What happens when patients run out of Medicare days?

2 answers | Last updated: Nov 24, 2016
Kathleen franks asked...

What happens when patients run out of Medicare days? My Dad is 83 and needs 24 hour care. He is in a nursing home. His Medicare benefits run out soon and he is $500 over the Medicaid limit. He has absolutely no assets. Help! He is a veteran but have been told it could take a year for those benefits to take effect.

Expert Answers

Help him apply for Medicaid, or apply for him, immediately. Even if it seems that he's "over the limit," he may qualify anyway. That's because he may be able to "spend down" the amount that he's over the Medicaid eligibility limit by paying that amount to the nursing home, with Medicaid paying the rest. To find out where to apply for Medicaid in your state, go to the Govbenefits.gov pagethat lists Medicaid programs by state, and click on the information for your state.

You can get excellent, free help with the Medicaid process from the counselors at the office nearest you of the non-profit State Health Insurance Program (SHIP) or Health Insurance Counseling and Advocacy Program (HICAP). To find a local office, contact the central office for your state listed on the Helpful Contacts page of the Medicare-Medicaid web site.

Community Answers

Kathleen franks answered...

Thank you for your help. The nursing home business office told me, I can't apply for Medicaid until his "30 day nursing home" stay is up. Which means we have to private pay for about 4 days & then the 45 - 60 days it will take to have all this approved. We are in the process of having a Miller's trust set up, costing money with an attorney that could be going to his care.

Does all this sound right? If we had known better we would have had him in a Medicare/Medicaid nursing home from the start. Thanks again, Kathy