Medicare Nursing Home

How long Medicare pays for nursing home care costs depend entirely on the situation. There is no fast answer. In general, Medicare is not income sensitive. This means that, unlike Medicaid, you may get some coverage regardless of whether or not you have a limited income or limited assets, but there are strict guidelines involved.

Medicare will cover nursing home care if a senior requires a lot of help in the form of rehabilitative services or skilled nursing—only after a qualifying stay at a hospital. If you or your family member had to be in the hospital for at least three days, if they need extensive care in a nursing home immediately afterwards, and if they go to a Medicare certified skilled nursing home, then Medicare will cover some of the nursing home costs. You will need to contact your local SHIP (State Health Insurance Assistance Program) or the Medicare Fiscal intermediary in your area to find out if your hospital stay was a qualifying one, and if the nursing home you would like to receive care from is certified.

Although Medicaid is a federal program specifically designed to target low income seniors who require varying levels of healthcare, Medicare typically expects some level of contribution from the senior or his/her family. In fact, about half of nursing home residents have to come out of pocket for at least some of the costs associated with continually staying there. That’s why Medicare offers supplemental insurance called MediGap. They know that many seniors who don’t qualify for Medicaid nevertheless need help with co-pays, deductibles and other out of pocket expenses. Many seniors who begin by paying for all or some of their nursing home care because they didn’t meet the qualifications or they didn’t qualify for Medicaid, eventually run out of savings. In effect, they end up qualifying for Medicaid when they have exhausted their own financial resources.

If you need to find more information about what Medicare and Medicaid covers or just about how to afford nursing home care, GeriCareFinder can help. Our site is full of free information and tools such as financial calculators to help you make informed decisions about how best to go ahead.

Under our Advisors for Seniors section, you can plug in your zip code and locate Medicare and Medicaid consultants in your area, as well as your local SHIP and Medicare Fiscal Intermediary office. These are the right professionals to seek advice from regarding what portion of the nursing home care costs you can realistically expect to be covered by your Medicare insurance plan.

You can go to our Senior Care Support Tools to figure out what, if any, out of pocket expenses you will have to shoulder, by using any of our financial calculators to see how far your Social Security, retirement plans, and/or savings will go. We have a host of articles, helpful advice and answers to frequently asked questions as well, to help guide you through this process. Visit us today to get started on a nursing home care solution.

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