A nursing home rep told my mom that if she puts my grandmother in a nursing home that, due to her severe Alzheimers, (my grandmother has Medicare and Medicaid of Tx), my mother has to still pay out of pocket costs. She said this is because the insurances do not pay for a nursing home stay in full. Is that true?
Expert Answer by Joseph L. Matthews
Not necessarily. It's true that Medicare nursing home coverage is very limited. It pays for only a certain amount of the cost of nursing home care, for only a limited time, and only following a period of hospitalization.
But Medicaid is very different. It can pay the full cost of nursing home care for an unlimited time. However, not all nursing homes accept Medicaid-paying residents. And some nursing homes that accept a limited number of Medicaid-paying residents may not have space available for your grandmother (as a Medicaid-paid resident) when she wants to move in.
But if three things line up for her, Medicaid could pay the full cost of your grandmother's nursing care for as long as she needs it: (1) you find a nursing home that you and your mother think would provide good care for your grandmother; (2) that nursing home accepts Medicaid-paying residents; and (3) the nursing home has a Medicaid-paying bed available.
To find out about Medicaid nursing home coverage in Texas, go to the official Texas Medicaid web page. It can also provide you with a listing of Texas nursing homes that accept Medicaid-paying residents.
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