医疗保险
Don’t Count on 医疗保险 to Pay for Your Long-Term Nursing Home Care
If you or a loved one is covered by 医疗保险, you have limited benefits 帮助 you pay for a stay at a 养老院 or other certified skilled nursing facility. 医疗保险 won’t pay for long-term care, so the period of time covered is limited. If you or a family member is trying to use 医疗保险 to pay for a stay in a 养老院, 我们可以帮助你.
医疗保险 is a federal insurance program that helps pay for hospitalization (Part A) and care by physicians (Part B); there’s also the 医疗保险 Advantage program (Part C) and coverage of prescriptions (Part D). Almost everyone who pays the FICA withholding tax out of their paychecks will receive Social Security and will be eligible for 医疗保险 supplement insurance. 医疗保险 coverage starts at age 65 (or two years after someone starts collecting Social Security disability benefits) no matter the Social Security retirement age or whether someone retires early.
医疗保险 payment for 养老院 care
医疗保险 Part A may cover skilled nursing care in a 养老院 as long as it’s medically necessary (for medical reasons you’re too healthy to stay in a hospital but not healthy enough to go back home). Most 养老院 care is considered custodial care (such as help with bathing or dressing), 不包括在医疗保险之内的.
Depending on the circumstances of your admission to a 养老院, you may not qualify for any 医疗保险 benefits. A 医疗保险-eligible person must be admitted as an inpatient to a hospital for three days and two nights and receive a rehabilitative discharge before coming to the 养老院 within thirty days of that discharge. 医疗保险 won’t cover 养老院 care if the person was seen in the hospital as an outpatient, was there just for observation or goes directly from their residence into a 养老院.
You’re an inpatient when you’re formally admitted to the hospital with a doctor’s order. A decision for inpatient hospital admission is based on your doctor’s judgment and your need for medically necessary hospital care. It’s generally appropriate if you’re expected to require at least two nights of care.
If the person is eligible for 医疗保险 coverage at a 养老院, it will fully pay for up to twenty days of care; then the resident may have partial coverage up through day one hundred depending on whether the patient is improving. During that second period, the resident has a daily co-pay of $167.50. Thereafter, there is no 医疗保险 coverage for a 养老院 stay.
Additional conditions on 医疗保险 payments include:
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Your doctor must decide that you need daily skilled care given by, 或在…的直接监督下, 熟练的护理人员或治疗人员.
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Your 养老院 is certified by 医疗保险.
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You need skilled nursing care for a medical condition that was either a hospital-related medical condition or one that you were diagnosed with while you were receiving care in the 养老院 for a hospital-related medical condition.
Services 医疗保险 will pay for at a 养老院
Some 养老院 services covered by 医疗保险 include:
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A semi-private room shared with another resident
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餐
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熟练护理
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Physical and occupational therapy as necessary
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Speech-language pathology services as necessary
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医务社会bet9九州体育登录
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药物
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Medical supplies and equipment used in the 养老院
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Ambulance transportation (if other transportation may endanger the resident’s health) to the nearest supplier of needed services that aren’t available at the 养老院
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膳食咨询.
在头二十天之后, in order for 医疗保险 to continue paying benefits you must show some improvement. Benefits will end if the progress ends before day one hundred.
Get help with 医疗保险 payment of 养老院 services
如果你正在考虑 养老院 for you or your disabled or aging loved one, do some research to find the best match while considering how the care will be paid for, 无论是私人薪酬, 医疗保险, 医疗补助计划 或者私人长期护理保险. If you have any questions or concerns about 医疗保险 coverage of a 养老院 stay, you can find out more by discussing it with the 新奥尔巴尼, IN, 长期护理律师 丘奇，兰登，洛普，巴内特·劳.
For skilled and knowledgeable representation, bet9九州体育登录线路 us by calling 812-725-8224 or by filling out our online form.
律师加里·巴内特
Gary is licensed to practice law in both 印第安纳州 and 肯塔基州. He concentrates his practice in estate planning, 遗产及信托管理, 遗产及信托诉讼, 监护, 老年人法和特殊需求规划. 加里赢得了他的J。.D. from the University of 路易斯维尔, Louis D. Brandeis School of Law, and formerly practiced law at Bingham Greenebaum Doll and Wyatt, Tarrant & 库姆斯. [ 律师生物 ]
