Question About Acute Rehab and Insurance

Ebaker54

New Member
3
Hi all, first post.

Here is the deal. My mother-in-law just had a tumor removed from her right front/temporal lobe. She is going to need access to a Stay-In Rehab facility for acute rehab (Speech/Occupational/Physical).

Here's where things get sticky/difficult. The insurance she was/is on, Aetna, is going to end coverage on 7/1/2015. Her now Ex-BF removed her from his business insurance when my Fiancee and myself removed her from his care when we deemed him incapable of caring for her.

Health South has already approved her for rehab assuming Insurance will cover her. The case manager at the hospital believes that Aetna is going to cease ALL payments of care on July 1st. She says that is how they operate and wont pay anything after that.

What my fiancee and myself are trying to figure out is WHAT CAN WE DO FOR HER? She is eligible for Medicare in August (2 years after she received her first SSDI payment), so that is a month out. We have tossed around the idea of Short Term coverage, but not sure if any of the plans will cover Acute Rehab.


I write this sitting in the hospital recovery room hoping someone will have an idea of what, if anything can be done. Look forward to hearing from anyone and everyone.

Thank you!
 
I'm sorry to hear about your mother-in-law. I'm not sure where you are at but I will give you my opinion based on where I am at (Illinois) as it seems most the states have at least if not better regulation that we do.

A short Term plan won't work as they have pre-existing condition limitations so it won't cover her therapy.

My suggestion would be COBRA of her AETNA plan. If she was on her ex-BF group plan (which is how I took the phrase "his business insurance") then by federal law the business has to offer her COBRA if the total number of employees in the business is 20 or more. If there is 19 or less total employees then there should be some kind of state program (here in IL it is called IL Continuation) that will allow her to keep her group coverage until her Medicare goes into effect. Once you know for sure that her Medicare will be active you need to get her a Medicare Supplement. Be sure to look closely at the supplements to be sure they cover the remaining portion of the rehab therapy left after Medicare pays there portion.

If you are have any additional questions, I would be glad to try to help.
 
She could get any plan on or off-exchange, effective 7-1 if you act by 6.30 at the latest, using her involuntary loss of group insurance coverage as a life change that would entitle her to a special enrollment period.
 
Keep in mind she will be starting over on her deductible and out-of-pocket with a new individual policy whether on or off the exchange where with her current plan she has probley already most if not all of these.
 
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