My mother-in-law has been in a nursing home for a month. For two weeks of this time, she was under hospice; the rest of the time she has been skilled nursing. She has poorly differentiated adenocarcinoma, and she was switched to hospice care due to a misdiagnosis of kidney failure. She's since been switched back to skilled nursing.
She is getting billed by the nursing home, and the nursing home says "room and board" isn't covered by insurance. She has Rural Carriers Benefit Plan primary with Champva secondary. Rural Carriers covers 30 days of skilled nursing, then Champva pays any additional days with no limit. I'm not sure how the hospice works, but it seems like it was covered subject to deductible and coinsurance, but between the two insurances it was all covered - the nursing home told my sister-in-law that it had been certified (a week at a time, I think - ?). She's 85 years old and doesn't qualify for Medicare - her late husband had a Civil Service job and opted out of Social Security - long story, but Medicare is not in the picture for her.
Can anyone shed any light on this? She wasn't any more able to go home during the hospice days than the skilled nursing days. Can she be certified for nursing home care while in hospice, or does it have to be one or the other? This is a big surprise to the whole family. None of us thought to ask beforehand, and I still can't find it in the online benefits.
She is getting billed by the nursing home, and the nursing home says "room and board" isn't covered by insurance. She has Rural Carriers Benefit Plan primary with Champva secondary. Rural Carriers covers 30 days of skilled nursing, then Champva pays any additional days with no limit. I'm not sure how the hospice works, but it seems like it was covered subject to deductible and coinsurance, but between the two insurances it was all covered - the nursing home told my sister-in-law that it had been certified (a week at a time, I think - ?). She's 85 years old and doesn't qualify for Medicare - her late husband had a Civil Service job and opted out of Social Security - long story, but Medicare is not in the picture for her.
Can anyone shed any light on this? She wasn't any more able to go home during the hospice days than the skilled nursing days. Can she be certified for nursing home care while in hospice, or does it have to be one or the other? This is a big surprise to the whole family. None of us thought to ask beforehand, and I still can't find it in the online benefits.