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marianne says

It is a very large group plan, which medicare is secondary. I believe it is a managed plan.

If your mother has a Part C Advantage Plan, their rules are different. She must go to a contracted provider SNF in order to receive any covered services. Their pharmacy rules might be different too - most nursing homes order meds from a commercial pharmacy and it's only after you get slammed with a huge bill that you find out they're not contracted providers for your insurance plan. I'd have to know a bit more - but if she's managed care the rules change a bit. I'm sure the Care Manager you choose can help you understand all this - and she might be able to help you locate a new place for your mom.

It's crazy - all the ins & outs of the insurance and nursing home biz. Even tho it's my job security, it's so complicated that even professionals don't completely understand it. I wish you luck.

Is part C Advantage Medicare? She has A and B only.

I think her Anthem is a managed care plan.

Her coverage for ambulance is 0 copay.

Her coverage for Er/Hospital is $50.00 admit/$50.00 discharge.

So, essentially, she could stay there a few more days while I figure things out, she has a wound so they cannot just discharge her.
They are turning her for wound care too,anf giving her antibiotics for the UTI for follow up treatment.

I am her Health POA, but I did not sign for her either.

Thanks to you, Ellie Mae!

marianne says

Is part C Advantage Medicare? She has A and B only.
I think her Anthem is a managed care plan.
Her coverage for ambulance is 0 copay.
Her coverage for Er/Hospital is $50.00 admit/$50.00 discharge.

She has A&B - but her medical benefits have been assigned to a Med C advantage plan. She pays a monthly premium (or doesn't depending upon the plan she's on) and her part D drug plan is bundled in there. The part A/B copays for ER is higher than the amount you listed, which verifies she's managed care and her choices are severely limited. You've got an insurance case manager who will be forcing you to move her, or the wrath of the plan shall fall upon you.

Time is of the essence. They'll move her with, or without your permission.

Yes, they actually can just discharge her to a lower level of care, part of the managed care agreement she signed onto. Her needs aren't acute, they're sub-acute and can be managed in a snf or at home with home health assistance. Even the antibiotics (abx) can be administered in a snf or acute rehab if it's IV abx.

Good luck.