If mom goes to hospice, what should we pay?

Sure, anytime, Rain

Thanks, igloo.

I should have written " black box warning". FDA requires RXs who have certain high areas of concern like for abuse, for proper delivery & disposal method, with issues for the patient (usually severe respiratory distress), touching medication can hurt others, etc. to have a warning on the medication. It is done within a black box on the info sheet that accompanies the medications. BBW meds are like opiates, oxocodone, hydrocodone, morphine and Fentanyl. BBW have a illegal drug value big time too. However, BBW are kinda drugs of choice for serious pain management often layering different BBW drugs to deal with 24/7 pain. So often those on hospice for a terminal disease - like a cancer - will be on BBWs as there is severe pain. Now if they are in a free-standing hospice -like my MILs was in - a lot of those there are younger cancer meds with constant pain management needed & the staff at these sort of places are pretty highly trained to deal with opiates. But for those in a regular NH, often the Nh have concerns with having severe pain management needing residents as there is a huge chance for abuse & problems, so it's a reason not to accept them as a resident. For at-home hospice, some won't take on high pain management patients as staff is either worried about getting hit for medications carried (this happens in my city -New Orleans) often hospice staff or hospice volunteers are not trained for dealing and administering BBWs pain drugs.

I asked cause I was wondering why the OP said their mom was moving to a hospice at 10k a mo, she didn't say a NH at 10k a mo. but a hospice. So if hospice only, why does mom need hospice facility, is it due to BBWs....that was what I was wondering about.

Btw Fentanyl, super scary stuff. Children who handle Fentanyl patch can die just by touching the disposed patch. More scary than Oxy ever could be.

Igloo - what are black box pain meds? Just curious. Thanks.

Hers my experience based on my mom & mil who have been on hospice & some thoughts on the CCdebt: both were on original Medicare. My mom moved to IL (private pay) and then into in a NH as medicaid pending & got approved for Medicaid around month 5; mom was in a NH with both Medicaid & Medicare for about yr & 1/2; then mom fell, shattered her hip so became bedfast and went onto hospice as the medical director of the NH wrote orders for hospice evaluation, mom totally qualified and hospice called. So basically my mom continued to stay in the same NH but hospice added. Now hospice is an mediCARE benefit which covers stuff WindyRidge described however mediCARE does not cover the room & board cost at the NH but MedicAID does. So between Medicare & Medicaid costs are covered. I will say that NH seem to love love love hospice residents as the hospice benefit provides for extra hands to help with residents needs. For the 18 long months my mom was on hospice, she was never cleaner as between the NH bathing team working with hospice aides has her squeaky clean & fresh due to the specialty bathing chair provided through hospice plus supplemental nutrition items. Hospice as a Medicare benefit is self-directed which means you can in theory select the hospice provider. But in some cases there is no choice available but 1.

Now for MIL, she was in a NH medicaid pending, got very ill & went into hospital.
Hospitalization was paid for by Medicare. Long story short, she got sepsis and was discharged from hospital to a free-standing hospice only facility. As this was a post hospital discharge, it was covered by Medicare. A 21 day post hospitalization coverage at a non-hospital but skilled facility for "rehab" seems to be the norm for Medicare. How this gets coded for payment from medicare I have no idea but we were led to believe its all SOP. After the 21 day point, the room & board aspect of hospice would likely need to be paid by something other than Medicare though. Now she died within 3 weeks so all covered by Medicare. Btw she was still Medicaid Pending when she died. My BIL & SiL dogged the medicaid application and she was approved about a year after death. NH sent past due bills out at private pay rates all this while too. So even if they die you kinda need to get the medicaid application finished.

On the CC debt. CC is almost always unsecured debt. There is nothing they can do to try to collect on it other than harrass you to give in and pay unless you live in one of the few states where they can get a judgement against you (& they have to go through the whole legal system to do this & good luck on getting into a hospice facility to serve her papers) and place a lien on your home or paycheck. However SS and most retirements cannot have a lien placed on them as only IRS & state have the ability to be a supercreditor to get a portion of ones SS check. Now for those on medicaid or other programs which require you to be "at need" financially, walking on CCdebt can be an issue later on due to 1099-C the original CC issuer can eventually send mom for the defaulted $.

BUT Mom will (& not to sound harsh) be long gone before any scenarios above could happen. I would not pay a dime more on any CC. Mom is likely going to need every penny to either cover her costs at the facility even with medicare hospice benefit covering some of the costs. Plus if mom does not already have a fully done pre-need funeral & burial done those costs will need to be paid eventually. It may be better to add up those minimum credit card monthly payments and pay instead on funeral pre-need.

? I have a ? for you, is the facility mom is going into a free-standing hospice so all beds are filled by patients on hospice OR it is a traditional NH that has some residents who are on hospice? Also ? Is mom on black box pain meds?

There are two factors here. Medicare will usually pay for the hospice services, Nursing, bath aid, social worker, meds etc, but if she's in a nursing home while receiving hospice care all those costs remain.

Personally, I wouldn't pay the credit cards. Spend whatever is left on her care and apply for Medicaid if she qualifies. Don't do anything to personally take on her credit card or other debt.

I am pushing this question back up to the top. You asked an excellent question about what you should be paying, the facility or pay off Mom's credit cards, etc.

Medicare does pay for Hospice, but does not pay for the long-term-care facility.

Medicare pays for some level of hospice though most likely not 24/7. Where is she now? Won't they allow hospice to come in? Sorry I do not know much about hospice. How much do you use attorney? Is there a reason other than helping to negotiate Medicare and Medicaid? Is this an elder law attorney that specializes in Medicaid planning? If not find one that is and setup a free consultation.