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.
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.
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.
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.
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.
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.
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.