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Medicare And Nursing Home Coverage

Users of this site are often asking how Medicare and nursing homes interact. For people looking at Medicare, and for whom nursing homes are likely to be a part of their future, having this information is vital. Medicare, as a whole, is designed for short-term care. While Medicare may cover medical services when provided in nursing homes, assisted living centers, or even in people’s own homes, the costs associated with custodial care are not covered.

The types of long-term care that are not covered include things like dressing, feeding, assistance going to the bathroom, and long-term rent in the home types listed above. There may be limited circumstances where a person can get home health services when going through an agency that is Medicare-approved. Also, there are times where Medicare provides coverage in skilled nursing facilities, when applied to short-term stays. An example of this would be going into a nursing home for short-term rehabilitation after spending time in a hospital. To get coverage for time spent at a skilled nursing facility, or SNF, at least three days must be spent as a formally admitted inpatient in a hospital if they have an original Medicare plan. In these cases, the longer you are in the SNF, the more you will end up paying per day. After 100 days, you will be responsible for the full cost unless you have a specific supplemental insurance plan, or Medigap plan, that covers the costs.

Keep in mind that while Medicare does not cover long-term nursing home expenses, there are other types of insurance, including long-term care insurance, that could cover the costs if needed. Expenses covered by these alternate health insurance plans will vary from one policy to the next, so pay attention to the terms and policies you are considering. Compare them to find the best health insurance plan for you today.