My parents are in a nursing home on Medicaid ,the pharmacy they use says I need to pay the co pays. Originally I was told to hang on to the bills, but now they say I need to pay them. If they only get $30 a month for incidentals how are they supposed to pay it. They also have Tricare which they say I should cancel. The bill is now several hundred dollars!!!! Am I legally responsible as POA?
for the copayments to the hospital they were admitted to and is demanding
payment for the copay but the person is now in assisted living and has verylittle
income to work with or cannot afford to pay
Please note the following:
The following services must be offered by all states :
• inpatient hospital services
• outpatient hospital services
• physician services
• medical and surgical dental services
• nursing facility services for individuals age 21 or older
• home health care for persons eligible for nursing facility services
• lab and x-ray services
• family nurse practitioner services
The following services are optional , but most states will offer them, also:
• ambulatory services to individuals entitled to institutional care
• home health services to individuals entitled to nursing facility services
• prescribed drug coverage
• optometrist services and eyeglasses
• prosthetic devices
• dental services
• in-home assistance
• physical therapy
• (there are other optional services, too)
However, if you are in a nursing home receiving Medicaid, there is NO co-pay required at all. According to a federal government document, "Dual-eligible beneficiaries are eligible to receive both Medicare and Medicaid coverage. Prior to Medicare Part D, Medicaid paid for most of the prescription drugs for dual-eligible nursing home residents. Under Part D, these residents now receive drug coverage through Medicare, and are eligible to have their premiums, deductibles, and copayments fully subsidized." http://oig.hhs.gov/oei/reports/oei-02-06-00190.pdf
The question is 'does medicaid pay for medication' , should the patient have to pay a co-pay for medications ???
Your reply seems to indicate that you are referring to Dr. co-pay.
The question implies " medication co-pays "
??
Thank you for your knowledgeable assistance.
Q: I have Medicare and Medicaid, both of which pay for most of my health care. But my doctor is telling me I still owe money. Is this right?
A: If you have both Medicare and Medicaid, and the service you received is covered under Medicare, your doctor's office cannot bill you for any Medicare co-pay costs. If you have Medicare Parts A and B (also known as Original Medicare) or are in a Medicare health plan, AND Medicaid helps you pay for Medicare premiums deductibles, and coinsurance, you are probably a Qualified Medicare Beneficiary (QMB).
Note: your doctor may bill you for Medicaid co-pays. Please check with your local Medicaid office to find out more about your Medicaid status, including Medicaid co-pays. If you are still being told to pay a Medicare co-pay and the service is covered by Medicare, please contact 1-800-MEDICARE to file an anonymous complaint.
I am his POA.
I'm not sure what state you are in but here in CT the patients are allowed $68./monthfrom their SS pensions.
I would want to believe that this amt. is equal, no matter where you live.
Yes, I do believe that with recieving such a small monthly stipend, there should be a fund to help pay fo rco-pays.
It seems unfair that this allowance has to be used for anything other than their own personal needs.
But then, the system is not all fair nor reasonable.
Have you checked to see if there may be other avenues of financial help, such as the Soldiers, Sailors & Marine fund ?
The Nursing home should have some info , if there is indeed any other help for the residents.