Husband has uncontrolled diabetes, dementia, alzheimers..is on Medicaid, medicare a, b & d plus humana drug program, federal. Has rental apt leases a car. No properties ..we are living on our ss checks - small pension. I want Medicaid to pay a nursing home room and board bill without them touching those checks..I need a roof over my head need to pay health ins have s mall 15, 000 $ life ins policy for his burial...can and will Medicaid oblige?
But BCBS did do a clawback for all those services which Medicaid could / should have been billed for as Medicaid retro'd the eligibility back to the date of her application. So a time lag of about 5 months. Some of the vendors were pretty nasty about it as BCBS pays just so much more and BCBS does the clawback from their future payments. We were fortunate as all the vendors also take Medicaid, so other than a flurry of letters, it was all resolved. But there could have been a costly problem if a vendor did not also take Medicaid and could have billed at full private pay rates for services. Although they couldn't have collected.
Now also the CS can file for MMNA - Monthly Maintenance Needs Allowance. What the MMNA does is divert whatever payment hubs would need to pay the NH as his co-pay or "SOC" under Medicaid rules, and instead pay (divert) to you the CS. Think of it as alimony for the nursing home set. The MMNA varies by state (as everything Medicaid does as each state runs it's program uniquely). There is a formula for MMNA. For TX, the max MMNA is about $ 2,300 (that is more than most elderly ever get as monthly income, so really this benefits younger spouses with older hubs in a facility). From what I've heard, TX MMNA is pretty high & most states are lower. But the key is YOU HAVE TO FILE FOR IT! There was a poster on this site, whose dad was in a NH on Medicaid and their mom still was the CS and dad's copay to the NH was about $ 45.00 a month once mom's MMNA was diverted.
You do need an elder lawyer to deal with the MMNA to make sure you get all you can based on your own finances, etc. Good luck.
I wsnt out. His last fall was through my plate glass table....glass everyhwhere...
At night I have to sleep w an eye open to make sure he foesn't set the house on fire..last wk he left the tea. cooking on the stove...everyday is something new...I need my life back..which went from normal to abnormal..it wd be nice to be able to have a conversation with a normal person who actually knows what your talking about..I lost my fiance when ge went through the Korean war as a navy SEAL UDT underwater demolition team and got back home only to get crushed under his car when it fell on top of him...then three close friends passed from diabetes. And .cancer.
Now this...I just want some happiness left in my life. Since I w/ be 75 in Sept..
He belongs in a facility to treat the mental and medical problems. I have just about had it