Mom has Medicare (Parts A, B, D and long-term) and Medicaid. Does she need both?

Does Mom need Medicare now that I placed her mom in a Community Care Home? She had been living with us (because of her Alzheimer's) for almost 10 years. After 3 years, I signed her up for Medicaid, mainly to pay for adult day care, as well as in-home care, so I could continue to work.

This year it became apparent that her needs were beyond my abilities. We, (because I conferred with both of my brothers) made the difficult but necessary decision.

She has no more siblings, so therefore no possibility of inheritance, which may bounce her off Medicaid.

Please guide me thru this process if you have cancelled Medicare and just let Medicaid take over.

Thank You

Suzanne

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In our state if the person has adequate income to pay for Medicare and a Medicare drug plan (part D), they are expected to do so if they go on Medicaid. If their income is very low, the state will pick up the cost of the premiums. We discovered when my brother in law went on Medicaid that Medicare has an "extra help" program for prescription drugs so my brother in law now has a $0 premium for Medicare Part D and his copays are covered. The Medicare supplement, paid to a private insurance company, is a little more iffy. We asked if we should drop it for my brother in law, and the caseworker said some people do and some don't, and though they didn't require it, it was best to keep it. We kept it, because we figured he could afford it and it would save our state's Medicaid program some money. If we dropped the supplement, all that would happen is that money would be added to his share of his NH costs.

I'm not sure what you mean by Medicare A,B, D and long term. Medicare doesn't have any long term program. Does she have a Medicare supplement from a private company, e.g., United Healthcare? Does she have private long-term care insurance? I would suspect she doesn't or she likely wouldn't have been eligible for Medicaid.

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Probably not....the state Medicaid is a payer of last resort and it would be expected that she keep the federal Medicare to save the state money. Don't know what her overall financial situation is but if it's low enough the state may pay her Medicare premiums. That's cheaper for the state than her only having Medicaid.

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I like that "payer of last resort"

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You need to talk to her caseworker as suggested. Her Medicaid may only be a suppliment to Medicare. Medicare is her primary. The provider bills Medicare and Medicare pays 80% of what they consider reasonable. The 20% left is covered by Medicaid. When Medicare is involved, I doubt that Medicaid will become her primary.

If she is has a another suppliment, Medicaid may allow that to be dropped. It depends on your state. If they have you keep it, it becomes Medicare, the supplimental and then Medicaid.

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Please ask her Medicaid social worker about this.

Canceling her Medicare could be a big NO NO and leave her without proper insurance coverage.

Because they are two separate programs and are funded differently, you really want to go to the source to know what to do.

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Mom has Medicare (Parts A, B, D and long-term) and Medicaid. Does she need both?

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