Is there a supplemental insurance you can buy for 20% nursing home care?

If this is for a person that will need care soon you would probably not be able to afford the coverage.
If this is for a young(er) person in good health Long Term Care Insurance is available.
Some are like Life Insurance Policies where if you die before needing care..like walking out to the mailbox to mail the check for the insurance a car hits you....the beneficiaries will get the payout. If you need care the policy will go into effect and provide the care specified in the policy.

As you can see the answers are all over the map because most people who understand this issue very well would not understand the question. I am going to guess you mean is there supplemental Medicare insurance that covers the 21st to 100th day in a skilled nursing facility for medically necessary care (rehab from a joint replacement, wound treatment following a serious accident, etc.). The answer is yes but
-- there is no 20% co-pay associated with the basic underlying Medicare coverage; there is co-insurance
-- there is no automatic right to 100 days in the underlying Medicare coverage; it is based on medical necessity and averages about 14 days (which are fully covered)

If you mean something else, maybe one of the other answers that thought you meant something else will help you

Are you talking about Medicare Supplemental?

Glodeo, you may want to see if medicaid will pick up what ur Mom can't afford.

Be aware, supplimentals don't really pay the whole 20%. It depends on the deductable and copays.

When my Mom was in rehab Medicare only paid 100% for 20 days after that it was 50% up to 100days. Her supplimental paid a small amount. She paid about $150 a day. The billing department should tell you this upon entering the rehab. Medicare does not pay for longterm nursing care.

I would rent the house to pay for upkeep on house. She can keep a car and the house plus her state's allowable cash and apply for Medicaid.

20% coverage won't help you. Medicare won't pay the other 80% for long term care. You need 100% coverage and you need to buy it twenty years before you actually decline in health.

Babalou is right, the house is an exempt asset. Mom can be either "Medicaid pending" or fully medicaid eligible & own her home as Its an exempt asset by & large for Medicaid in all states. It is only the month in which mom actually gets the actual hard$ proceeds from its sale that her assets go over 2k so she becomes ineligible that month & stays ineligible till she does a spend down.

Personally I think you should mull over IF you want to deal with & do the VA A&A paperwork or just forget a&a & only do the VA $90 allowance. VA A &A is tricky on that it pays IF there isn't another primary payor. The semantics is confusing...but here's how it's been explained to me....Say mom is in AL and it's 3k a mo; mom gets $1800 VA A&A plus her SS of 1k; so mom pays out of pocket $200 and between the 3 her AL is totally & easily paid. Mom gets worse & now needs a NH & it's 6k a mo, mom jumps from $200 to needing $3200 a mo. The $ just isn't there so mom qualifies for medicaid. Now once mom becomes eligible & on Medicaid, it will become her primary & will pay all her room & board costs plus between Medicare & medicaid all health providers costs get fully paid. VA will decline to continue to pay the A&A once medicaid eligible as they are no longer either a primary or secondary. Once on Medicaid, VA A &A stops BUT VA now pays a $ 90 personal needs stipend.

You still with me? Now here is where it gets sticky....medicaid will retro payment to day 1 of the application and pay the NH several back months of payments at NH Medicaid reinbursement rate set by your state. It could be way less than mom paid as a private pay resident. The NH will need to return the A&A payments as VA wants the $ back from mom. If you are personally paying the gap -which is $3200 in the example - you want the $ paid to you - like check written to you - not mom as you dont want it coming up as "income" for mom and needing to go into her bank account as its written out to her. Comprende? You are going to need to be very ocd on records on all this as the timing by medicaid, VA is not synchronized. if mom should die while all this is getting rebalanced, it gets quite complex.

Sometimes it's just easier to apply for Medicaid; to have in place a plan on how to spend down ASAP the proceeds from house sale so that all clears bank account within 1 or possibly 2 bank statements, so mom can requalify for Medicaid. If moms state places a lien on property, then at act of sale the medicaid costs to date get paid from proceeds of the sale. Most states don't do this. I'd see an elder law atty to see what's what for yiur state and what mom could use the house $ for - like paying a preneed no cash value funeral & burial; a better wheelchair beyond what medicaid would ever pay for; dental care or even get set up a special needs trust account for mom, etc that is totally medicaid compliant. If yiu do this, remember Mom has to get all done & cleared ASAP so she can be ok for Medicaid the same month or the next month as the house closing ideally. You want to have realtor set closing on the first of the month.

