Follow
Share

My mother lives in an AL and has Medicare, Mutual of Omaha, and Medicaid. There's no possibility of her ever leaving assisted-living.  Can anyone tell me if she needs this supplement for any reason?
I have contacted the local office that signed her up with Mutual of Omaha in our town and her agent has since left. They said I have to contact headquarters, so, in the meantime I'm waiting till they receive POA papers from me.
I am trying to resolve this myself without involving my mom because she has had another stroke and anything like this brings on major anxiety for her.
Since she's in AL and on Medicaid I don't understand why she would need to have a supplement too.  It is costing her $240 a month.

This question has been closed for answers. Ask a New Question.

41 Answers

Most
Helpful Newest
First Oldest
First
1 2
If she receives Medicaid, it is because she doesn't have enough money to pay for her care. Who is paying for her Supplement (Mutual of Omaha)? It doesn't make any sense to me that she would continue the Supplement, unless for some reason her Medicaid status is only temporary.
Helpful Answer (4)
Report
Yes I agree it does not make any sense! Mutual of Omaha office refused to talk to me. I have just recently taken over my mothers affairs for her. She has been in this assisted-living for almost 2 years and has always paid this supplement herself out of her checking account and has been on Medicaid that whole time. No one at her assisted living can answer this for me either, it's so frustrating!!!
Helpful Answer (1)
Report
She does not need A Medicare supplement.
Helpful Answer (3)
Report
Thank you!!
Helpful Answer (1)
Report
I had the same question when Mom went on Medicaid and was told by Medicaid it wasn’t needed. So I cancelled her Aetna advantage plan, now she just has Medicare and Medicaid. No problems. However was her $240/mo payment disclosed during the Medicaid application and is excluded from the amount of her cost sharing? In other words are they allowing her the funds to pay it? If so, and you cancel it, you may be required to disclose that you no longer have this expense, so they may increase your cost sharing. When I cancelled moms I had to pay the “savings” to the NH.
Helpful Answer (7)
Report
Trying to find out when she got the supplement...sending POA papers to Medicaid too to find out if she disclosed that she had a supplement. I don't know why when she signed up at assisted-living while doing all these important papers for Medicaid that they did not catch this?!? Their financial office girl couldn't even answer me... but then this AL is a joke.. in more ways than one!
Helpful Answer (0)
Report
personal experience - If you drop the Medicare supplement, that $240 will then need to go to the NH ! Medicaid mandate.
Helpful Answer (4)
Report
My mom has been on medi-care & Medi-caid (medi-cal since she is in California.) She too had a supplement she paid for herself but needed to because at the time she had in home care & needed to pay for addt'l insurance to bring her share of cost down for the medi-cal. It gets complicated. Now years later she is in skilled nursing long term care. Has medi-care & medi-cal & kept the supplemental insurance. I don't know if it is needed to but I was afraid not to as looking at explanation of benefits it is being used. Medi-cal lets her keep the funds to pay it but if I cancel it I need to let medi-cal know & then the amount goes to the nursing home instead. So either way mom doesn't get the money. She gets only $35.00 a month out of her social security the rest to nursing home & or insurance. I figured why not keep the insurance  can't hurt. I think they do this because then thats less they need to pay if another insurance picks up part of a medical bill but I'm only guessing. Assisted living is different than skilled nursing long term. Good luck maybe more people have some insight. I also pay for prescription drug plan monthly but that I understand became mandatory for medi-care.
Helpful Answer (5)
Report
When my MIL went into a nursing home on Medicaid, we were thinking the same thing several people here are saying -- she wouldn't need her Medicare supplement plan and the money currently paying for it would go toward nursing home care along with the rest of her income except for the small monthly personal care amount. However, MIL's social worker said no, keep the policy. MIL will be allowed to pay for it. Medicaid preferred to have the insurance paying for some of MIL's medical needs, even though it meant Medicaid would need to pay more of her nursing home costs.

This may vary by state, I don't know. Does your mother have a social worker you could talk to? That was the person who was most helpful to us when we were trying to figure out Medicaid.
Helpful Answer (4)
Report
Dogperson- thank you for your insight it helps me too.
Helpful Answer (2)
Report
Oh great! We canceled the policy yesterday 😣
No she does not have a social worker
Helpful Answer (1)
Report
It's not so cut and dry. There are instances where you may have more choice for specialists for your loved one if they need to see one. Some doctors don't take medicaid patients anymore. If upon applying for long-term care your LO had supplemental, that premium is deducted from the patient paid amount each month and the supplemental can be continued. In that case, I would keep it to allow for more choice. If your LO can by you or wheelchair van get to their cardiologist, neurologist, pulmonologist, oncologist (you get the idea), or if they are likely to be hospitalized once or twice in a year, keep it. It is actually worth it to the state because BCBS supplemental for example is far cheaper than the payment that Medicaid would have to make.
Helpful Answer (1)
Report
If you just cancelled, I think you can quickly reinstate it. Do it.
Helpful Answer (1)
Report
I went through this situation as well and I asked the Elder Lawyer who helped us with the Medicaid application.

His suggestion was to KEEP Medicare Supplement, 1. because if she did not, then that money would automatically go to the NH anyhow, and 2. there are doctors who your loved one might need who only take Medicare and its supplements, and not Medicaid.

