Original Medicare may cover specialized care in a nursing home or in your home (with home health care), if you need short-term specialized care for an illness or. Nursing homes are centers where people can live and receive long-term, full-time health care. Most nursing home care is custodial care, which helps people carry out activities of daily living (such as bathing, dressing, and eating). Original Medicare doesn't cover custody care if it's the only care you needs.
Original Medicare may cover specialized care in a nursing home or in your home (with home health care), if you need short-term specialized care for an illness or injury and you meet certain conditions. Yes, Medicare Part A can partially cover up to 100 days in a nursing home if specialized nursing care is required. Medicare will not cover stays longer than 100 days and will not cover a nursing home stay at all if skilled nursing care is not needed. Medicare Part B covers outpatient expenses and doesn't cover a nursing home stay.
Privately purchased Medicare Advantage plans (Part C) vary widely in terms of coverage, but they generally only cover short-term nursing home stays if someone needs specialized nursing care. With Medicare, long-term non-medical care in a nursing home isn't usually covered. This is generally true for all types of “custodial care.” Custody includes things like food preparation and other tasks. of the household.
Someone other than a medical professional can provide it for you. Some people buy long-term care insurance to pay for custody care in a nursing home or assisted living facility or for a caregiver to come home. When you receive care in a skilled nursing facility, your care is measured in benefit periods, which are related to the number of consecutive days you receive care. Nursing homes, or skilled nursing facilities, provide medical and personal care services to people who cannot live safely alone. If you're enrolled in a Medicare Advantage (Part C) plan (such as an HMO or PPO plan) or another Medicare health plan, check with your plan to see if it covers nursing home care.
In particular, Medicare only pays for a maximum of 100 days of care in a skilled nursing facility during each benefit period. After spending 100 days in a long-term care facility for each benefit period, this type of care is no longer covered by Part A. People who get their health insurance through one of these plans receive at least the same coverage as people who choose original Medicare. If you or someone you know is considering nursing home care, make sure you fully understand what services Medicare does and doesn't pay for. Medicare Part A will fully cover an older person's rehabilitation stay in a nursing home for up to 20 days, and partially for days 21 to 100.
What Medicare won't cover is rent or room and board in a long-term care facility, including nursing homes. Ask your plan about nursing home coverage and check the facility's quality ratings before making arrangements to enter a nursing home. It must be medically necessary for you to receive skilled nursing care (for example, if you need help changing sterile dressings). Nursing homes, also known as skilled nursing facilities, provide ongoing medical care and personal care services to people who need that support and can't get it at home.
