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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.

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I would think this OTC card is non-transferable. My husband and I each have our own through his union prescription insurance. Please call the insurance company and update us on what you find out.
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Reply to JoAnn29
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You should be using his card to purchase the supplies he needs. You should not be purchasing the supplies he needs with your money.
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Reply to Grandma1954
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Put in perspective, Group facilities can use residents SNAP benefits to buy food for all the residents living there, so not surprised if ALF would do something similar with medical and/or food benefits.
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Reply to cover9339
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Do not give them his OTC card. I agree with you, they will use it for other purposes. If you buy Dads needs, there is no reason they need to purchase anything for him. The problem I see is that certain OTC like Tylenol and for my Mom laxatives, cannot be brought into the facility. Its was ordered thru their pharmacy at a higher cost to my Mom. (I used to get my Moms OTC on sale. Could not do that after she went into the AL) The medtech dispensed the Tylenol and laxatives. I got a bill for them at the end of the month. If Dads AL is doing this, you may want to ask the Insurance company how Dad can be reimbursed.

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.
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Geaton777 Jan 1, 2025
I think the OP means that she changed the clinic that his Medicaid came through. In MN where I live, we chose which insurer/provider she got every open enrollment: BCBS, HeathPartners, Allina, UCare, they all have plans specific to Medicaid (and honestly they all seemed identical). So we always picked the one that provided the network she was used to having. I think this is what was meant.
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An assisted living facility can make its own rules, but they need to be posted and understood and a part of the contract. It seems clear they are using these cards as they please. As this is a facility that cares for Medicaid patients they must abide by governmental rules, and I think may be are out of bounds if they aren't giving you a monthly bill that enumerates expenditures.

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.
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Reply to AlvaDeer
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So I have to ask the obvious: why are you personally buying supplies for him (presumably with your own money) when he has a card that can do this?

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.
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