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Medicare is a benefit provided by the Federal government that helps
cover residents in a Skilled Nursing Facility (SNF).  residents who no longer
need intensive hospital care but still need skilled nursing care
and rehabilitation services on a daily basis can use their Medicare benefits.  However, Medicare does not cover long term care or nursing home care that ispersonal or custodial (example: help with dressing, bathing and eating).

Medicare has Two Parts: 

• Part A (Hospital Insurance) - hospital care, home health care and care
in a Skilled Nursing Facility. If you are eligible for Medicare, you do not
pay a premium for Part A. If you are not eligible, you may enroll by paying a monthly premium.

• Part B (Medical Insurance) - helps cover many medical services and supplies
not covered by Part A. Part B coverage requires a monthly premium.

To be eligible for Medicare benefits, you must be: 

• Age 65 or older and have worked long enough to be insured under  
  Social Security, the Railroad Retirement system or the federal
  government.

• Under 65 and have received disability benefits through Social
  Security for more than 24 months.

• Already receiving benefits from Social Security or the Railroad
  Retirement System.

• A person who has permanent kidney failure If you’re covered by
  Medicare, you can qualify if you meet all conditions. You must:

• Be certified by a Doctor that you need daily skilled nursing or
  rehabilitation services.

• Need daily care that can only be provided in a Skilled Nursing
  Facility on an in resident basis.

• Have been in a hospital for at least 3 consecutive days, not counting
  your day of discharge.

• Be admitted to a Medicare-Certified SNF within 30 days of your
  hospital discharge.

• Receive Care in the Skilled Nursing Facility for a Condition that was
  treated in the hospital.

MEDICARE  PART A 

Medicare Part A insurance helps cover up to 100 days of care in a Skilled
Nursing Facility per benefit, if needed.

Part A Benefit Period

• Begins the first day you are admitted into a Skilled Nursing Facility for
  inresident care.

• Ends when you have been out of the hospital and not receiving in
  resident Skilled Nursing facility care for 60 days in a row.

• There is no limit to the number of benefit periods you can have for
  Skilled Nursing facility care.

Benefit Period

• First 20 days of a benefit period - Medicare Part A pays all costs that
  are covered for Skilled Nursing Facility care.

• Next 80 days of a benefit period – Medicare Part A pays all covered
  costs over $114.00 per day. • The $114.00 per day is called a “co-pay”
  which must be paid by the resident/resident or an insurance company
  that covers the “co-pay” amount.

Skilled Nursing services that Medicare Part A helps cover:

• A 2 to 4 bed semi-private room

• All meals, including special diets

• Nursing Care

• Therapy

• Medications
• Medical supplies such as splints and casts

• Medical equipment such as wheelchairs

MEDICARE  PART B

Medicare Part B helps pay for certain medical services and supplies that
Medicare Part A does not cover.

Under Medicare Part B:

• You pay the yearly deductible.

• After you meet the deductible, Medicare usually pays 80% of charges.

• The additional 20% is called “co-pay” which must be paid by the
  resident/resident or an insurance company that covers the “co-pay”
  amount.

• You also have to pay for any amount over the approved costs.

Medicare Part B helps cover:

• Physician services

• Diagnostic tests

• Certain ambulance services

• Outresident hospital services

• Physical, occupational, and speech therapy

• Medical equipment used at home

• Mental health care

• Services of other healthcare professionals such as chiropractors,
  podiatrists and dentists under limited circumstances

• Other services and supplies such as pap tests, mammograms,
  prostate cancer screening, and home health care (if the person does
  not have Part A)

Medicaid
Medicare
 

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