Here’s a closer look at Medicare coverage for nursing homes and hospital stays.
Medicare explained
Medicare Advantage plan comparisonHere’s a closer look at Medicare coverage for nursing homes and hospital stays.
Medicare will not usually cover services that help with everyday life functions, such as assistance with dressing, eating or going to the bathroom. Generally, if the care you receive in a nursing home does not require a degree to provide, Medicare won’t cover it.2 However, Medicare Part A may provide coverage for skilled nursing facility (SNF) care that’s medically necessary (for example, changing sterile dressings).
Note: If you have a Medicare Advantage plan (Part C), contact your insurance carrier. You may have extra benefits for vision, hearing and dental that Original Medicare doesn’t cover.4
Humana Medicare plans offer benefits beyond what Original Medicare covers. Explore all of the plans available in your area today!
At a skilled nursing facility, care is usually provided by registered nurses under the supervision of a doctor. Generally, patients will go to a skilled nursing facility for recovery after an injury, sickness or surgery. The care is usually meant to be temporary, with patients returning home once they are able.
At a nursing home, the care is typically more long-term. Licensed practical nurses or nurse aides help residents with daily life functions, such as bathing, dressing or eating. This care is meant for patients who may not be able to live comfortably on their own due to chronic conditions.
Medicare Part A does not cover most nursing home care. Medicare Part A may help cover some medical services in a nursing home under certain conditions. If you need skilled nursing care, such as changing sterile dressings, Medicare Part A may help cover some costs.
Medicare Part B helps cover most preventive care and medically necessary doctor’s services. In a long-term care setting, this could mean services such as physical therapy or speech therapy. After 100 days in a long-term care facility each benefit period, this type of care is no longer covered by Medicare Part A. At this point, Medicare Part B is typically used to help cover some of the costs of these services.
Medigap plans, or
Unfortunately, Medigap generally won’t cover nursing home care. However, it may help with some of the costs for short-term care, such as copays or coverage toward deductibles.
Medicare Part D is prescription drug coverage designed to help pay for medication. If your stay in a long-term care facility is covered by Medicare Part A, then some of your prescription drugs may also be covered under Part A. If your stay is not covered by Medicare, then you may be covered for certain medications under a
SNF care is nursing and therapy that can only be performed or supervised by professionals or technical personnel. Medicare Part A may help cover SNF care in certain conditions for a limited time if all of these conditions are met:2
Medicare Part A may pay for medical services at a long-term care facility for up to 100 days. After this period, Medicare may still be used to cover some treatments, such as occupational therapy, speech therapy or speech-language pathology. However, Medicare won’t cover room and board after 100 days.3
If you need coverage beyond 100 days of skilled nursing care, or if you need help with the cost of nursing home care, you may have other options:4
If you need long-term care, or you’re planning ahead, you may have options available. Talk to family, your doctor or a counselor for help choosing the best option for you.
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