In most states, Medicare pays for some of the cost of nursing home care, but not all of it. This is because the type of care that Medicare pays for depends on how long a person stays in the hospital. In many states, Medicare will pay for care in a skilled nursing facility for up to 100 days.
Medicaid pays for both skilled nursing care and custodial services in a nursing home. Skilled nursing care focuses on treating long-term health problems. On the other hand, custodial care isn't medical and is usually needed for everyday tasks. It means helping with activities of daily living (ADLs) like bathing and getting dressed. Most of the time, it is older people who need this care.
Original Medicare is a government program that has been around for a long time. It is made up of Part A (hospital insurance) and Part B (medical insurance) (medical insurance). Medicare Part C, also known as Medicare Advantage Plans, is an alternative to Original Medicare. Medicare Advantage Plans offer more benefits than regular Medicare and can pay for care in a nursing home. Members should talk to their plan provider before choosing a nursing home.
If Medicare doesn't pay for a nursing home, you may have to pay for it out of your pocket. This can be pricey if you have to pay for the whole stay. But if you meet the above requirements, you might be able to get the help you need. You can file an immediate appeal for a nursing home that meets Medicare's requirements. All you have to do is call the number on the notice or the Center for Medicare Advocacy.
If you don't have much money, you can also think about Medicaid. This joint program between the federal government and the states helps people with low incomes pay for medical costs. If you are eligible for both, you should be able to get most of the care you need in a nursing home. However, before choosing a long-term care insurance policy, you should talk to your financial advisor because the costs may be more than what you have saved.
Medicare can help pay for some types of care in a nursing home, such as skilled nursing care and prescription drugs. You might also have a Special Needs Plan, which pays for specific care or medical conditions. Medicare Part D can pay for prescription drugs if you don't have a Special Needs Plan. Sometimes, private insurance companies can offer Medigap policies that supplement Medicare.
Medicaid can also help pay for some nursing care costs. This program is designed to help low-income individuals and families. Many seniors use it to pay for their nursing home care. To qualify, you must meet specific income and asset requirements. Some seniors may decide to give away or "pay down" assets to get into the program. But this must have happened within the last five years before you can get Medicaid.
Most people can't pay for care in a nursing home on their own, but Medicare can help pay for those who just moved in or who live there five days a week. Also, if you are a low-income senior who can't live on your own, you may be able to get care through Medicaid.
You might be able to buy long-term care insurance if you don't qualify for Medicaid. But it would be best if you bought a plan as soon as possible because the premiums increase as you get older. Additionally, if you're a veteran and need long-term nursing home care, you can receive help from the Department of Veterans Affairs.
Medicare will pay for which of the three types of care in a long-term care setting? Medicare does not cover most long-term care services, including personal and custodial care. It will pay some of the cost for each benefit period, though. Depending on your plan's rules, this payment period can last up to 20 months. Medicare generally only pays for stays in a nursing home if the person needs to get better or needs special nursing care.