What Seniors Should Know About Nursing Home Coverage By Medicare

4 minute read

By Chelsea Dolan

Despite the growing need for long-term care, this essential service remains unaffordable for a growing number of seniors. Fortunately, if you start searching now, you can find the right Medicare plan to suit your needs.

Everyone needs help as they grow older. Which is why it helps to have insurance coverage in case you ever need help from professional nurses. In some cases, Medicare can step in to help with the costs associated with nursing home stays.

Does Medicare Cover Nursing Homes?

Medicare can help pay for the cost of nursing, but not long-term stays at nursing homes. Instead, they cover something called skilled nursing facilities. Essentially, what’s covered is the type of care that can only be given by a registered nurse or doctor. Medicare covers this type of service for a limited time on a short-term basis.

So, what professionals qualify as a skilled nurse? Here are some examples:

That being said, Medicare does not cover traditional nursing home facilities. These are considered non-skilled personal care and custodial care. Anything related to helping people with performing regular daily living is not covered.

Some examples of nursing care services that are not covered include:

If you do want coverage for nursing homes, it might help to look into Medicare Supplement Insurance (Medigap). This type of plan can help you find coverage sold by private companies for things not covered by Medicare. They can help you pay for remaining health care costs like copayments, coinsurance, and deductibles. Search online to learn more about Medigap.

Coverage From Medicare

Medicare can help pay for skilled nursing facility costs under certain conditions. First, it must be considered a medically necessary treatment by a doctor and approved by Medicare.

Skilled nursing facility coverage falls under Medicare Part A. In order to receive coverage, you must meet the following qualifications:

If you meet all of these qualifications, here is what you will pay and what Medicare will cover:

Medicare can help pay for short-term skilled nursing home stays. You can learn more about the ins and outs of what’s covered by searching online or speaking with a Medicare customer service agent.

Learn More About Medicare Coverage Online

If you want skilled nursing included in your healthcare plan, then you must be enrolled in Plan A. This can give you monetary assistance for up to 100 days should you ever need services from a skilled professional.

Medicare offers a variety of health plans, many of which include Plan A services. It’s important to read up on what each plan offers to ensure you’re getting coverage for what’s most important to you.

Here’s a brief rundown of each Medicare plan:

Whether you’re looking to enroll or want to make adjustments to your current Medicare health care plan, start an online search. You can learn more about what plan can best suit your needs and ensure you’re getting the proper coverage.

Learn More Today!

As the need for long-term care grows with age, understanding your Medicare coverage options becomes crucial. Medicare provides substantial support for short-term skilled nursing facility care, but traditional nursing homes and non-skilled personal care remain outside its ambit.

To ensure you are adequately covered for your specific needs, it’s essential to be familiar with the various Medicare plans available, from Part A to Medigap. As always, a thorough online search or consultation with a Medicare representative can offer invaluable insights and clarity.

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Chelsea Dolan