Does Mom need a supp. ins. plan if she is in a nursing home on institutional Medicaid? They get all her income (SS) in an in-house account.

My mom use to have supplemental ins on top of her Medicare SS benefits. Supple was great at one time because we didn't have to worry about getting bills from surgical, docs, meds, etc. Now we no longer have the suppl and she qualified for Medicaid as well as having her Medicare (United). They are referred to now as "Dual Complete". Insurance is so complex, it's up in the air about what happens when mom needs full Care facility so I'm hopeful that Family Social Services will be able to guide me. Also check with United HC, mom's portion comes out automatically with her social security check. Good luck

Thank you, everyone, for your answers and information!

In re-reading my original post I see I made a typo: It should read that I set up that supplemental when she only had Medicare, not Medicaid. I finally got her set up on Medicaid after she'd been in the nursing home about 5 months. We ended up paying cash for a couple of those months and that was all the savings.

Even though it's not something I can easily afford, I don't think I have any choice but to keep paying for it, as I can't access the account. I don't have POA and so no one at United Healthcare will let me do anything. And of COURSE they want to keep collecting! Why would they care about my or my mom's situation? Why would they want to help when they're making money? Yes, I'm very bitter at the whole system after several years of trying to manage care for her in her gradual stages of aging with it's various trials. I know I'm not alone in this sentiment.

At the time of the shutdown, my mom had been in the NH 9 months, and though not able to talk due to a stroke, she was otherwise mentally 95% there, and physically not too bad aside from being a bit wobbly. I was still checking her out of the NH for dinner and a movie, and shopping, no issues. With a rolling walker she could go for miles, and preferred activity to sitting or lying. She could groom herself, use the bathroom, dress, etc, was alert to everything and engaged, though very much frustrated by her inability to verbally communicate. Then we shutdown and during the next 20 months, I was not allowed to visit. This particular nursing home in Las Vegas shut definitively and completely off from the world. I dropped off cards and flowers and gifts, etc., but my only communication with Mom was through a sympathetic nurse's iPhone Facetime. Then that nurse got Covid and never came back to work there. About halfway through that 20 months is when she took a sharp and sudden decline physically and, apparently, mentally. That was when the staff at the NH called me and suggested hospice. I could only remember her as I'd last saw her in March, and was baffled. They kept describing to me how in the last month she'd lost a ton of weight, stopped walking completely, wouldn't get out of bed, had stopped doing everything for herself including eating. I just couldn't believe it. But after being in denial for a week, I spoke to the people at the hospice company and frankly they seemed a lot more caring than the staff at the NH either way so I signed on. It's been a year since then and she is still going, but is little more than a shell. I was finally allowed back in on Thanksgiving last month and was in shock and despair at the difference in her since I'd last seen her in March 2020. I can't help but feel that she just gave up, thinking that she had been abandoned. She had also been moved to the "secured" ward, since she liked to go for walks, and let me tell you, that asylum floor would push anyone into the end range of dementia. Especially when you feel forgotten there. I don't even know if she was getting the things I would leave for her over the months of the shutdown.

I didn't think to do a POA with her before the shutdown, I guess I should have just looking to the future, but she wasn't that bad. And who knew we would suddenly be cut off from our loved ones for a prolonged period? Now she can't really use her hands to sign it, if she would even still qualify mentally to sign it. I read a bit about guardianship on this site yesterday, I hadn't even heard of that before. I know elder care lawyers are very expensive, as I'd looked into consulting them over a previous issue. It seems like the entire system is against you just wanting to take care of the people you love! It's deplorable and heartbreaking!

Sorry, I went on a bit of a vent there, but I know so many of you can relate! Thank you again for the info and help, what a great site.

United Healthcare in the amount you describe is most likely a supplemental ("Medigap") policy. Some states may require the person to retain that coverage when the person goes on Medicaid as it saves the state money in the ling run if the person has expensive medical care, which Medicare covers at 80%. However, that payment should be coming from the person's monthly income, in this case social security. When the application is made for Medicaid, any medical insurance premiums are considered (e.g., Medicare part B, which is deducted from SS, and any medigap or prescription policies); any balance left from the SS after these are paid is what would be expected as the person's share of cost to the NH. State Medicaid policies vary a lot, however, and in some instances Medicaid will cover the Medicare part B cost. When we applied for NH Medicaid for my brother in law, we asked the caseworker whether he should still pay for the United Healthcare suplement, and they said it would be good to do so, though not requied. Once he was on Medicaid, he was covered for special help from Medicare in his prescription drugs, so his premium was covered as well as all his co-pays.

no, you don't need to be paying for that. LTC Medicaid pays for everything.

My MIL has been on Medicaid in MN since 2016. She's never had supplemental insurance yet has had great care and no other medical expenses that were not covered. The facility even ordered a special type of wheelchair for her with extra cushioning and a high back because of a past spinal injury and surgery that is causing her pain.

As JoAnn29 says the facility would have needed to know about the supplemental insurance for billing purposes.

If you don't even know what the supplemental insurance is covering, maybe find that out first, but my guess is that she doesn't need it now.

In my State when on Medicaid for LTC my Mom also had Medicaid for health. Its automatic. Some States, I have heard, do require a supplimental but the premium is deducted from the person's SS. Family is not expected to pay for it. The NH should have on file what insurance Mom is on. Her records should show Medicare as primary and Medicaid as secondary. If info of the suppliment was given at time of admittance, that should be there too. They have to have this info to give to the hospital if she ever needed it.

My Moms suppliment prior to the NH was United. So, Medicare would be first, then United then Medicaid. Dads former employer paid for Moms supplimental. The NH is probably getting these statements.

Medicare is paying for her prescriptions and her hospice care.