Medicaid madness.....

Nurses General Nursing


Can anyone out there clarify medicaid billing for an LTC? My question is about the "patient liability" and Social Security.


67 Posts

What is the question your asking?

Are you asking what % they pay?

For the most part, if they are using medicaid, medicaid would pick up the majority of the bill.

I believe the % the patient would pay would depend on what they get for their SSI, then I think it goes on a sliding fee scale of what their actual total costs are outta pocket.

Hope that helps.

Long Term Care Columnist / Guide

VivaLasViejas, ASN, RN

108 Articles; 9,984 Posts

Specializes in LTC, assisted living, med-surg, psych.

In Oregon, LTC residents on Medicaid are left with something like $35 out of their Social Security check after the rest goes to the state for their care. It's unbelievable that they're expected to live on that for an entire month........certainly doesn't give them much $$ for personal items, gifts, clothing or other things that make life in an institution more bearable. But with Medicaid reimbursement rates being as low as they are already, I don't know what else can be done. It's a sad situation when people who have paid into the system for their entire working lives can no longer afford to buy themselves shoes or a little bottle of cologne, while the corporate fat-cats running health care run around in Armani suits and Ferragamos. But, that's a rant for another day.:(


258 Posts

Thank you. I knew they had to ay something if they entered an LTC and were on Medicaid and getting SS, but I wasn't quite sure how that worked!

By the way- I agree. 35$ a month for "personal funds" is just sad.

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