How to Afford the Best Possible Nursing Facility Under Medicare

When you or a family member turns 65, there's a high chance you will need some form of long-term care. In most cases, this care may go on for more than five years.

The sad part is that nursing home care costs have skyrocketed recently. A 2021 Glenworth Survey showed that staying in a semi-private nursing care room costs around $7,908 each month.

These startling statistics can quickly rule out the possibility of affording a nursing home facility. However, there's a relief – you can afford the best nursing facility under Medicare.

Read on to learn what Medicare does and doesn't cover related to nursing facilities, how you can strategically choose plans that fit your anticipated needs for a nursing facility, as well as how you can afford the best possible services at a nursing or retirement home.

Medicare Basic Coverage

Medicare offers insurance coverage to individuals with end-stage renal disease, young people with specific disabilities, and seniors.

Understanding how Medicare works can help you choose a plan that best suits your needs. Here’s a brief overview of what your Medicare Plan Covers:

Short-Term Nursing Home Stay

First, if you are looking for skilled nursing care in a nursing facility, your Medicare plan will pay for it. Usually, such care is differentiated from long-term stay because the latter requires ongoing personal care and assistance.

Secondly, Medicare cover will pay for rehabilitation expenses in a nursing facility, provided it is not over an extended period. For the cover to be applicable, your stay in a skilled nursing facility is limited to up to 100 days.

Long-Term Nursing Home Stay

Generally, your Medicare program won't cover your long-term care costs in any nursing facility. You can still use it depending on the circumstances. For instance, if your need for long-term nursing care seems unavoidable, though not necessary, you may use your Medicare plan.

In this case, you will be covered for all the home health services such as occupational therapy, speech-language pathology, physical therapy, and intermittent skilled nursing care.

Also, you will find your Medicare health coverage helpful while in the nursing home, especially in paying for medical supplies, doctor services, and hospital care expenses.

What’s the Best Medicare Plan for You?

The extent of Medicare coverage depends entirely on the type of coverage you took. For instance, your Medicare coverage may cater for all the prescription drugs and health care you get at a nursing facility.

Let’s break down this further for you.

The Medicare health program is categorized into several types. The popular ones include the Original Medicare, Medicare Advantage, and Medicare Prescription Drug Coverage (Part D) plans. Each of these plans covers a varying degree of care.

●???????Your Original Medicare plan won't be used to cater for most nursing home care. Usually, this type of plan is designed for short-term skilled care, either due to an injury or illness.

●???????The Medicare Advantage Plan and most other related programs may cover nursing facility care. However, in most cases, this happens on a contractual basis. So, it would be best to find out from your nursing home whether such care will be covered.

●???????Your Medicare Drug Coverage (Part D) plan will pay for all your prescription drugs from a recognized pharmacy contracted by the nursing home.

How to Afford Services of Nursing Facility Under Medicare

Financing your nursing home stay is expensive and can be overwhelming. However, with prior and proper planning, you can have an easy time at the facility.

Some of the options at your disposal to complement your Medicare plan include:

Long-Term Care Insurance

It is advisable to purchase a long-term care insurance plan in advance. However, invest some time in research, so you understand different policies. For instance, some policies will pay for your nursing home care while others only cater for some medical equipment, informal home care, assisted living, and adult daycare.

Medicaid

Medicaid is a health insurance program offered by the state in collaboration with the federal government. It's designed to help citizens with limited income and often covers most healthcare costs. However, you must check with your nursing facility whether they accept Medicaid.

Personal Resources

Another way to afford the best possible nursing facility under Medicare is by using your savings and personal money. Set aside some amount from your savings to cater for your expenses while at the facility.

Additionally, some insurance companies will allow you to pay for your stay at a nursing home with your life insurance policy. However, make sure you liaise with your insurance company to determine whether they have such a plan.

Final Thoughts

There you have it – everything you need to know about nursing home care costs. The right payment plan can ease your stay at any retirement or nursing home.

Medicare is an excellent program for individuals aged 65 or older. However, most individuals miss this opportunity due to a lack of awareness of what the program covers or doesn't. Don't fall for the same – seek help from experts in this area.

The Medicare Family has helped seniors navigate the application process. Get in touch with the professionals at Medicare Family for guidance on enrolling in Medicare as needed throughout your life.