What Kinds of Nursing Home Care Does Medicare Cover?

Medicare pays some nursing home care in most states, but not the entire cost. This is because the length of stay determines the type of care covered by Medicare. For example, Medicare will cover up to 100 days of skilled nursing facility care in many places.

Medicaid covers two types of nursing home care: skilled nursing care and custodial care. Skilled nursing care is a type of treatment that focuses on chronic diseases. On the other hand, Custodial care is non-medical and is typically required for daily chores. In addition, it entails help with ADLs (activities of daily living), such as bathing and clothing. The elderly are the most likely to require this type of care.

Original Medicare is the federal government's traditional Medicare program. It comprises Medicare Part A (hospital insurance) and Medicare Part B (disability insurance) (medical insurance). Medicare Advantage Plans (also known as Medicare Part C) supplement Original Medicare. Medicare Advantage Plans extend conventional Medicare benefits and can cover nursing home care. Members should, however, contact their plan provider before choosing a nursing facility.

You may have to pay privately if Medicare does not cover the cost of a nursing facility. This can be expensive if you have to pay for the entire stay. However, if you match the conditions mentioned above, you may be able to acquire the care you require. In addition, you can file an expedited appeal if you live in a nursing facility that fits Medicare's criteria. Call the number listed on the notice or the Center for Medicare Advocacy.

If you have a low income, you should look into Medicaid. This federal-state partnership program assists low-income persons in paying for medical expenses. If you are eligible for both programs, you should be able to acquire the majority of the nursing home care you require. However, because the costs may surpass your assets, you must consult your financial counselor before purchasing long-term care insurance.

Medicare can assist pay for certain types of nursing home care, such as skilled nursing care and prescription drugs. You might also have a Special Needs Plan that covers specific medical issues or types of care. If you do not have a Special Needs Plan, Medicare Part D can cover the cost of prescription medicines. In addition, private insurance companies may offer Medigap policies to complement Medicare in some instances.

Medicaid may also pay for some nursing care expenditures. This initiative is aimed at assisting low-income individuals and families. Many older adults utilize it to pay for nursing home care. You must fulfill certain income and wealth requirements to qualify. Some seniors may transfer or "pay off" assets to qualify for the program. However, this must have occurred within the last five years before applying for Medicaid.

While most people cannot afford to pay for nursing home care independently, Medicare can help newly admitted residents in a nursing home five days a week. Furthermore, you may be eligible for Medicaid care if you are a low-income senior unable to live independently.

If you are not eligible for Medicaid, you may be able to get long-term care insurance. However, purchasing a plan as soon as possible is critical because rates rise as you age. Additionally, the Department of Veterans Affairs can assist you if you are a veteran in need of long-term nursing home care.

Which of the three forms of long-term care will Medicare cover? Most long-term care services, including personal care and custodial care, are not covered by Medicare. However, it will pay a percentage for each benefit period. This payment period can run up to 20 months, depending on the terms of your plan. In addition, Medicare often only covers nursing home stays, including rehabilitation or skilled nursing care.