When Does Medicare Pay For Nursing Home Care?

Kaiser Medical Insurance - When Does Medicare Pay For Nursing Home Care?

Hello everybody. Today, I found out about Kaiser Medical Insurance - When Does Medicare Pay For Nursing Home Care?. Which could be very helpful in my experience so you. When Does Medicare Pay For Nursing Home Care?

One of the most tasteless phone calls I receive in the office is when someone's mother or father is admitted to the hospital. In this time of crisis, answers are not easy to come by.

What I said. It isn't the final outcome that the true about Kaiser Medical Insurance. You see this article for home elevators a person want to know is Kaiser Medical Insurance.

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How does their health guarnatee work? What does Medicare pay for? Once the parent is discharged, what happens, where do they go, how is it paid for, what are our options? What do we do if mom or dad is going to have to go to a nursing home? How do we pay for it?

This blurring is staggering as the senior health care ideas can be a very confusing and amazing process. The first thing to do is to understand the basis for today's system.

In 1983, Congress created the Prospective cost System. This is prominent because when a man 65 or older is admitted to a hospital, he is assigned only one of 473 Diagnostic related Groups (Drg's). This is prominent because Medicare compensates the hospital a flat dollar estimate for the Drg assigned to the patient.

Let me give you an example. Say that my father is admitted to the hospital with lung problems and the Drg is four days. If my father is discharged in three days, then the hospital makes one day of profit. If my father is discharged in five days then the hospital loses money and cannot bill the inpatient for the one extra day.

Back in the good old days, I remember when my grandfather was in the hospital and the nurse asked him if he felt well adequate to go home because if he didn't, he could stay a few extra days until he felt better.

Today, it is all about the money. Once a inpatient is no longer getting best or worse, in other words, is deemed to be "stable", then the inpatient is discharged whether to home or a Medicare certified nursing home or rehab facility.

In order for Medicare to pay for rehab care the inpatient must have been in the hospital for three consecutive days (72 hours). Then, no later than thirty days after removal from the hospital, be admitted to a Medicare certified nursing facility.

If these criteria are met, then for 2010, day's one through twenty in the rehab factory are paid for 100% by Medicare. For days twenty one through one hundred, your co pay is for this year is 7.00 per day.

From day 101 and beyond, regardless of your condition, you are responsible for all of the factory costs.

Keep in mind, that in order for this repayment schedule to happen, you must whether be getting best or getting worse. Like the hospital, once you are deemed to be stable, you come off the Medicare repayment schedule and must pay for all costs.

In California, most patients will come off of Medicare repayment around week three and must begin incommunicable paying from this point forward. The enterprise office will propose you when this is staggering to take place.

If the factory has long-term care beds, then the inpatient may be able to stay in the same facility. But if the factory is strictly short-term care or rehab, then the inpatient must find an additional one factory or go home.

How does the patient's health guarnatee fit into this? It all depends on what type of plan that the senior inpatient is on. Is it a Medicare supplement plan or Ppo, or is it a Medicare advantage plan like an Hmo?

Medicare supplement insurance, also called Medigap, is incommunicable health guarnatee designed to supplement Medicare. A excellent is paid for this coverage which is age rated.

There are twelve standardized Medigap plans, A through L. In most states, you can go to any doctor or hospital that accepts Medicare without pre-authorization. Under plans C through J, days one through twenty are completely paid for by Medicare. For days twenty one through one hundred, the Medicare co-pay for 2010 is 7.00 which is covered by the Medigap policy. From day one hundred one and beyond, the inpatient is responsible for the full cost.

For Medicare advantage plans such as an Hmo like obtain Horizons, Scan and Kaiser, the patients may have a co-pay from day eleven of 0. It is best check the benefits booklet or call the customer assistance department.

If man goes to a factory without going to the hospital first, then you must incommunicable pay from day one.

Once the inpatient comes off Medicare reimbursement, if qualified, Medi-Cal will help to pay for the nursing home costs. If going to the factory directly from home, then, if qualified, Medi-Cal may help to pay for the nursing home costs from day one.

Please consult with a Medi-Cal specialist for more facts and the exact procedures.

Copyright 2010 by Karl Kim

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