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General information from a recorded webinar, not legal advice for your situation.
Will Medicare pay for a nursing home?
Short answer
Only for a limited time. Medicare pays for skilled nursing care after a three-day inpatient hospital stay followed by direct discharge to a skilled nursing facility. Observation status does not count. Days 1 to 20 have no copay; days 21 to 100 have a daily copay. Medicare does not pay for assisted living.
Key points
- You must be admitted as an inpatient, not under observation.
- Coverage is up to 100 days.
- The daily copay changes each year.
Lauren FinkFounding attorney, Everbright Legacy Law
Read this part of the transcript
Medicare is a government entitlement program that pays for care at a skilled nursing home for a limited timeframe. So Medicare will not pay for care at an assisted living facility. Medicare will pay for long-term care at a skilled nursing facility if you have a three-day inpatient hospital stay and then you’re directly discharged to a skilled nursing facility. So with the nursing home benefit for Medicare, it’s very important to note that that is an inpatient requirement. So you cannot be on observation status and have Medicare pay for your care. And many times we do have people who have to go to the hospital, and the hospital doesn’t admit them, but merely puts them on observation status.
Created automatically from the recording. Full transcript on the webinar page.
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