My mother's health requires she live closer to me to aid her with health ailments. Last year she and I bought a house close to me, making attending medical appointments easier for everyone. I was unable to get the loan myself because my income was not enough and only a few months before I bought a new home for my family, so mother and I bought the house together. I had to put several thousand into closing costs and repairs to make the relocation possible. We are starting to get medical bills that mother will not be able to cover and are not covered by insurance according to recent billing statements. I am concerned all that I have invested in getting the house will soon be subjected to creditors and potentially state control. Mother sigend a quit-claim deed about 8 months ago to me. I have little coinfidence the quit-claim will do much to protect my expenses after reviewing the look back periods in the the US-TN to be more specific. Do I have cause for concern with the roughly $50k in equity that we might lose? Should we just sell the house and I buy a different home in my name only before any problems begin? I called an "elder law" attorney in TN who was surprisingly of no help. Thanks in advance for any help.
https://www.medicare.gov/coverage/dialysis-services-supplies#:~:text=Inpatient%20dialysis%20treatments%3A%20Medicare%20Part,dialysis%20facility%20or%20your%20home.
Please appeal this denial in writing immediately. Then get on the phone to the Social Worker at the rehab center and get help in getting this paid.
Medicare Advantages works so different than having traditional Medicare. Medicare contracts them out. They are suppose to honor A&B but they always don't so its a fight getting things paid.
With Traditional Medicare you get a statement/summary. It shows what the provider charged, what Medicare feels is reasonable and then Medicares 80% leaving a balance that the suppliment should pay. The supplimental statement/summary the supplimental sends is the one you worry about. This shows what is due. You match that up to the providers bill.
"out of network provider" is probably your problem. When using Network providers you may get the provider paid in full. When out of Network, theres out of pocket.
So, there are two homes now? One you bought for your family and one mom bought for herself that also has your name on it? The quit claim may be of no consequence. Is your name on the mortgage and the deed? Warranty deed?
More information would be helpful.
1. Your mother needs to assign you as her DURABLE POA for medical and financial NOW while she is competent. That is something you can re-visit with an elderca Re e attorney. Only your mother can do this; no one else can "assign" this job. If she fails to do this now, you may have to sue in court to get guardianship when/if she becomes incompetent
2. You need to APPEAL the denial of coverage of dialysis NOW. Your Medicare statement should have a number/address: : "my mother was in rehab and unable to get to regular dialysis facility. This was a medical necessity and an emergency situation". You appeal to the insurance carrier, in writing, not to the rehab center.
3. Your mom has Medicare. If she is unable to afford her Medical bills, you need to look into getting her qualified for Medicaid. There is Community Medicaid which is medical insurance and LongvTerm Care MediCAID, should she need to reside in a Nursing Home. The qualifications are different got each one.
4. Tell your mother that starting now, she is to sign NOTHING unless you look at it first.
5. Get the book "Medicare for Dummies" so you understand how it works.
6. Your concern about your joint home being subject to creditors/state should probably include a concern about that transaction disqualifying your mother from receiving MEDICAID, which could be what the eldercare attorney was trying to explain.
You should document the payments you made into the house ($ and what they were for), and get your mother to sign to verify them. Of course I wouldn’t recommend that you back-date the document to the time of the quit claim, though I know some people would try that.
I suspect that the lawyer who was unhelpful found your ‘brief’ confusing to understand, and not all that hopeful for litigation – also that litigation wasn’t imminent so what was the lawyer supposed to do? I’d suggest that you first get your ‘brief’ documentation together, then wait until you get proceedings that make sense against you rather than your mother, then contact a lawyer who seems to know more about the deal.
Good luck, it’s not easy. Margaret
You need an elder law attorney very well versed in medicaid.
This is in the later part of my original post: "I called an "elder law" attorney in TN who was surprisingly of no help."
Why medicaid when she is on medicare?
Are you her medical or financial POA? Did you or she approve the out of network charges, or were you made aware of them?
Mom is still of sound mind according to recent statements from her PCP so we have not assigned me with PoA. I'm sure it will be me at some point in the near future. I have no idea what mom signed at the nursing home...she definitely signed a ton of documents that would have taken hours to parse properly. I would not be surprised if she signed her life over to them as they requested NUMEROUS signatures.
I totally expect this and that to not being covered and this to be nothing more than the beginning of endless and unaffordable billing.
"We are starting to get medical bills that mother will not be able to cover and are not covered by insurance according to recent bank statements."
Acording to bank statements? Bank statements have nothing to do with what insurance covers.
Is mom on Medicare? Does she have a supplemental plan, or is she on a Medicare Advantage plan?
I regularly get statements from Medicare saying that I may be responsible for large amounts of money. My supplement takes care of that. Make sure you understand stand mom's medical insurance whether it's Medicare/Medicaid.
The real estate is a separate issue. Wiser posters will help you with that.
Medicare B with BCBS FEP as secondary.