I am moving my uncle from a nursing home to my home. Will he revert back to Medicare and Medicaid as before entering the nursing home?
I believe he only receives a few hundred dollars per month in Social Security and that is it. Hopefully my household income will have NO bearing on his insurance coverage.
Check your local Area Agency on Aging (state home care in our area is by county) and they may have a program/case manager that transitions folks from SNF to home addressing all the valid issues raised regarding LTC vs. Community Medicaid status, PACE program or other various incentives to keep people in the community (much cheaper than SNF for the government). In our state (MA) the agency may have funds (dep on budgets) to get someone set up with all the things that insurance may not cover.
Medicaid should cover the copayments for his meds. If his income is below 100 percent of the Federal Poverty Level; the state agency home care worker can also help you apply for QMB (qualified medicare beneficiary) which helps pay for MCR part B.
If he is in a NH on medicaid, then Medicaid is paying the NH a daily rate for his room & board as well as medical costs not paid by Medicare. Medicaid NH is it's own application & coverage managed by the state. When he discharges from the NH, he will discharge from that specific Medicaid program as well. There will be paperwork or perhaps an application for community based medicaid programs that he or his DPOA will need to do IF he still needs Medicaid coverage. I would ASAP schedule an appointment with the social worker @ the NH to find out how to transition his medicaid coverage if needed. Also speak with SW on what the day to day reality of his care needs are. As freqflyer asked, how is this going to be done....family for free & 24/7 or you are going to personally private pay as needed as he doesn't have $......?
Medicaid will NOT pay you to care for your Uncle as they have been paying the NH. If your area has a broad community based medicaid funded program for the elderly, like PACE, he may need to be evaluated to be in PACE first & foremost before Medicaid will pay for any In-home health services.
Realize that Medicare only covers at best 80% of part B costs. If his SS check is low, he is going to be short to cover his copay as the costs of care & medications are nothing but expensive. Most have a gap policy to cover this but within whatever coverage rules of the gap policy, if not on Medicaid. Right now is open enrollment period for Medicare!
If yiu still plan on doing this, try to get his medications. You will need to legally have DPOA & MPOA paperwork to do this. Take small ziplocks & a sharpie marker to put them in and label. Most drugs Rx'd in a NH are 90 day blister packs held & locked at nurses station. If Medicare paid for them, medicare will NOT likely pay for a second set either. Could be $$$ to have to private pay to redispense both in drug cost at pharmacy and to find a MD to write the RX's.
No, your household income will have no bearing on Medicaid. Check to see what Medicaid will provide for your uncle while he is staying at your home.
Just curious why are you moving your Uncle out of the nursing home as your profile indicates that he has Alzheimer's/Demetria. Will you be bringing in caregivers to help you or do you have others in the family who will take different shifts for his care?
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Medicaid should cover the copayments for his meds. If his income is below 100 percent of the Federal Poverty Level; the state agency home care worker can also help you apply for QMB (qualified medicare beneficiary) which helps pay for MCR part B.
Medicaid will NOT pay you to care for your Uncle as they have been paying the NH. If your area has a broad community based medicaid funded program for the elderly, like PACE, he may need to be evaluated to be in PACE first & foremost before Medicaid will pay for any In-home health services.
Realize that Medicare only covers at best 80% of part B costs. If his SS check is low, he is going to be short to cover his copay as the costs of care & medications are nothing but expensive. Most have a gap policy to cover this but within whatever coverage rules of the gap policy, if not on Medicaid. Right now is open enrollment period for Medicare!
If yiu still plan on doing this, try to get his medications. You will need to legally have DPOA & MPOA paperwork to do this. Take small ziplocks & a sharpie marker to put them in and label. Most drugs Rx'd in a NH are 90 day blister packs held & locked at nurses station. If Medicare paid for them, medicare will NOT likely pay for a second set either. Could be $$$ to have to private pay to redispense both in drug cost at pharmacy and to find a MD to write the RX's.
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Just curious why are you moving your Uncle out of the nursing home as your profile indicates that he has Alzheimer's/Demetria. Will you be bringing in caregivers to help you or do you have others in the family who will take different shifts for his care?