Medicare Plans by Turning 65 Solutions


medicare, long term care

Does Medicare Pay for Nursing Home Stays?

Seniors with worsening medical conditions may have issues with daily activities that they previously needed no help for. This leads many to require additional assistance in an institution – particularly nursing homes. While Medicare has extensive coverage, it can only go so far. However, there are options.

Why doesn’t Medicare cover long-term care?

Nursing home care is a type of long-term care. Long-term care, also called custodial care, involves assistance with daily activities such as bathing, getting dressed, and getting in and out of bed. While Medicare is targeted at taking care of seniors, it’s limited to medical care. Assistance with daily activities is not considered a medical service.

However, you can get medical care in nursing homes, and this is something Medicare covers. Some nursing homes include skilled nursing facilities. The difference between nursing homes and skilled nursing facilities is that one aims to manage day-to-day life, and the other focuses on treating a medical issue.

What can Medicare cover?

No form of Medicare goes toward the non-medical care you get in a nursing home. However, the medical treatments you receive while in the nursing home are covered.

If your nursing home has a separate floor for skilled nursing care, then your Medicare Part A coverage will cover that. You pay a $1,484 deductible, but nothing in coinsurance if your skilled nursing facility stay is 20 days or fewer.

Medicare Part B can help if you use any durable medical equipment such as a CPAP machine or an insulin pump.

However, the most ideal Medicare coverage you can get is a Medicare Advantage Institutional Special Needs Plan (I-SNP), which is designed for those living in institutions such as nursing homes. The I-SNP enables you to get an affordable health care plan tailored to your specific medical needs. All SNPs are required to cover prescription drugs. This also includes the other facets of Medicare, such as inpatient and outpatient treatment coverage.

What are my options for long-term care?

There are other ways to get long-term care coverage. You can get Medicaid if your earnings are below a certain level. Your state determines the income level required for enrolling in Medicaid based on your Modified Adjusted Gross Income (MAGI).

Long-term care insurance is another option. You can get this separately. This way, if you have Medicare as well, you can get your medical treatments and nursing home stay at a fraction of what they would cost without insurance.

Our coverage stays with you

Whether you reside in an institution or at a private residence, we at Turning 65 Solutions provide you with the knowledge and assistance necessary to make you feel at ease. When you call us, we can help you get the best Medicare policy available. Call us today at 830-217-6711.

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