Medicare in a Nursing Facility
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Medicare covers some skilled care in an approved skilled nursing facility. |
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A minimum three-day prior hospital stay is required. |
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The patient must enter a facility within 30 days after discharge from a hospital. |
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The patient must continue to show improvement. |
Medicare in a Home Setting
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The patient must be confined to home and under a doctor's care. |
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Covers part-time skilled nursing care or physical therapy, speech-language therapy and home health aid services. |
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The patient's condition must continually improve. |
Examples of skilled care:
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Short-term IVs or tubing |
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Physical or speech therapy |
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Dressing bed sores |
Examples of non-skilled care:
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Oxygen or respiratory therapy |
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Colostomy drain |
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Catheter maintenance |
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Assistance with Activities of Daily Living (ADLs) such as bathing, eating, dressing, toileting, transferring and continence |
What does Medicare pay when parameters are met*?
| Time Period |
Individual Pays |
Medicare Pays |
| 0 to 20 days |
$0 |
All Costs |
| 21 to 100 days |
First $114 |
Above $114 |
| Over 100 days |
All Costs |
$0 |
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*Figures for 2005
Medicare guidelines vary by state. Contact your local Medicare office for details.
For more information regarding benefits provided by Medicare or Medicaid, visit the Centers for Medicare and Medicaid Services Web site.
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