Granny in nursing home, money runs out, keep private room with Medicaid?

Question

My grandmother is in a nursing home. She is in a private room for $ 6,000 a month. She has long term care insurance, which pays just a little bit. She pays the rest with her pension and savings. Her account is shrinking very fast. The insurance will stop to pay soon.

When she lost all her savings, she will have to use her pension and Medicaid pays the rest. She is concerned, that she will loose the right to be alone in one room. The Medicaid people are in rooms with 2 beds. She is very sensitive to noise and smell. She is sick and wants to be alone.

When she receives Medicaid, will she be kicked out of her private room?

How can I protect her, so that she still can keep her room?

Answer 1

You can't. She will get the room Medicaid will pay for. You could rent an apartment and get a home health worker for a lot less than $6000 a month. Do you realize that is the payment of a $600,000 home a month?

Answer 2

Unfortunately Granny has done what she can do to keep her private room longer than most in her situation. Unfortunately that will cease when Medicaid steps in. Unfrtunately the person who sold her the long term care insurance didn't write one that would cover the bulk of the care then she could keep her private room, and her savings. Only 7% of America has Long Term Care Insurance so kudos to her for getting something. All Americans need a policy if they can afford it, and get it health wise. Learn a lesson, and make sure your parents and you get this valuable insurance, and don't let what happened to Granny happen to anyone else you love.

Talk to the facility and find out what they can do to assist you since she has established residency there, and they are aware of her situation. They may be able to help in moving her to a less expensive room. PS to those who told you to take her home and hire in home care, have never had to do this themselves. It has nothing to do with how much you love your family whether this is an option. Medicaid in most states does not cover home care or assisted living. Only Nursing Homes the one place no one wants to be. So for the lady saying she is going to stay at home til she dies, she better get a Home Health Care Long Term Care Policy. Please spread the word, because those of us that are trying to educate folks are looked at as pushy salesmen that are selling policies, not people who are trying to protect our clients' dignity, choices, assets, and legacy

Answer 3

Hopefully there are other options I'm not aware of, but one thing you might check into is the possibility of a different nursing home. Some nursing homes only have private rooms. My dad was in one for a few months a couple of years ago after breaking a hip, and we chose the nursing home we chose specifically because all the rooms were private. (And his Medicare covered it....not sure about Medicaid) Good luck to you. This kind of thing is so difficult to have to deal with.

Answer 4

Get the 'exact numbers' on the rooms at that nursing home ... and find out if there isn't a 'smaller' room that would hold only one person and cost less than the room your Granny is in now. You MAY be able to pay the 'extra' if your Granny is on Medicaid, but you should call and ask the 'welfare department' what the 'rules are' on that ... and THANK YOU for caring about your Granny ... but WHY is she in a 'nursing home' if she has YOU ... you do 'have the option' to take Granny in and hire a 'home nurse' to take care of her 'medical needs' and she would be TONS HAPPIER even if she could never go in any but that 'one room' ... it would be in your home, and you'd be 'around' all the time ... and that could be very wonderful, if you can manage it.

Answer 5

Well, either bring her home pay to hire a nurse...

YOU can pay the difference between the private & semi-private room rate once medicaid takes over...

Or, she's stuck in a semi-private room.

It sucks, but that's the way it is. Medicaid (and private health insurance for that fact) will only pay for the less intensive level of care that's required to treat her health conditions. Unless its medically necessary for her to be alone in a private room, she will ultimately be placed in a semi-private room. You can try to find a medicaid nursing home that has ONLY private rooms, it happens but its rare.

Answer 6

I'm glad to hear that the private policy she had has allowed her privacy so far. Unfortunately when the gov't starts to pick up the tab, they will dictate what type and where she receives care.

I'm not only licensed for LTC (it's a separate license in NC), but my great-grandmother-in-law just passed away after receiving Medicaid. They moved her to a facility that was 2 hours away from her daughter who was taking care of her at the time.

Answer 7

If she becomes Medicaid dependent, there is nothing you can do to keep her in a more expensive private room, unless a doctor certifies medically that she needs to be in a private room. This is easier said than done, since Medicaid only allows private rooms on rather strict circumstance, such as having a communicable disease.

Answer 8

Well, she's right. You don't get a $6000 a month room for $2500 - what medicaid is likely paying.

If you want her to keep the private room, you will have to pay the difference.

Answer 9

when my mother went on medicaid they moved her to a semi private room in the medicaid section of the nursing home.

Answer 10

The only way to stay privet is if you pay the rest of the bill...but 6000 a month is rediculious...she needs to be in a room with people...she will feel better...meet new people and socialize...shell get out and play Bingo and have friends..new friends...she needs this...to feel good...or shell sit alone and die of lonesomeness...Believe me she will...my moms in a nursing home and was doing the same thing....now shes doing alot better....Switch her to a shared room and save the rest of her money...