Can my mother be required to apply for Medicaid?

1 answer | Last updated: Oct 16, 2016
Wyoming asked...

My mother is in a nursing home facility and Medicare is about to run out for her skilled nursing . She is about to go into long term care and the nursing home administration wants me to have my mother sign up for Medicaid. I think my mother's income is too much for Medicaid standards. My mother has independent insurance (BCBS) from her retirement which covers long term care. She also has a life insurance policy rider which has a benefit of $17,000. The skilled nursing administration is putting pressure on me, stating that I have to fill out the Medicaid application. My question is, do I have to fill out the medicaid application even though my mother has long term benefits from BCBS and life insurance? Do I need to seek legal help? What are my options?


Expert Answers

The nursing facility is probably concerned that your mother will soon be unable to fully pay her bill and that, without Medicaid coverage, the nursing facility will be stuck without full payment. The nursing home may not be aware of all your mother's assets and insurance coverage, or they might not be certain that these will fully cover her nursing home stay (her BCBS insurance, for example, might pay a certain daily benefit amount for long term care, but that amount might not be enough to fully cover the cost of this nursing home). The first thing to do is to request a meeting with the nursing home administrator to find out exactly why they want you to fill out the Medicaid application.

If you are not satisfied with the reasons the nursing home gives you for their wanting you to fill out the Medicaid application, you may be faced with a difficult choice. The nursing home certainly cannot force you to fill out the application, but before they accept your mother as a long-term resident, they may legitimately ask to know her financial situation. And they may decide that, without Medicaid as an immediate back-up, they do not want to accept her as a resident. Then you'd be in the position of looking for another nursing home (although shopping around for facilities at this point may not be a bad idea anyway, just to find the best place at the best cost for your mother).

Filling out a Medicaid application has some downsides to it -- it takes time to gather the supporting information, and it means disclosing your mother's entire financial situation. On the other hand, filling out a Medicaid application and being rejected creates no problems with Medicaid itself. If Medicaid does reject coverage for your mother, there is no penalty for having unsuccessfully applied, and she can apply again for Medicaid if and when her financial situation changes.