Geri - if she is on Title 19 then at some earlier point in time she did something to apply for Title 19 aka Medicaid. Perhaps she has been low income and was on Medicaid for a community based program? or maybe has been receiving some mental health services in the past with Medicaid paying for it? If they are receiving Medicaid, then they have to be in compliance with Medicaid's rules. And often it is done as an acknowledgement of participation, so if you take Medicaid you accept whatever terms of the program. You do not necessarily do a sign off.
Now for those on Medicaid & in a NH or in another skilled nursing facility like a free-standing rehab center, they are required to do a co-pay / "SOC". Their copay will be all of their monthly income each month less a small personal needs allowance. The allowance varies by state and runs from $ 35 - 90 a month. Often the NH will put the allowance in a personal needs trust @ the NH which can be used for them to pay for beauty shop, pay for phone or cable charges (which are not covered by Medicaid) or for buying small items from the "canteen" @ the NH. So all of their SS $ goes to the NH. Most NH routinely become the rep payee for SS as it is easier. However, you do not have to do it this way. My mom gets about $ 800 in SS and then 1K in retirement and both get direct deposited to her checking account and then I write a check each month for her required Medicaid co-pay of $ 1,740.00 as her state has a $ 60 allowance. If you do it this way, often the NH will require whomever is able to be the financially responsible person for the resident to sign an admissions contract so they can come back at you if the SOC is not paid.
Now if mom went into rehab after a hospitalization (of 3 full days) then the first 21 days are covered by Medicare (Medicare was also her primary insurer for the hospitalization). But if she is not progressing, then Medicare will stop paying and then Medicaid will pay for her stay. She is actually fortunate to already be on Medicaid, as you are not going through the application & vetting process to be accepted for Medicaid which can take months and can be declined.
Is she in rehab after a hospital stay? Or was she admitted to the nh as a Medicaid patient? Talk to social worker and business office at nh to determine what kind of patient she is considered at this point. What Pam says is accurate.
Look over what she signed, because anyone going into a Nursing Home as a Medicaid client agrees to make the NH their representative payee. That means the SS checks go to them. Title 19 is a Medicaid program.
I am new here sorry..I'd also like to add that she has title 19 and Medicare we are in the state of Wisconsin.just was a shock to my mother and I as to how this happend.she had not signed anything and was never made aware of anything to do with this ...thought insurance was going to take care of the rehab stay.thank you
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Now for those on Medicaid & in a NH or in another skilled nursing facility like a free-standing rehab center, they are required to do a co-pay / "SOC". Their copay will be all of their monthly income each month less a small personal needs allowance. The allowance varies by state and runs from $ 35 - 90 a month. Often the NH will put the allowance in a personal needs trust @ the NH which can be used for them to pay for beauty shop, pay for phone or cable charges (which are not covered by Medicaid) or for buying small items from the "canteen" @ the NH. So all of their SS $ goes to the NH. Most NH routinely become the rep payee for SS as it is easier. However, you do not have to do it this way. My mom gets about $ 800 in SS and then 1K in retirement and both get direct deposited to her checking account and then I write a check each month for her required Medicaid co-pay of $ 1,740.00 as her state has a $ 60 allowance. If you do it this way, often the NH will require whomever is able to be the financially responsible person for the resident to sign an admissions contract so they can come back at you if the SOC is not paid.
Now if mom went into rehab after a hospitalization (of 3 full days) then the first 21 days are covered by Medicare (Medicare was also her primary insurer for the hospitalization). But if she is not progressing, then Medicare will stop paying and then Medicaid will pay for her stay. She is actually fortunate to already be on Medicaid, as you are not going through the application & vetting process to be accepted for Medicaid which can take months and can be declined.
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