Medicare is a Federal program enacted in 1965. It is an earned-benefit program for those that are aged 65 or older or disabled. It consists of parts A, B, C and D. Part A is for hospital insurance coverage, as well as limited stays in nursing homes and some rehabilitative services such as physical, vocational, and speech therapy. Usually, there is no co-pay for Part A coverage. However, it is $167.50 per day for skilled nursing facility visits in excess of twenty-one days. Continue reading “Navigating the Uncertainties for Long-Term Care Needs”
Medicare is a federal program enacted in 1965 that was established to provide health coverage to those 65 and older and those with a qualifying disability. Medicare consists of four sections:
- Part A – hospital insurance, inpatient care, rehabilitation care in a skilled nursing facility, as well as physical, vocational, and speech therapy, hospice, lab tests, surgery, and home health care. Medicare Part A does not have a premium, so long as an individual or their spouse worked forty quarters or more. Part A provides twenty days of full coverage for those in a skilled nursing facility. After the first 20 days, however, there is a $167.50 per-day-co-pay.
- Part B – covers 80% of outpatient insurance for physician office visits, medical devices, and some rehabilitative services. Medicare Part B has a $134.00 premium but varies with income.
- Part C or Medicare Advantage – is an optional plan that replaces Medicare Part A and B for a private insurance company.
- Part D – covers prescription drugs.
A common misconception is that a community spouse must spend down all of his or her assets due to an institutionalized spouse requiring nursing home care before Medicaid benefits will be available. Medicaid is a means-test program that entitles individuals to benefits including Chronic Care Medicaid. Chronic Care Medicaid covers care that is provided in a skilled nursing facility. Because Medicaid is a need-based program, certain income and asset requirements must be met in order to be eligible for the benefits. Continue reading “Spousal Refusal”