Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
My 90 y.o. mom has a supplemental policy she got when she was 70 (Blue Cross Medex Bronze). In 20 years, she has never seen one bill!
I've been paying for that, but can no longer afford it. I got her on Medicaid and my question is:
She has had both hips replaced and a recent accident where she was in the hospital for a week and a great rehab for 3 weeks. Numerous trips to the ER.
I look at what Blue Cross has paid out and it's ALOT. The recent accident was $36K for the hospital and $25K for the rehab.
If you have Medicare and Medicaid, will there be co-pays involved? And for all the above services she has received, are there things that Medicaid would NOT have paid for?
My late husband was on Medicare and Medicaid for nine months. During that time he was hospitalized five times, plus had several weeks of rehab. He had zero co-pay for his hospital/medical/doctor bills.
However, I/we paid almost $2,000 a month for our "cost share" portion to allow him to be on Medicaid (basically his SS payment). This had nothing to do with his medical bills.
I *think* that Medicaid coverage that is paying for someone to live in a nursing home is handled differently than Medicaid that is only a person or family's health insurance coverage.
Medicaid paid for my Mom's last few years in a nursing home and all but $50 per month of her Social Security was applied to the nursing home's monthly charge.
Medicaid as health insurance for a person living in the community is something different.
My late husband was on Medicare and Medicaid for nine months. During that time he was hospitalized five times, plus had several weeks of rehab. He had zero co-pay for his hospital/medical/doctor bills.
However, I/we paid almost $2,000 a month for our "cost share" portion to allow him to be on Medicaid (basically his SS payment). This had nothing to do with his medical bills.
I don't understand the "cost-share" statement? Can you please explain?
My 90 y.o. mom has a supplemental policy she got when she was 70 (Blue Cross Medex Bronze). In 20 years, she has never seen one bill!
I've been paying for that, but can no longer afford it. I got her on Medicaid and my question is:
She has had both hips replaced and a recent accident where she was in the hospital for a week and a great rehab for 3 weeks. Numerous trips to the ER.
I look at what Blue Cross has paid out and it's ALOT. The recent accident was $36K for the hospital and $25K for the rehab.
If you have Medicare and Medicaid, will there be co-pays involved? And for all the above services she has received, are there things that Medicaid would NOT have paid for?
Thanks All,
Jules
My mom does not have a co-pay. She is in a Blue Cross plan (in NJ they switch you from Medicare to a managed Medicaid plan once you are on Medicaid long term care). I was worried there would be co-pays as there were way back when she was in a Medicare Advantage plan, but so far so good 2 years plus in. She has to use certain doctors though, but the one that comes in her ALF and was her doctor since moving in was on there.
If your mom is allowed to stay on traditional Medicare, she will have co-pays unless she is allowed to keep her supplemental (some states will allow this).
I *think* that Medicaid coverage that is paying for someone to live in a nursing home is handled differently than Medicaid that is only a person or family's health insurance coverage.
Medicaid paid for my Mom's last few years in a nursing home and all but $50 per month of her Social Security was applied to the nursing home's monthly charge.
Medicaid as health insurance for a person living in the community is something different.
My mom lives with me and I will continue to have her at home. I had been paying for her BCBS supplemental for the last couple years but just can't swing it anymore. It is my understanding that because her only income is SS, that Medicare with Medicaid will cover any and all medical/hospital bills.
I won't put her in a home. EVER.
It's getting harder as she has dementia, but it's not super bad yet. I'm getting support online and in local support groups.
Even her BCBS policy won't cover a nursing home. It's just before I quit paying for policy she has had for 20 years and couldn't even get now, I want to be sure Medicaid is going to pay for all the things that BCBS did.
My late husband was on Medicare and Medicaid for nine months. During that time he was hospitalized five times, plus had several weeks of rehab. He had zero co-pay for his hospital/medical/doctor bills.
However, I/we paid almost $2,000 a month for our "cost share" portion to allow him to be on Medicaid (basically his SS payment). This had nothing to do with his medical bills.
Quote:
Originally Posted by Forum_Newbie
I don't understand the "cost-share" statement? Can you please explain?
Thanks!
Jules
It is my understanding that each state can determine a "cost share" portion (co-pays, deductibles, co-insurance, etc.) for a person receiving Medicaid benefits depending on that person's income (or in our case the income of the husband and wife). I received two bills from the state for my husband each month. One was for $900 for "room and board" in his facility and the other was for $1,100 for his "cost share". I used the money that I received from his SS check to pay those bills. I was told that if my health improved and I was able to care for my husband again in my home (I was his full time caregiver for several years and part time caregiver for many years) I would still need to pay the $1,100 per month to keep him on Medicaid.
Each state has different rules. And, someone else's situation may be quite different than my situation. My husband qualified for Medicaid as we were "low income", had limited savings/resources and my husband had less than $2,000 in savings.
Now, I believe, that the "cost share" only considers that individual's income (SS, pension, etc.) unless they are married.
Medicaid can be very complicated. Almost everyone that I know applied for Medicaid with the help of an attorney or specialist in elder care or elder services. I applied by myself (with the help of our son). The completed application, with the attached documentation, was something like 60 pages. Your situation may be completely different.
I don't understand how any medical provider could possibly give her co-pays when she exists on 700/mo social security. I got a waiver from the state for Part B ($185/mo). I can afford Humana for drugs for $18/mo.
But what do they do? Ding her credit for non-payment or don't see her for certain tests if needed because Medicare or Medicaid don't pay?
I don't understand how any medical provider could possibly give her co-pays when she exists on 700/mo social security. I got a waiver from the state for Part B ($185/mo). I can afford Humana for drugs for $18/mo.
But what do they do? Ding her credit for non-payment or don't see her for certain tests if needed because Medicare or Medicaid don't pay?
The elderly people that I have known on Medicaid were all in nursing homes/facilities and the rules are different for that situation. But, I do not think that they were billed for services that weren't covered or denied medical treatments because they were on Medicaid. In fact, in my state, dental work, dentures and eye glasses (with strict guidelines and at specific providers) were covered by Medicaid and not by Medicare or (most) Medicare supplement plans.
You will have to get specific information for her situation and what is covered in your state. I am guessing that if her total income is $700 a month she would not have to be responsible for additional expenses beyond that. In fact, if her only income was SS of $700, unless she had a lot of other assets, it is possible that she could have been on Medicaid for years (which would have saved you the expense of her Medicare supplement health insurance plan). But, every state is different in regards to Medicaid.
I suspect that we paid almost $2,000 a month, for my husband's Medicaid, because my husband's SS was almost $2,000. If his SS was less I am guessing that we would have been responsible for less.
I would contact your local Counsel of Aging or other government agency to get more information of Medicaid. If you can afford it I would suggest contacting an elder care attorney or elder care specialist as filing for Medicaid can be quite complicated and confusing (at least it was in my state).
However, maybe it will be easy to file in your state or maybe they have free assistance to help the elderly file in your state. You can find out a lot of information on-line.
Good luck.
Last edited by germaine2626; 04-08-2018 at 04:51 PM..
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
