The Truth About Medicare: Will It Cover You When You Need It?
Posted on December 24, 2008
Filed Under Health and Fitness
Most people believe that Medicare will pay for all their long-term-care expenses. It does not. Fewer than 2 percent of the long-term-care costs in our nation is covered by Medicare. The coverage is restrictive and pays for such care only if you meet very strict criteria:
1. You must be in an acute-care hospital for three days before entering the “skilled” nursing facility. An acute-care hospital is an institution licensed by the state and legally qualified to provide skilled care.
2. The “skilled” nursing facility must be Medicare-certified. Skilled care is medical care that can only be performed by or under the supervision of licensed nursing personnel.
3. Your care must be defined by Medicare as “skilled” care, not custodial care. Custodial care is what most people receive by attendants in nursing facilities. It is not defined as medical care, as is skilled care.
When Medicare does pay for your skilled nursing care, it pays the full amount for the first twenty days only. For the next eighty days you must pay $81.50 a day before Medicare will pay the rest. After the one hundred days are up, you must pay the entire amount . With in-home health care, the same limitations apply. Medicare covers only a small portion of home health care and only if it meets the criteria of skilled nursing care.
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