place costs to be in!
In Texas, non-seniors cannot have a supplemental plan (I think you mean medi-gap if you're talking about a plan that would pay this co-insurance). I was just posting, for clarification, what Medicare rules are on that.
You didn't say he was a non-senior. Are you sure it's not Medicaid he's on? They are all Advantage plans now run by private insurers.
You didn't say he was a non-senior. Are you sure it's not Medicaid he's on? They are all Advantage plans now run by private insurers.
Positive. He makes too much. I can see into his 'MyHumana' portal. He has an advantage plan through them. I'm sorry I didn't mention before he is not a senior. In Texas, that matters for Medi-gap. Seniors can have it for $500 a month but non-seniors can't get it at any price.
That's WAY cheap for a daily rate, even for room only.
Yeah IDK what to say. It's a low cost of living state compared to many? That is what it said on their website and then when I asked the facility she said that is the insurance contracted rate I think,.... and she sort of trailed off. Said I really need to talk to business manager. And they JUST picked up Humana contract to complicate things a bit further.
I might get to see exactly soon. Someone is supposed to send me an itemized bill. If it's complete, it will show days Humana covered but he paid co-insurance and days from another visit he was self-pay.
But anyway I was mainly just sharing what I learned in general. That it doesn't SEEM to be 80/20 for this. Not pretending I have a full handle on that, but the medicare site doesn't say 80/20, it says that specific co-insurance amount of 164/day for days 21-100.
Yeah IDK what to say. It's a low cost of living state compared to many? That is what it said on their website and then when I asked the facility she said that is the insurance contracted rate I think,.... and she sort of trailed off. Said I really need to talk to business manager. And they JUST picked up Humana contract to complicate things a bit further.
I might get to see exactly soon. Someone is supposed to send me an itemized bill. If it's complete, it will show days Humana covered but he paid co-insurance and days from another visit he was self-pay.
But anyway I was mainly just sharing what I learned in general. That it doesn't SEEM to be 80/20 for this. Not pretending I have a full handle on that, but the medicare site doesn't say 80/20, it says that specific co-insurance amount of 164/day for days 21-100.
I understand that, but again it is inaccurate to say that is a Medicare rule, it is not. It is Texas specific, and Medicare for non-seniors is obviously under different guidelines. I just don't want people to get the idea that $164 day applies to Medicare in general, it does not, nor that Medicare only pays for 20 days.
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