Medicaid The Last Word

Many times nursing homes will work with you and give you a placement before your eligibility has been determined, knowing that when the determination is finally made, it will be retroactive (meaning Medicaid will pay its share of the cost of services you have already received).

It is important for families to realize, however, that the patient co-pay amount determined by Medicaid will also be retroactive - and the resident (or resident's guardian) will get a lump sum bill for the cumulative co-pay amount for the months of service already received. This first co-pay bill can cause a financial imposition for families that haven't been setting aside the appropriate portion of the residents' monthly income (i.e. social security) in preparation for this bill.

Nursing homes are not legally required to continue serving your loved one indefinitely if he or she regularly fails to pay the patient co-pay amount set by Medicaid. Letting the co-pay amounts accumulate and build up until they are unmanageable is a very unwise thing to do and can result in an involuntary discharge from the nursing home.

*Medicaid rules and guidelines differ by state and can change yearly, you should contact your local Medicaid office for the most current information.

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