Medicare is the public health insurance that the vast majority of elderly individuals in the United States rely on for their medical care and prescription drug coverage. You need to be 65 or older to qualify for this insurance or suffer from a permanent disability. It’s a safety net of sorts to help those that are no longer working still be able to afford their medical expenses.
And while Medicare does a lot of good for seniors, it doesn’t cover everything. For example, long term care is not covered by Medicare’s umbrella.
However, short term care is covered by Medicare, and this can include stays in nursing homes. Part A of Medicare covers a stay in a nursing home under the following conditions: there has been a hospital stay of at least three days prior, a doctor determines that skilled nursing assistance is necessary, and skilled nursing is needed to assist with a hospital related issue. If these conditions are met, Medicare will fully cover the first 20 days in a nursing home. Days 21-100 are only partially covered. The individual receiving treatment will be responsible for up to $200 per day during this extended timeframe.
After this, Medicare no longer pays for nursing home assistance.
Finding an alternative option becomes necessary. Some people do have the ability to pay for this kind of care out of pocket, but that is quite rare, unfortunately. Luckily, there are a lot of other options. Using insurance can help, if applicable. While Medicare won’t cover nursing homes at this point, Medi-Cal might. Long term care insurance or other private insurance policies might, too. If you’re unsure about your coverage, have a conversation with your insurance company and get an idea of what’s covered well before it is needed.
Medicare is a great safety net for millions of seniors across the country. But the reality is that it doesn’t cover everything. There are lots of things that will pop up during the average person’s retirement years that need to be addressed that basic Medicare doesn’t cover. At this point, you have a few options–the major ones have been discussed above. Being prepared long before these things become emergencies is the best way to approach insurance.
Navigating Medicare’s coverage of services traditionally thought of as “long term care” can be a little tricky, especially if assistance is still needed after the coverage window provided by Medicare comes to an end.
Finding the right care for a loved one can be confusing and overwhelming. It can also be tricky figuring out how insurance fits in with all of this. Having expert help can make it all a lot easier.
We’d love to be that expert for you and your family. Our team of professional caregivers would be happy to walk you through the process and answer any questions that you might have about senior care. We offer free consultation sessions designed to help with this and make life for your whole family a little bit better. All you need to do is call us to get your session scheduled. We can get the ball rolling from there.
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