Does Medicare Cover Nursing Homes?

When it comes to health care in America, trying to learn all the ins and outs of what it actually covers can be tricky.

If you are a legal guardian or have questions about Medicare coverage regarding nursing homes for yourself, the information below will provide some answers.

Medicare Part A

If you are turning 65 years old, or are under 65 years old, but receive Social Security disability benefits, you are eligible for Medicare. Furthermore, if you are under 65 and have end-stage renal disorder (ESRD), you are eligible for Medicare coverage.

For those who are eligible for coverage, Medicare Part A is the section that covers hospital insurance. This benefit includes a skilled nursing facility (SNF), but a physician must medically clear you, or deem this service necessary for your condition to improve.

On the other hand, there is nursing home care, which has very similar guidelines to a SNF. Medicare Part A does cover nursing home care, and this care includes custodial care. Custodial care is the assistance with the essential activities that one needs to do on a daily basis. These activities include bathing, dressing, eating, and getting in and out of bed.

Note: Medicare does not cover custodial care alone if this is the only kind of care that is needed.

Alternative Methods of Obtaining Nursing Home Care Without Medicare

Not everyone will meet the requirements for Medicare. For those who fail to qualify, getting quality nursing home care can still be a reality. If you feel it is the best option for you and your family, here are some ways to make this possible:

Your Personal Bank Account/Savings

If you have saved money your whole lifetime, those funds can be used to pay for quality nursing home care at one of the 15,000 nursing home care facilities around the country.

Whole/Permanent Life Insurance

Whole, or sometimes called permanent life insurance, has the ability to build up a cash value over time. That cash value can be used for anything the policyholder wants to purchase such as nursing home care. However, any loan taken out of that cash value will decrease the death benefit by the same amount.

Medicaid (State Assistance)

Medicaid is a large government program that helps millions of people obtain certain types of medical assistance they might require. However, one thing to note, not every nursing home accepts Medicaid as a payment method. If there is a local nursing home near and you want to know if they accept Medicaid, the best way is to call them directly and inquire about their specific billing requirements.

Final Thoughts

Medicare does cover nursing home care. However, there are stipulations such as it does not, generally, cover long-term care. Also, if custodial care is the only service you require, Medicare would not cover that as well. With that said, Medicare still has many great options and should not be dropped from your health care portfolio.

To learn more about enrolling in Medicare, contact the experts at (877) 829-1109. Our licensed insurance experts will be happy to answer any questions you have.