Understanding Medicare Nursing Home Coverage: A Guide from Suncrest Hospice Care

Understanding Medicare Nursing Home Coverage: A Guide from Suncrest Hospice Care

Medicare nursing home coverage can be a complicated and confusing topic, but it's important to understand what options are available to you or your loved one. At Suncrest Hospice Care, we aim to provide comprehensive support and guidance for families facing end-of-life care decisions. In this article, we will break down the basics of nursing home coverage and help you understand what to expect.

What is Medicare Nursing Home Coverage?

Medicare is a federal health insurance program for individuals over 65, those with certain disabilities, and those with end-stage renal disease. Medicare covers a wide range of medical expenses, including hospitalization, doctor visits, and prescription drugs. When it comes to nursing home care, Medicare provides coverage under specific circumstances. This coverage can be broken down into two parts: Part A and Part B. Part A covers inpatient care in a hospital or skilled nursing facility, while Part B covers outpatient care, such as doctor visits and physical therapy. It's important to note that Medicare does not cover long-term care, meaning that it does not provide coverage for nursing home stays that are primarily for custodial care.

When Does Medicare Cover Nursing Home Care?

It is available in certain circumstances. If you have been hospitalised for at least three days and require skilled nursing care, Medicare Part A will cover up to 100 days of care in a skilled nursing facility. Skilled nursing care includes services such as wound care, injections, and physical therapy.

It's important to note that Medicare will only cover the full cost of skilled nursing care for the first 20 days. After that, there is a daily coinsurance charge that must be paid by the patient or their insurance. Additionally, Medicare coverage for skilled nursing care is contingent on the patient's condition improving, meaning that once the patient has plateaued or their condition has worsened, Medicare coverage may be discontinued.

How to Determine Eligibility?

To qualify for Medicare coverage of skilled nursing care, you must meet the following criteria:

● You must have been hospitalized for at least three days.

● You must require skilled nursing care.

● You must enter a Medicare-certified skilled nursing facility within 30 days of your hospital discharge.

If you meet these criteria, you may be eligible for Medicare coverage of skilled nursing care. However, it's important to note that Medicare does not cover long-term care, which means that if you require custodial care, you may need to explore other options.

Conclusion :-

Understanding Medicare nursing home coverage can be complicated, but it's important to be informed about your options. At Suncrest Hospice Care, we are committed to helping families navigate the end-of-life care process and providing compassionate care to those who need it. If you or your loved one requires hospice care or palliative care, please visit our website to learn more about our services.