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Hello I have a family member who is younger at a facility recovering from an illness. She is bed ridden. She is on Medicaid. In October management changed the type of insurance needed to stay at the facility. They came to her room and asked her to sign a piece of paper changing it. She was very ill, and not feeling well so they said they would come back later for her to sign it. They never came back and she is not well and quite honestly she figured there was an issue they would notify her. Maybe they didn’t need her to change her insurance? She asked to speak with the office and manager but they never returned. This happened in October. It is now April. They just came to her room and delivered a $110,000 bill. My question is, are they allowed to do this? They notified her, then didn’t return with the needed paperwork. How is she liable to be billed when they did not follow through on their end? She is bedridden, she can not just go and track them down. Is this legal? If she gets the right insurance now will Medicaid pay the back dated bill? She’s very young and still recovering and I really do not want her to have a bill this large starting out in life. Very disappointed in this facility and very upset at the people who did this. Any advice would be welcome. Thank you.

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Clearly she was put on an advantage plan. This isn't uncommon. Many advantage plans now work within facilities. In my brother's case he chose to keep his United Health (mistakenly I think) because he wanted choice of any MD anywhere. But most chose the Advantage Plan recommended and with that a Nurse Practioner came one a week and checked on folks, diabetics, those with high blood pressure, those with any wounds or any problem, and etc. I thought it would have been a good choice. Once a year the choice can be changed, and this is apparently when your loved one changed plans.

Now as to whether she was competent to make this choice or had instead a POA who this should have gone through, we cannot be certain. The POA will have to trace down exactly what was changed, exactly what these costs are, and etc. They have nothing to do with supplemental insurance, and if they have to do with long term insurance, then having someone not competent to sign things is fraudulent.

The 80,000 bill for facility of course has NOTHING to do with any health insurance supplements.
You will have to have the POA contact the admins of the facility and discuss what this charge is. We surely, as complete and total strangers could not fathom a guess.

I can but wish you the best of luck tracking down what all is happening her.
I hope this elder has a POA and one who is very COMPETENT in knowing what to do, what attorneys to contact and etc. Good luck. Hope you will update us.
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Hi everyone, I’m just on here to clear up a few things, she is sound of mind just not sound of body. The nursing home changed to a different kind of nursing home or something (sorry I am not completely clear on that either) but in doing so they changed insurance. They still take Medicaid, but they were going to come back with the necessary paperwork to change her Medicaid to the right kind. I’ve been trying to reach management with phone calls (I live two states away so I can’t physically check) but they are never there/half the time I get voicemail and my calls are never returned. She has been asking the aides to get management, but they will not come to talk to her. We are probably going to move her to another facility who has better communication, but in the meantime what can be done for the remaining six months bill that was received? Can we be held liable even though they never returned with the paper work? Just very confused as to why we got a bill when they never returned to facilitate the change.
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Geaton777 Apr 2, 2024
Talk to her caseworker for guidance. Everyone on Medicaid has a caseworker, it should be listed on her paperwork from the county. Who has been managing her mail? Does she do it herself, in her condition?
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Perhaps she had Community Medicaid and it was getting changed to Long term Care Medicaid?

I would call the local Area Agency on Aging and local elected representatives; they generally have specialist who work on elder affairs and can help sort this out.
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Contact your state's ombudsman. They should be able to offer some assistance.
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I don’t quite understand what took place at this facility as there are too many unanswered questions to piece this together. You stated that a younger family member, who has Medicaid, is recovering from an illness in a facility and “management changed the type of insurance needed to stay at the facility”. Does this mean that this facility is no longer accepting Medicaid insurance? Did the facility just abruptly stop accepting Medicaid? Did something happened at this facility which caused Medicaid to stop doing business with them?

To get an answer as to why this happened, you need to speak to management at this facility. You also need to hire an attorney to see what can be done about the $110,000 charge. Otherwise, if your relative cannot afford to pay an attorney then the other alternative will be to apply for Charity Care to prevent payment of this hefty facility charge.

Sadly, this will be an uphill battle but you just need to persevere and don’t give up with the roadblocks you will face and everything will be fine.
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Confused26 Apr 2, 2024
The nursing home is accepting Medicaid they just changed what type of nursing home they are so they changed the Medicaids they take. I’ve definitely tried to get in contact with them even leaving voicemails about that (and other issues) but have not received any information back. I’m two states away so it’s hard for me to check in physically, and they’re ignoring when she asks for them. It’s definitely frustrating. Were thinking about transferring her to another facility that is more communicative, but the problem of the charge still remains. I wish she could afford an attorney but this illness happened quickly and a good majority of her finances went to that. She lost her job, everything. It’s been really hard.
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They didn't issue a 30 day notice? If she can't pay , that would probably be the next step the facility would do.
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Confused26 Apr 2, 2024
No they didn’t issue a notice. They just gave an invoice for all charges up to April.
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Is this person a senior? Younger than 65?

Maybe the facility stopped offering Medicaid beds. Talk to an ombudsman. Talk to her caseworker.

Your family member may need to assign a PoA to advocate for her if she's that sick/disabled.
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Confused
You are talking a 110,000 bill here!
You say she cannot reach anyone.
You aren't there, and I think your thinking she is capable of handling what is happening here is in error, as she has signed things she admits she doesn't know what she signed.

This is time for a visit if you are at all her POA.
If not, this is the time for HER to visit an ATTORNEY, as they are not communicating with her and this is 110,000 BILL! That is a whole chunk of change.

Just tell her that until she clears this up she pays NOTHING because if she starts paying on this she may be legally "assuming the bill".
Hope you will update us on this mess! Yikes. Scary stuff.
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I didn't answer this question before because I really did not understand it because the facility does not determine what type of healthcare coverage you have. I assume that by "She's on Medicaid" you mean Medicaid is paying for her care and as such if she is on Medicare Medicaid is now her suppliment. All the facility needs to worry about is that Medicaid is paying for her care and they are getting her SS and any pension she receives.

Providers are the ones who would be asking what insurance she has. A facility doctor should be able to bill both Medicare and Medicaid. The pharmacy doing business with the facilty should be able to bill Medicare and Medicaid.

I have a gut feeling that this facility no longer takes Medicaid for LTC. And as such, Medicaid no longer pays providers. Medicaid may not have renewed their contract with this facility or visa versa. Residents should have been notified in writing. No private insurance is going to pay for LTC.

Another scenario would be that she started out in Rehab. Medicare only pays for 100days, 20 days 100%, 80days 50%. The balance that Medicare does not pay is the patients responsibility. If she has Medicaid for health insurance that balance should have been paid. Just because you have Medicaid for health does not mean you have it for LTC. After 100 days if she is staying in LTC she now must pay for it. If she can't she applies for Medicaid. The NH can do this for her. She may have been turned down. So now she is responsible for the months never paid by Medicaid.

You really need to sit down with the finance dept and see what she is being billed for and what she signed.
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OP says this person is young, so unless she has a disability she wouldn't be on Medicare, but could be on Medicaid due to being low income. Younger people on Medicaid are generally covered for medical care in the community, and it's quite unusual for a younger person to be in LTC in a nursing home. If a person needs Medicaid for LTC, that would be a different application process and different criteria than for "community" Medicaid coverage. She, or someone on her behalf, would have to apply for LTC Medicaid. Some states I believe have Medicaid managed care systems where services are contracted through 3rd party contractors, and it's possible this young person had been covered in one of those systems before entering the nursing home. This would have been just for community care, not facility care. https://www.medicaid.gov/medicaid/managed-care/index.html
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