Introduction
Medicare is a facility that is provided to the individuals that acts as a aid for them. Medicare is usually for poor and elder people that are unable to pay their medical expenses. Although the Medicare is of different type it depends on its category that explain what types of expense will it cover. Medicare will cover your food expenses or your medical bills. Medicare pays short term bills. It is not a long-term stay. When Medicare stops covering the expenses then the families are struggling for what to do next. In this article we will discuss why Medicare stops paying, what to do afterwards, what options are available.
How Long Does Medicare Cover Nursing Home Care?
Medicare only covers nursing home care if you are hospitalized at-least for three days and you need a skilled nursing or rehabilitation and doctor thinks that you need continuous care and have to be hospitalized. Medicare covers up to 100 days depending upon the coverage period. For first 20 days Medicare pays 100 percent of your bills but from day 21 to 100 you have to pay a daily co-payment while after 100 days Medicare stop paying your expenses till you are not eligible for new benefit period.
What Happens When Medicare Stops Paying?
Let me clear something Medicare did not end paying your bills on its own. It notifies families and residents before the coverage ends. Then afterwards the family has to decide how to continue the care coverage. They may have some savings or have any private insurance coverage or any medical eligibility.
Options for Paying When Medicare Ends
Medicaid (Government Assistance for Low-Income Individuals) Medicaid is a joint federal state program that pay for long term nursing home care if you meet financial and medical requirement. Eligibility criteria included that you have minimal assets and have low income. If you want to apply then contact your state Medicaid office. Then provide proper details of financial records, medical documents and also proof of nursing home need.
Private Pay (Using Personal Savings or Family Help) If you didn’t qualify for Medicaid then you have pay out of pocket. This can be expensive. Different ways to pay your nursing home care is savings or retirement account, by selling assets, family contributions etc.
Private Pay (Using Personal Savings or Family Help). Some people buy long term insurance for covering nursing home costs. Policies does not cover pre-exist conditions. You have to buy the plan first for get covered in future. Services are different premium services are more expensive especially for older people.
Planning Ahead: Avoiding Financial Stress
Talk to a financial advisor before care is needed. Some families use legal strategies for the qualifying of the services while preserving their assets. If you are healthy and feel no underlying disease still look into coverage option to avoid stress. Set up a power of attorney. This will allow to take decision when you are not able to and will manage your work seamlessly.
What to Do When Facing Medicare Termination
Understand your appeal right. If you believe that Medicare still should pay than appeal the decision. The nursing home must give you a notice for non-coverage and also instruction for appeal. Talk to the Nursing Home. Discuss whether they accept Medicaid or not and try to know other payment option and plans. Discuss alternate care plans if staying in the nursing home is not possible. Seek help from medical officer, financial advisor or elder law attorney.
Conclusion
Medicare is not a long-term solution for nursing home care. When coverage ends families must find an alternate way to pay. These ways include insurance, Medicaid etc. Planning ahead can prevent financial hardship and ensure better care choices. If you’re unsure about your options, seek professional guidance to navigate the process smoothly. Contact us for more details visit my site.