Does Medicare Cover Nursing Home Services?

Medicare was established to cover medical bills of all aged Americans. Medicare provides health assistance to individuals aged 65 and above. Younger disabled persons are also covered by Medicare. Medicare is available in almost every state and almost everyone who is aged 65 and above is protected by this company. 40 million beneficiaries have contributed to Medicare.

Medicare provides nursing care facility for 20 days at a full cost. Private Medicare add-on is also available and currently pays for 80 days if the person carries the right insurance and policy. There are instances when Medicare stops paying even before the full 100 days have been reached. The supplement coverage is stopped if Medicare stops paying.

An individual will qualify for Medicare nursing home coverage, if the person stayed at the hospital for 3 full days and the doctor advised that the person needs a skilled nurse care. The transfer from the hospital should happen in a specific time period.

Common misconception about Medicare is that it automatically pays for 100 days for nursing home stays. Not all nursing home and hospitals receive Medicare. There are patients who are under 65 and are not on Medicare. For a patient who are over 65, stayed in the hospital and needs to be transferred in a nursing home, doesn’t guarantee that they will be covered by Medicare. It may be because they have not stayed in the hospital for three days or they do not need a skilled nurse to take care of them. Even if a person qualifies for Medicare coverage, the average coverage is about 20 days and not 100 days.

Medicare is the main provider of home health care in the US. Instead of nursing care, home health care is an alternative for patients trying to recover from surgery, joint replacement or complications caused by diabetes. Patients who stay at home but have congestive heart failure or disabling conditions are covered when they have “episodes” at their home.

Home care must be ordered by a doctor. A skilled nurse or therapist must be required for frequent visits to the patient. Aides may be provided by Medicare to help the patients with their day to day activities. Social services may also be provided. In addition, a person should be homebound and is not able to leave the home while trying to recover. Recently, a ruling was passed that Medicare patients can still be covered even if they can leave their home because of therapy and treatment. Medical equipment such as bed rails, walker and others may be provided by Medicare.

Long-term care, chronic, non – improving patients are now taken care of Medicare. Recently, Congress passed a ruling to restore funding to home care. This was done after the government received pressure from various health agencies.

It is important that people plan for long-term care. Planning for long-term care secures coverage for you future health bills. Medicare is not the only agency that provided long-term care; there are other private insurance companies who provide this policy.