I need help/advice with an ACA question.

[panader0]

My brother has been in a hospital in Tucson for six and a half months. He had to have part of his butt cheek removed, had a colostomy until it heals and a skin transplant over the removed butt cheek. So he is in rehab. He is 65 years old, an army vet, and on Social Security. He informed me today that the rehab center (Villa Maria) is taking $1000 a month from his SS, leaving him with a bit over $20. Can this be right? Is it legal? Won't the ACA prevent that? What can be done? When he eventually gets out, he'll have nothing, as he lost his apartment and car while in the hospital. Thanks for any advice.

[LAGC]

1. Does he have any sort of insurance?

Presumably he's not on Medicare yet...

But the ACA provisions only help if you sign up and opt-in to a plan. Even Medicaid (if you are lucky to live in one of the states that expanded it, if you are poor) -- you still have to sign up for it in advance.

[jehop61]

2. ACA payment has not really kicked in AND

has little to do with Medicare. Medicare only pays a small portion of nursing home care and then the state moves in with medicaid that can make you spend down assets. That said your brother needs legal help to see if he's not being taken advantage of. Good luck.

[elleng]

3. Not sure but

he should have medicare, and vets should also provide some, imo.

As suggested, he could use legal advice (with experience in these matters.)

[panader0]

5. I agree about the legal advice, but it's going to have to be free.

[elleng]

6. Its possible to find attorneys who will provide such advice free,

maybe among vets and others. At least a first meeting/discussion is usually free, and general advice should be provided then.

[Thinkingabout]

4. You mighy be able to get help through the veterans admin, I am not certain.

As far as nursing home type care it is not covered by Medicare and it is normal for the facility to take most of a Social Security check and the portion he is allowed to have should take care of hair cuts, etc. Probably Medicaid is picking up the cost between his check and the cost of rehab. Medicare only provides 20 days of nursing home care. If he is on Medicare then he would not be in the ACA program, the healthcare.gov goes to age 64. I would suggest you check into VA for assistance since they seem to assist more. Good luck.

[jwirr]

7. When someone is in a care center over 180 days Social Security/Medicare starts to pay for the care.

That means that they then get your Social Security check except for a small part that is allowed for personal spending. If he is on Medicare or Medicaid he does not get ACA. When he returns home the check will continue to be his.

I think there is one way around this. If he is paying out of facility costs to keep his home intact until he can go back to it then there may be a difference.

Note: It has been years ago that I learned this working with seniors and it may have all been changed by the rethugs by now.

[YarnAddict]

8. Sounds like he is on Medicaid

When my mom was in a nursing home, costs were sky-high, I'm thinking $5000--$6000/month. She had no assets, and the only income she had was her social security and a small pension. the way medicaid works is that the income is applied to the bill, leaving only a small amount of spending money, and medicaid pays all medical costs over and above the income. Not a bad deal at all, considering.

Medical care is NOT free, even with the ACA. And after you die, any assets you may have can be taken by the government to recoup their costs for medicaid.


http://www.washingtonpost.com/national/health-science/little-known-aspect-of-medicaid-now-causing-people-to-avoid-coverage/2014/01/23/deda52e2-794e-11e3-8963-b4b654bcc9b2_story.html

[etherealtruth]

9. That was my first thought as well