Why does Mom need a secondary insurance when she has Medicare Primary and Medicaid?

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Hannaht212 Asked October 2018

Why does Mom need a secondary insurance when she has Medicare Primary and Medicaid?

She is in a nursing home and they control her finances. We have been adding money to Mom's account to help cover the Secondary insurance for five years...but just now are wondering why she needs this secondary insurance when there is also the Tertiary of Medicaid.

Paying for Care Skilled Nursing Facility

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score 0 · Answer 1

Each state has it's own limits for personal needs. My dad got 120.00 monthly.

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My mother is in NJ, where the poster is living. Thanks for sharing that each state has its own set amount for the nursing home residents.

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score 1 · Answer 2

Once my Mom was in a NH a secondary insurance was not needed, Medicaid paid what Medicare didn't. Mom used the facilities Dr. Wpwho had a NP. She had dental and vision and both doctors saw her on site. I kept Moms policy for a couple of months to make sure all her previous medical bills had been paid. Medicaid told me to drop it. I live in NJ.

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Thanks....I have been going on what Mom's ins agent said BEFORE she went to the nursing home! (With Mom's dx of dementia/Alzheimer's) The home also is in NJ! I must find out if the home is using Mom's funds for their benefit. She gets $35 each month after the home takes her social security and pension checks. So I need to ascertain if any monies Sister and I put in Mom's account are being used for insurance rather than hairdresser charges. Thank you for your quick reply.

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score 3 · Answer 3

Medicaid is paying for the NH, Medicare is paying for the doctors and meds, but a supplemental will pay more and have more benefits. In New York, United Health Care Nursing Home Policy provides more benefits like an on-site nurse practitioner, it’s $36/month, and any supplemental policy under $40 will be covered by Medicaid so it’s free. You probably don’t need a really expensive supplemental, you may want to investigate UHC.

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Why does Mom need a secondary insurance when she has Medicare Primary and Medicaid?

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