Hi everyone. I'm new here. I'm having a tough week. My husband lives in a nursing home with Huntington's disease. He's only in his early fifties. I just found out today that his Medicare medigap plan was terminated because the nursing home didn't pay the premium. He depends on that plan to pay the 20% gap and coverage for his diabetic supplies. He's a type 1 diabetic that uses a continuous glucose monitor (CGM). Because he's under 65 and it's been over 60 days since the insurance was terminated, he can't get reinstated or re-enroll. He has Medicaid, but I'm not sure if they will pay the gap in coverage. Not sure what to do. Has anyone gone through this, or could offer any advice?
If Medicaid is paying for Husbands care, you are not responsible for any bills. Call the office person who bills Medicare and Medicaid at the NH. I am pretty sure you do not need to pay for a supplimental insurance. Please come back and tell me what u find out.
I have read your responses and they are good ones.
I think only your facility has the answers for you. You say "meanwhile here I am" as regards the facility, who gets his SS, being responsible to now for paying his Medigap. What do you mean by "here I am". Are you being billed for care, supplies, medications?
I sure do hope you will update when the financial folks get back and give you answers as to what's happening now.
I, like others here, don't understand who now is in charge of paying his bills. I imagine the only one he has is medigap insurance and that comes from his SS as he no longer has assets at all. It is almost sounding like the nursing home itself is in charge as his financial POA? Or are you? This is all so confusing. He is not left with funds enough to pay any Medigap insurance, and I am wondering if now, all his things are not paid for by medicaid.
My husband no longer has any bank accounts. When we had to spend down for Medicaid to cover his long-term care, his bank accounts were closed. The facility receives his social security payments and has an account for him there. He gets so much money each month for personal needs. They had been paying the premium for his Medigap plan up until recently, so I never questioned whether or not it was allowed by the state if he's also on Medicaid.
I contacted the administrator, who referred me to finance, but she is on leave for another week. I'll address it with her then.
I know the rules for Medicaid vary for each state, but I was wondering if anyone else had this experience. Hopefully, I will get answers from the facility soon, but in the meantime here I am.