Dad lived in a nursing home for 2.5 years. His last 3 weeks were in palliative care at the same facility. Does anyone know or have experience that would indicate if Medicaid or his insurance covered the cost if his stay for those 3 weeks? I have called several resource and am getting mixed responses. Thank you for any insight!
My Mom was on Hospice the last 6 days of her life. I do not remember getting a statement from Medicare showing me the service was covered and you will not get a Statement from Medicaid. They don't do statements.
As said, the service is covered but not the cost of the facility. If Dad was on Medicaid, Medicaid continued to pay for the facility until his death. If paying privately, he was responsible to pay the facility. You can call the facility office to see if there is a balance on his acct with them. You personally cannot be held responsible for any balance unless you signed as a responsible party. If a balance, the bill should be sent to the estate. That would be the Executor. It then becomes a debt the estate is responsible for. All outstanding bills of the deceased are paid before beneficiaries get their inheritance. If there is no money, a letter should be sent to the NH saying that. Again, family is not responsible for the debt.
If Dad was on Medicaid, a Personal Needs acct should have been set up for the small % of money taken out of his SS (my State $50). If not used, the money accumulates. Upon death, this money does not go to Medicaid it goes to the estate. I had Moms death certificate and my short certificate showing I was now Executor. I took them to the facility office and in 2 weeks had a check. In NJ your allowed 2k in assets. That too does not go back to Medicaid but goes tovthe estate.
Hospice services are available in every state through Medicaid and you can find information about those benefits on Medicaid.gov. Additionally, the Centers for Medicare & Medicaid Services has prepared a downloadable PDF with more information on the hospice benefit and patients’ rights.
Does Medicaid cover palliative care?
Some states, such as California, require community-based palliative care to be available to people on Medicaid.
For example, California’s Senate Bill 1004 (SB 1004) requires Medi-Cal managed care plans to cover palliative care for patients suffering from cancer, end-stage liver disease, chronic obstructive pulmonary disease, or congestive heart failure. Patients may continue curative treatments while receiving palliative care.
Other states do not require or offer Medicaid coverage of palliative care services.
Be sure to check your state’s website carefully so you can get all the benefits to which you are entitled."
Source: https://www.caringinfo.org/planning/financial-matters/medicaid/
Hospice is covered by Medicare.
Palliative care is a medical specialty, much like Geriatric care or genrontology. Requesting palliative care is something that someone does when it is recognized that there is no longer going to be a "cure" and that whatever diagnosis (even if it is only normal aging) there is no longer any wish for heroic measures such as dialysis, tube feedings, ventilators, and etc.
Palliative care often allows more medication. It is recognized that the end may be near. That addiction is no longer the concern, but relief IS.
So I think that there may be some misunderstanding here between what Hospice is and how it is covered.
PS Please scroll down to discussions and read the discussion heading "Palliative Care", as well.
Palliative care is a specialty, much like geriatric care. It would be covered in the same way a gerontologist is covered. But it is not covered by Medicare as Hospice is. Hospice is end of life care, and death is predicted within a six month period in the best judgement of the doctors.
But like Midkid said below, you should not be responsible for any outstanding balance your dad may have, unless you signed paperwork stating otherwise.
If it's Medicaid, that may be different.
Are you being hit for payment? Because YOU are not responsible for dad's bills.