We just moved my dad to a new ALF because his previous one closed. Before we moved him in, there was the agreed terms which did NOT include changing his Medicaid plan to another provider. After his first week, the ALF administrator requested we change his provider. We obliged even though it’s been hell. Now they keep asking for his OTC food and med cards to “buy him supplies” even though we send him food he likes, adult diapers, toiletries and all his needs. Mind you, most of it is supposed to be covered within the ALFs services but here’s where my issue is. Even before we received the new OTC card, we were buying his stuff. The ALF continues harping on getting the cards yet, when I ask them what he needs so we can purchase it they say “no, that’s ok. He doesn’t need anything right now”…They then said “we need the cards because every little bit helps” and that “the card belongs to him”. This leads me to the conclusion that if I’m asking what he needs and they say nothing then, they’re buying general supplies for the ALF with all the patients cards. This doesn’t sit well with me. I have POA and am his healthcare surrogate and proxy. I am not going to have the ALF add my dad’s card to their collective pool to cover supplies they’re already billing for and not solely for my dad’s use or benefit. Does this sound legitimate and above board? It is very odd that they can’t tell me what he needs purchased but insist on getting his cards. Something isn’t right here.
I would never dropped his Medicaid. What do they care what Health insurance he is under. Medicare is his primary. Medicaid pays the 20% that Medicare doesn't and in my State dental, vision and prescriptions. Even if the AL has a certain pharmacy they deal with, that pharmacy should take Medicaid.
Call Dads new insurance and ask them about the AL requesting the OTC card. Also ask since you buy Dads supplies can you be an authorized user.
These cards have a minimum amount put in them yearly. FOr me and DH its $200 each. I have a book listing what Items are covered and the price I should pay. I know under the Medicaid card my nephew has, he gets his Vitamin D for nothing.
I would tell them you don't wish to discuss this further with them, that you manage his cards for him as his POA; THEY are not his POA and have no right to manage his cards, that they should let you know of anything he needs. Tell them further contacts as regards this will lead you to contact an ombudsman, or to contact Medicaid itself regarding their request and how rules work for "this sort of thing".
Good luck. And as Geaton says below, expenditures for his needs should come from this money, not your own. If he requires more than the OTC money, then you can certainly send further supply needs if you can afford to do so, but careful records should be kept, as is always the case in acting as POA.
I don't personally have experience with an OTC card but my MIL was on Medicaid in LTC for 7 years (no OTC card in her plan). The facility supplied all her disposables, creams, OTC pain meds, etc. They also "co-opped" supplies from other residents, presumabley ones who had passed on, as we sometimes found her wearing other people's clothes if we didn't provide what she needed right away.
Healthcare plans vary by state, and how facilities operate can vary as well. It's a fair question to maybe ask the business office of the facility, or the admins, to find out what their actual policy is and then hold them to it. Sounds like a communications breakdown to me, though.