Have you wondered, does the skilled nursing facility near me accept Medicare coverage? If not, what could you be missing out as a long term care patient? You should be able to enjoy the services at any skilled nursing facility near me facility.
Still, not all such facilities want to understand the plan. Some turn away the patient to avoid dealing with the strict rules of the scheme. Such a lax policy benefits neither party. Why Medicare?
In an aging society like the US, long term care is an ever-increasing cost. Picture this. Statistics show that at least 5.7 million Americans live with Alzheimer’s. And, by the year 2050, this number will reach 14 million.
Now, everyone in the US must sign up for Medicare before turning 65. Still, not all long term care facilities have Medicare as a payment option. How so?
Medicare Guidelines for a Skilled Nursing Care Facility
To understand the strict rules about Medicare, let’s explore this. Why do doctors ask their patients to check into a skilled nursing facility? To refrain from paying avoidable medical bills as they heal.
Hence, Medicare becomes the first choice for many. It pays for the following health care costs: –
- Doctor’s fees;
- Hospital stays;
- Cost of prescription drugs and;
- Long term care costs at skilled nursing facilities.
The first three costs apply during hospitalization. The last one is only for skilled nursing facilities. Here, the long term care costs include: –
1. The costs right after discharge from hospital if: –
- The doctor suggests the help of skilled nursing facilities or;
- You check into any such a skilled facility within three days of admission or;
- You move to a Medicare-certified skilled nursing facility near me before 30 days end.
If you meet these terms, Medicare pays for your stay in this facility for up to 100 days.
2. Any costs that a doctor prescribes as necessary with or without hospitalization.
These include occupational therapy, physical therapy, and speech-language pathology. The facility offering the services must have Medicare\’s approval.
Also, Medicare pays for the cost of the supply of vital medical equipment. These include a hospital bed, wheelchairs, and walkers. Here, Medicare caters for 80% of the cost of equipment.
The program pays all approved costs as long as the doctor prescribes them every two months. Hence, whether you get better or not, your cover remains valid.
3. Preventive Costs
Some patients may have a medical condition that seems not to improve. Here, Medicare pays for unlimited long term care services to manage the condition. These ailments include Alzheimer’s, ALS, stroke, and Parkinson’s disease.
4. Hospice Care
Patients with terminal illnesses may seek the services of a skilled nursing facility. Then, Medicare pays for any medicine to control the symptoms and relieve the pain. If you check into the facility with a necessary caregiver, Medicare pays for some of his/her short stays.
Why does Medicare emphasize on skilled care?
Medicare caters for skilled long term care only. The only exception is persons using the Medicare Advantage Plan. Even here, Medicare will pay for part of the total cost when under custodial care. Why the difference?
Custodial care is individual attention provided by persons with no medical training. It includes help with bathing, feeding, taking medication, and getting out of bed.
In contrast, skilled care is by a certified medical professional. This care can be either at the nursing facility or home.
Are you a long term care patient living on a fixed income? Then, a skilled nursing facility that accepts Medicare is a welcome relief. Such facilities take their time to understand the scheme for the benefit of the patients.
This way, they don’t turn away needy patients who can’t afford to pay cash or expensive insurance plans. Skilled nursing care goes beyond the physiological needs of the patients.
It’s not always easy to find a skilled nursing facility near me under Medicare. So, know that you’re not alone. Do you struggle with the same? There are Medicare-certified long term care facilities in Kirkwood. Call them today.