That seemed to make sense to me, so I have stayed with the Medicare supplemental insurance for my Mother.
Helpful Answer (2)
Report
I wonder if a local center on aging could help you. I would not rely on the company selling the policy to decide whether it should be purchased. What you might want is a copy of the policy so you see what it covers.
Helpful Answer (2)
Report
Keeping the supplement, which is her choice for medical care (PCP, labs, Hospital/ER, specialists, etc) provides CHOICE. As many said, medi-Cal (California) has a very limited
selection of providers (PCP, labs, Hospital/ER, specialists, etc) along with delayed access to using them.
Helpful Answer (1)
Report
If it is an Assisted Living facility, and not a 'nursing home' for medical care reasons, they are not reimbursed by Medicaid or Medicare. Also, Medicare does not pay for long-term care (even medical), unless a person has a supplemental long-term care policy. Assisted Living facilities typically have a set 'room & board' cost that exceeds a person's income (usually SSI/SSDI).
I work in NE and our patients who are in this situation, residing in ALF's that are more costly than their monthly income, make up the difference in cost by applying for an an extra 'grant' from DHHS (Dept. of Health and Human Services) Economic Assistance called AABD ( Aged to the Blind and Disabled). That covers the monthly 'excess' cost.
Ask a DHHS rep if your state offers this option, since she is likely low-resources enough to qualify if your state has this.
Helpful Answer (2)
Report
CAkers
Some posters on this forum mention that there are states that do take Medicaid.
Here is a list

google.com/amp/s/www.payingforseniorcare.com/medicaid-waivers/assisted-living.html%3ftmpl=amp
Helpful Answer (0)
Report
Bella, if Mutual of Omaha will not talk to you, tell them that you will get the state Insurance Commissioner after them. I worked in insurance for many years, but I never had to deal with something like that.
Helpful Answer (2)
Report
My mother has been paying really high premiums for health insurance since her husband died. She has been paying around $600 a month and it has recently gone up to right under $700 a month. When she went into the nursing home a year a couple of years ago, I was not told to drop the insurance and was told it's better to keep it. So she still has a very expensive supplemental plan, her Medicare, and now her Medicaid. She paid the nursing home privately until all her savings were depleted.

If you drop it, you will be required to pay that amount to the nursing home. Once on Medicaid you are only allowed to keep a small amount of your income per month. The rest goes to the nursing home and then Medicaid pays the remainder.
It can be very complicated and frustrating dealing with the nursing home staff. I have been in situations where the Office Mgr. was not very helpful, nor seemed very knowledgeable, so I feel your frustration.

I'd suggest to keep the health insurance.
Helpful Answer (2)
Report
My mother has all 3, Medicare, Medicaid and her AARP supplemental. At one time we did cancel the supplemental and Medicaid paid it, but since Rick Scott Governor of Florida, when he came back into office he made a lot of changes and we went back to AARP supplemental. I think I am going to revisit this situation myself and maybe cancel AARP.
Helpful Answer (2)
Report
Call the insurance co. They don't know if you're mom or daughter.
Helpful Answer (1)
Report
My Mother lived in Nebraska. She made slightly too much to qualify for Medicare. When she bought supplemental insurance, her income was reduced enough so she could qualify for Medicare.
Helpful Answer (0)
Report
Thank you all for the advice!
We are in Illinois. I do understand the assisted-living will get that amount she has been paying monthly. I'm still re-reading all the answers here and not sure what to do.
 I'm thinking I need to try to get it reinstated.
Helpful Answer (0)
Report
Get in touch with your local SHIP/HIICAP counsellor. Usually at the local Office for Aging in her state/county. They are trained to sort out this stuff and can explain to you if she is better off keeping it or has no need for it. My Mom is in AL with Medicare, Medicaid and a Medicare supplement. If she needs to go to the hospital she would have copays if she didn't have the supplement. The Medicaid is only for out patient care. They allow the cost of the premium off her Medicaid buy in, so that would end up being paid to them to continue her Medicaid coverage so we just keep the supplement. Hope this is helpful. Everyone in every state is different, so check it out.
Helpful Answer (1)
Report
My mother was in a NH and applied for Medicaid. After she was approved, she kept her Medicare Supplement and it was paid for from her Social Security check as it was previously. Illinois Medicaid wanted her to keep it.
Helpful Answer (1)
Report
Went over moms EOB's from Mutual of Omaha and it has been paying pretty good on different doctor visits and procedures etc. Based on the advice given here, I want to try to get that insurance reinstated on Monday
Last Thursday is when she canceled it, I just hope it's not too late!!
Does anyone know???
Helpful Answer (0)
Report
Is it hard to get an insurance supplement reinstated?
Helpful Answer (0)
Report
I read a bunch of different things online; it looks like 10 days is pretty typical.

Please call them first thing tomorrow, just in case it's 72 hours.
Helpful Answer (1)
Report
FYI. Many people do not know that you can suspend your Medicare Supp. Coverage for up to 24 months, and later reinstate it.
Helpful Answer (2)
Report
1 2
This question has been closed for answers. Ask a New Question.

Recent Questions


Popular Questions


Related Questions

Ask a Question
Subscribe to
Our Newsletter