Alternatives To Nursing Home Care For Medicare Beneficiaries

By Author: Georges Baxter
Total Articles: 15
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Have you ever considered what you would do if you needed to utilize the services of a nursing home? Will your Medicare Advantage Plan or Medicare supplemental insurance pay for the expense?

“Under certain limited conditions your Medicare insurance will pay for some nursing home costs,” suggests Alan Weinstock, insurance broker with MedicareSupplementPlans.com. “However to be covered you need to have a qualifying hospital stay before being transferred to a Medicare certified skilled nursing home.”

Medicare Advantage and Medicare Supplemental Coverage

Knowing what your Medicare Insurance will and will not cover when it comes to nursing home care can make all the difference when you need it.

Managed care plans do not pay for nursing home care unless the home has a contract with the plan. So find out which nursing homes your plan covers and make sure your plan monitors the home for quality of care.

Medicare supplemental insurance (or Medigap) plans typically help pay for skilled nursing care; however, only if the care is covered by Medicare.

Program of All-Inclusive Care for the ...
... Elderly (PACE)

PACE is an optional benefit for older adults who meet their State’s standards for nursing home care. For many patients the comprehensive service package makes it possible for you to live at home while receiving services. However, PACE is only available in states that have chosen to offer it under Medicaid.

You must be at least 55 years of age, live in a PACE service area, be screened by health care professionals and be able to live safely in a community setting. For more information visit the Center for Medicare and Medicaid Services PACE website.

Social Managed Care Plan

Social Managed Care Plans offer the full range of Medicare benefits along with additional services such as prescription drug benefits, chronic care benefits covering short-term nursing home care, and home- and community-based services such as adult day care and medical transportation.

Other Elder Care Services

In addition to the services already mentioned, there are also home and community care services, non-medical subsidized senior housing and assisted living, board & care homes and continuing care retirement communities (CCRC).

Home and community care services include services such as Meal on Wheels, shopping services and adult day care. Depending on your situation, Medicare may pay for some home care costs.

Senior housing services include federal and state programs (subsidized) or private programs (assisted living) that help pay for independent-living facilities that offer assistance with such tasks as shopping or laundry.

Board and care homes are for those who cannot live independently and require nursing services. In most cases you would receive assistance with eating, walking, bathing and such. Typically Medicare does not pay for this type of service.

Finally, CCRCs provide differing levels of care based on individual needs and include everything from independent-living apartments to skilled nursing care in an affiliated nursing home.

The best way to get more information about nursing home care alternatives and Medicare is to contact your local State Health Insurance Assistance Program (SHIP).

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