My mother has had 2 strokes within the past year. The 2nd stroke was severe enough that my mother needed to be placed in a long term/nursing facility. According to the admissions person at the nursing facility, my mother’s 100 days of Medicare ended 9/15/16. Mom was Medicaid eligible as of 7/1/16. The nursing facility sent a bill for the resident responsibility for the entire month of September. Since Medicare coverage was until 9/15/16 and Medicaid took over on 9/16/16, is my mother responsible for the entire resident payment amount for September? She has recently passed away. Am I still responsible for the funds?
ATTORNEY ANSWER BY MARGARET L. CROSS BELIVEAU:
While Medicare covers 100 days, it does not cover the entire bill for the 100 days. After 20 days, the patient is responsible for a 20% co-pay. After 40 days, the patient is responsible for a 40% co-pay, and it continues that way every 20 days. It appears that there is a gap in the coverage for your mother. The start date requested for Medicaid should have been when the first co-pay started. A call to the facility is in order to straighten out exactly for what it is billing, and be sure to point out the Medicaid start date. If you used a company to file for Medicaid, be sure to contact the company as well.
Your mother’s estate is responsible for payment of the bills. You could be responsible if you signed her admission papers individually and not in the capacity of her health care agent or power of attorney.
Legal Disclaimer: Please note that this answer does not constitute legal advice, and should not be relied on since each situation is fact specific, and it is impossible to evaluate a legal problem without a comprehensive consultation and review of all the facts and documents at issue. This answer does not create an attorney-client relationship. A lawyer experienced in the subject area and licensed to practice in the jurisdiction should be consulted for legal advice.
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