Health

Your Guide to Medicare and Nursing Homes

In the United States, about 1.5 million people live in nursing homes and 44 million people are enrolled in Medicare. As people age, these two topics become more and more important. You might have questions on your own behalf or because you’re beginning to care for an older parent or family member. If you need to know more about nursing homes and Medicare, here’s what you need to know.

Medicare Vs. Medicaid

Medicare is federal health insurance that many Americans take advantage of after retirement. You can qualify for Medicare if you’re over the age of 65 or have a qualifying disability. The program is split into three parts: Medicare Part A, Medicare Part B, and Medicare Part D. Part A covers hospital care, including stays in a hospital or skilled nursing facility and hospice care. Part B covers doctors’ visits and outpatient care. Part D is the prescription drug plan. You can choose one or more of these three options or enroll in Medicare Advantage, which bundles all three parts. It’s easy to get quotes for Medicare insurance so you can start coverage.

If you do qualify for Medicare, you’ll want to know what is and isn’t covered. Unfortunately, nursing home stays are typically not covered by Medicare. The program will pay for up to 20 days in a skilled nursing facility after a hospital stay. After that, you’re responsible for $176 a day unless you have a Medicare supplement. Additionally, this is only for the first 100 days. After that, you’ll be responsible for the entirety of the bill.

Medicaid will pay nursing home expenses, but it’s much more difficult to qualify for Medicaid. You’ll have to meet your state’s income standard, which can range anywhere from $15,000 to $4,000. This means that you cannot have any cash or cash assets over this amount and if you’ve made any large gifts in the last few years, you may also not qualify. If you believe yourself or a family member will need nursing home care in the future, you’ll need to take a look at the insurance plans and see which will work best.

Pros and Cons of Nursing Homes

If you’re the sole caretaker for your loved one, a nursing home might be the right option. Long-term care facilities provide a safe place for seniors to live in. They’ll have the assistance of the home staff and the entire burden of caregiving won’t be on you. Your family member will have other people to interact with and many nursing homes provide activities for residents. Their food will be taken care of, as will their medical needs. A nursing facility is a great option for someone who needs frequent care and you’ll know that you’ve done the right thing for your loved one.

Unfortunately, not all nursing homes are up to this standard of care. You’ll need to keep an eye out for signs of abuse and neglect. 1 in 10 Americans over the age of 60 has experienced some form of elder abuse, which includes physical abuse, sexual abuse, emotional abuse, neglect, and financial exploitation. Some staff members will take advantage of their vulnerable residents and steal what little money they have. Some will neglect the residents’ needs. When you visit, look for signs that you’ve loved one is a victim of abuse. Bedsores, withdrawal, fear, and dehydration are all signs of abuse or neglect.

If you notice these signs, speak with a lawyer for nursing home negligence. You can take legal action and receive punitive damages. While many nursing homes are wonderful facilities, it’s important to stay aware of the potential dangers and seek legal advice if needed.

As you and your family members age, you have to know how to care for the elderly. Understanding insurance and nursing homes will help you and your loved ones stay safe.