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Will Medicare Pay For A Nursing Home Stay?

 

In this Elder Law Minute, Wes Coulson discusses if Medicare will pay for someone’s nursing home stay.

Transcript:

I want to talk today about whether Medicare will pay for someone’s nursing home stay. Quick answer: Only for a little while, if certain conditions are met.

What are the conditions?

  • First of all, you still have to have part of your Medicare Part A days left for the year. So other circumstances might limit the amount that you have available.
  • You have to have a three day minimum inpatient hospital stay. If you’re there under observation, that doesn’t count as an inpatient stay.
  • You need to go into the nursing home based on a doctor’s advice within thirty days after that stay

If all of those conditions are met, Medicare will pay for your care during the first 20 days, and will pay subject to a deductible, that for 2020 is $176 a day, up to the next 80 for a total of 100. But in each case, only if you are still getting skilled care, which most of the time means physical, occupational, and/or speech therapy.

There is a whole separate question, by the way, about when therapy should be continued so that Medicare will still pay for it. Don’t count on the 100 days. The typical is closer to 30. As to that deductible, if you have some Medicare supplement insurance policies or Medicare Complete, they will pick up the deductible again, only in some instances. So that is something you need to call the carrier about right away and find out whether you’re going to have to pay that first $176 a day for those days beyond the first 20 days.

One other hint on this, we call that the “Window of Opportunity” for Medicaid planning. Most of the time when people are in for rehab, they wind up staying longer term in the nursing home, so that time during Medicare days is a great opportunity to do some planning while you have somebody other than your own pocket paying for care.

Also looking for information about Medicaid and Asset Preservation? Visit these articles:

    • Do Living Trusts Protect Assets From Medicaid or VA Spend Down?
    • How an Asset Preservation Trust Protects Your Life Savings From Long-Term Care Costs
    • Why Do I Need an Asset Preservation Plan?

“Your Trusted Advisor on the Elder Care Journey”

Dent-Coulson Elder Law is dedicated to providing families in the St. Louis area with their Elder Law needs. Our practice areas include Asset Preservation Planning, Veterans Benefits, Medicaid Eligibility, Alzheimer’s Planning, Special Needs Planning, Estate Planning and more. We understand the financial challenges you may face as you and your loved ones grow older. At Dent-Coulson Elder Law, our clients’ well-being is our number one priority. For immediate help, call (618) 632-7000 (IL) or (314) 567-9292 (MO), or Contact Us and we will get in touch as soon as possible.

Veterans Benefits O'Fallon ILFor Immediate Help

If you or a loved one needs immediate help with a planning matter or legal issue, please contact us, and we will get back to you promptly.

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Free WorkshopsIf you have reached age 65, there's about a 45% chance that you will eventually need long-term care.

Join us for one of our highly informative and FREE workshops and find out how you can protect your family's hard-earned life savings.

Visit Free Workshops for more information.

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774 Sunset Blvd Suite 200
O'Fallon, IL 62269
IL: (618) 632-7000
MO: (314) 567-9292

415 W. Virginia Ave.
Effingham, IL 62401
(217) 330-5500

Fax: (618) 632-7333
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Front office building of Coulson Elder Law

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774 Sunset Blvd Suite 200
O'Fallon, IL 62269
IL: (618) 632-7000
MO: (314) 567-9292

415 W. Virginia Ave.
Effingham, IL 62401
(217) 330-5500

Fax: (618) 632-7333
Send us an email

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