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AL’s are not private pay. Many DO take Medicaid. And Medicaid in the OPs state pays for assisted living. In many other states. Medicaid also pays for AL or for some of the costs of AL.
She is not on Medicaid. A friend of mine moved her grandmother into a facility in California and when she changed the address, the supplement dropped her. Perhaps she was on Medicaid. Now I’m not sure.
She is not on Medicaid. A friend of mine moved her grandmother into a facility in California and when she changed the address, the supplement dropped her. Perhaps she was on Medicaid. Now I’m not sure.
If your friend moved her grandmother to another state, then that is probably why the insurance dropped her. If it was Medicaid, that’s definitely what happened because Medicaid does not cross state lines.
I believe she can keep the BCBS while in AL, since they are not paying for the AL facility, they don't care where she is living. However, if mom needs to go to a long term nursing home, then in that case she may be dropped after a few months there.
If she is in AL on long term care, she will have to give upBCBS. Medicaid will become her supplemental. There are AL’s in both Ohio and Maine that accept Medicaid.
There have been some discussions for this subject on the forum in the past. You can use the search and look around for threads that might help. I think what I remember learning is that if a person is on Medicaid, it’s often thought that there will be no money for the supplement premium but it turns out that the supplement payment can be allowed by Medicaid. So it doesn’t cost the patient extra to keep the supplement. There are some LTC facilities that offer their own Medicare advantage plans and they tell patients they don’t need the supplement plans. There are some situations where that might not work out if care is needed that isn’t provided by their on staff doctors. If your mom is going to be private pay at the ALF and it isn’t a requirement to go to that particular ALFs insurance, I don’t understand why she would be even considering dropping her supplement. It’s a very complicated issue. Very state specific. I think I would do as suggested by ITRR and call your carrier to discuss. Do come back and let us know what you learn.
Medicaid can cross state lines through reciprocity agreements between states. It is a federal program that is managed differently in different states. Planning is key.
That’s only for states that have opted in to the reciprocity agreement & it’s for Medicaid asset protection AND you still have to apply for Medicaid in the new state AND qualify for it AND that state must have a reciprocity agreement with the previous state. It’s for LTC partnership programs though. So it is actually correctly that Medicaid does not cross state lines. You can’t use NY Medicaid in California, or Illinois Medicaid in Florida.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I would not get rid of her supplemental insurance if she is self pay in AL. The co-pays for NOT having it pay for the plan and then some.
Can you let us know if she is on Medicaid?
I am in AZ and my dad got insurance while he was in a facility with no problem.
Let us know what you find out.
When Medicaid is involved, you may not need a supplimental. It depends on your State.
I think what I remember learning is that if a person is on Medicaid, it’s often thought that there will be no money for the supplement premium but it turns out that the supplement payment can be allowed by Medicaid. So it doesn’t cost the patient extra to keep the supplement. There are some LTC facilities that offer their own Medicare advantage plans and they tell patients they don’t need the supplement plans. There are some situations where that might not work out if care is needed that isn’t provided by their on staff doctors.
If your mom is going to be private pay at the ALF and it isn’t a requirement to go to that particular ALFs insurance, I don’t understand why she would be even considering dropping her supplement. It’s a very complicated issue. Very state specific. I think I would do as suggested by ITRR and call your carrier to discuss.
Do come back and let us know what you learn.
Note: here is one search for you on this topic
https://www.agingcare.com/search?term=Supplement+plans+in+ALF