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Question

Should I Pay My Mother's Nursing Home While Her Medicaid Application is Pending?

September 11th, 2015

Q

I applied for Medicaid in April for my mother, but the application was not approved until August. The nursing home claimed that it needed to be paid during the delay, so I paid out of my own pocket for those months in between. Now the Medicaid caseworker will only approve my mother's application to begin benefits in August because the rules say that if the nursing home was paid, then the state (Michigan) cannot provide Medicaid benefits for those months. Can Medicaid deny payment for the months that I paid the nursing home? I was just trying to help mom. This is not right!!

Answer 1

A

You’re right, this is not right. But it happens. We advise clients not to pay nursing homes, other than the resident’s income, while the Medicaid application is pending in order to avoid this situation. The other option, if the facility insists on payment, is to lend the money to the nursing home under a written agreement. Perhaps you can convince the nursing home to recharacterize your payments as a loan –- which, in fact, they were since you anticipated being reimbursed -– and to resubmit its claim to Medicaid. We can’t advise you on whether and how this would work in Michigan. You should consult with an elder law attorney in your state. Here is a directory of attorneys: http://www.elderlawanswers.com/elder-law-attorneys

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