The Medicare healthcare insurance plan does not cover long term nursing home care, but the Medicare nursing homes section of the Medicare scheme does cover short term stays in nursing homes. The coverage is dictated by the length of the stay and the type of nursing home care required.
In order to qualify, you must have spent at least three days in hospital prior to transfer to a Medicare certified nursing home facility and you must enter a nursing home within thirty days of your hospital stay to qualify.
The cost of a Medicare certified nursing home is covered for up to twenty days. Thereafter, you are responsible for part payment for the next one hundred days of care per diagnosis and hospitalization. Medicare does not cover nursing home cover stays for duration of longer than one hundred days. Medicare coverage also ends if medical professionals document that you are failing to make progress towards independence.
If you reach the point where you are no longer able to be rehabilitated, but you still require nursing care, you will have to pay for your care. This might mean using your savings or selling your assets to cover the cost of care. If you reach the point where you have cashed in all your savings and assets and can no longer afford to pay for care, you can apply for Medicaid, which will then start paying for the long term nursing home care.
Once it is established that you will need to stay in a nursing home for a period of time, you will need to start looking for nursing homes in your area. The Medicare nursing homes compare tool can be found on the Medicare website. This is an informative guide to helping you find and compare nursing homes based on geographical criteria. Alternatively, you can ask for guidance from people you know and trust, for example friends or relatives who have used nursing homes, or medical personnel.
The Medicare Compare scheme helps you to make the right decision based on your needs by giving you information on how Medicare nursing homes are rated in your area. New guidance instigated in 2009 ensures that all nursing homes covered under the Medicare healthcare scheme are regularly inspected by nursing home surveyors to see that they maintain certain levels of care for the residents. These include ensuring the residents are able to live with dignity, they have choices in care and services, their environment is accommodated to their needs and preferences, and the home can offer a home-like environment that includes access for visitors. All of these guidelines are designed to ensure that the people who spend time in nursing homes can enjoy an improved quality of life.
There are many factors to consider before choosing a Medicare approved nursing home for you or your relative. If there is a possibility you might be in the home for a long duration, you need to be certain that the home is right for you. Once you have decided on the home that is suitable for your needs, the home is obligated to help you apply for and use the Medicare benefits available to you. They can also help you claim refunds on any payments already made that are covered by Medicare.
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