If this is a lower value house, it may not be all that much $ to push through in 2 or 3 weeks & easily doable imo.

Also if you or other family have fronted costs to make the house sellable, if you want to be reinbursed for those costs, you need to have some sort of contract with mom as to this before closing. You cannot be just reinbursed as it comes across as gifting and can place a transfer penalty by Medicaid on mom. The info on the sale of the home to the penny is recorded so the state has all details.
It's a lot to think about, try not to get overwhelmed.

I think she should be Medicaid eligible until the house actually sells. It's an exempt asset for Medicaid, so it doesnt HAVE to be sold, slthough upkeep, taxes and insurance are always an issue.

I think i might think about taking the house off the market. Igloo might have some thoughts about this...

Also there is a one to two month wait for closing on the house when it does sell.

Thanks for the info and I will get with the NH business office again as I already have and they told me what you told me but Mom has a house on the market and if there is a sale then she will not be medicaid eligible. Then I can send in my paper work for the Aid & Attend through the VA but then there is the waiting period that has to be paid for at the NH.

Glo - it really should be moms finances paying the copay. Moms not yours, or other family if paying her copay puts you at financial risk.
If mom just doesn't have the $, then she can apply for Medicaid. Medicaid will pay her room & board costs at the facility with Medicare & Medicaid co-sharing covering the medical costs. Her Blues will need to be "suspended" during this period - there should be a specific form from bcbs for this. SUSPENDED not cancelled. It's going to be pretty paperwork intensive & someone at the billing office at the rehab place is going to have done this before & can help you. You do need to try to make sure that moms PT, OT or any others doing her "gait training" participate in Medicaid as well as BCBS - often they are independent vendors to a rehab facility (so not staff) & bill independently & do not participate in medicaid.

If this is about finding one to work in tandem with MediCARE, you need to clearly find out if they are on "original" Medicare or if instead they are on a Medicare "managed care" type of plan as whatever secondary or supplemental must be on a approved secondary participant list for the specifc medicare primary insurance.

If your elder is right now in the hospital & about to be discharged to "rehab" OR is already in rehab, your not going to find a secondary policy as most require a 30 -90 day minimum window for any coverage to be in force.

As an aside in all this if they are currently in rehab, I'd suggest you clearly speak with the PT & OT working with them as to their progress. Every day there's some sort of measurable "progress" update done. If their health chart is edging towards a "plateau", you need to start thinking about just where they go after rehab. Often the initial 20 day 100% Medicare rehab benefit is just window-dressing as they likely aren't going to ever get better, so they plateau day 21 & off Medicare BUT they need to stay at the NH as they cannot return to their old life, return to living at home. If this could be your situation, you kinda need to use those first 20 / 100% medicare days or day 21-100 / 80% medicare days to get finances together, see an elder law atty if need be and do a medicaid compliant spend down ASAP to get them eligible for Medicaid. So they can transition from a Medicare rehab bed to "Medicaid Pending" bed at the NH. It can get quite overwhelming.....

My Mom is in rehab after a leg brake but also has AL and the type of surgery she has is NON weight bearing for 3 months and then will have to be taught to walk. This takes care of the 100 days and I also have the 20% insurance but after the limit she will have to wait 60 days to get a second round of rehab. I will have to pay the two months room and board till she can get the second rehab. She cannot come home as I am not set up to take care of her. The system is just not good as it takes down the whole family.
Blue Cross Blue Shield has the secondary insurance to answer the question but it is only for a limited time also!

I was told that that amount minimum is 161.00 a day. That is a lot of money if you don't have it. This is when one ends up with all their savings out the window.....

Are you talking about the 20% that Medicare does not cover after the first 20 days of rehab after a qualifying hospital stay? Be aware that the MAXIMUM number of days that Medicare will cover at 80% is 100, meaning that you will only be paying the 20% for an additional 80 days, tops. After that, it's private pay, until you have another qualifying hospital stay.

We will need additional info to consider your question. For whose benefit would such a policy be needed? What is their age? Is the person already in need or nursing home care? Is the person already in a nursing home? The more info you provide the more folk will be able to think it through..

Grace + Peace,
Bob