Medicare or health insurance generally can be complicated. There are times when what’s not covered, and at what prices can come as a shock.
Skilled Nursing Facility Care
The most frequently cited source of confusion is skilled nursing facility care as well as nursing home care coverage.
Health Care Facility with Skilled Staff
If you go through the list of benefits provided in Medicare Part A of medicare.gov, you will see nursing home services or skilled nursing facility services. But, these terms can be somewhat confusing.
What Medicare refers to by this are facilities for rehabilitation and recovery to treat an injury or illness. These facilities are prevented by hospitalization and require the approval of a physician.
Medicare is not able to provide any long-term or custodial services. Therefore, a condition that is long-term such as Alzheimer’s is not eligible to be covered by skilled nursing facilities that are covered by Medicare.
If you need skilled nursing facility assistance it is necessary to be admitted to a hospital. You must after receiving a physician’s order be admitted to a nursing home or a facility. The stay at the nursing facility must commence within 30 days after being removed from the hospital.
The first twenty days there’s no cost. Then, costs include Up to $194.50 per day for coinsurance. If your stay is extended by 100 days, you’re fully responsible for all costs.
Of course, you can purchase a Medicare Supplement Plan to help offset or pay for these expenses should you choose to do so. A lot of medicare benefit plans also provide coverage for SNF.
In the nursing home, you’ll receive rehabilitation services such as occupational, physical and speech therapy. In addition, your treatment will comprise skilled nursing services that require medical education.
Skilled Nursing Facility Care
What Does Medicare Pay for?
There are many benefits that are covered by Medicare. Benefits include:
- A semi-private room
- Care for nursing professionals who are skilled
- Physical Therapy
- The field of occupational therapy
- Speech-language pathology services
- Social and medical services
- Medical equipment and supplies
- Ambulance transport (when medically needed)
- Food counseling
What is Medicare Not Insure?
Medicare coverage for skilled nursing facilities doesn’t include:
- Radio, television, or even a telephone
- A private nurse
- Private rooms (except the medically needed)
If you’re in a nursing home solely because you are unable to shower, feed, clothe or move around regardless of whether these issues are due to your recent hospitalization, then you are not in the running to be covered under Medicare Part A coverage. However, if you need part-time help, Medicare may cover home health care.
Additionally, if your illness is long-term, then you may not be eligible for nursing care skilled under Medicare. If you are unable to attend for 100 days, you will be responsible for the totality of cost.
If you have long-term conditions it is possible to look into long-term care plans.