Medicare, Medicaid and Nursing Care
There are two distinct types of nursing care solutions available for seniors today: Skilled Nursing Care and Nursing Home Care. With skilled nursing care, Medicare certifies that nursing facilities meet certain qualifications and must have the staff necessary to provide patients with the care they need. Many times, this includes more intensive nursing care or help with different types of rehab as well as other included health care services. This includes, but is not limited to care such as physical therapy and even injections. Skilled care is administered by trained professionals, as opposed to traditional nursing home care which can be administered by non-professionals. For example, a senior living in skilled nursing can receive physical therapy as part of their care regimen, while an un-trained individual providing general care in a nursing home would be unable to provide their patients with physical therapy services. It is important to note that a stay at a skilled nursing facility can cost upward of $ 11,000 per month. The good news is that for those with limited assets, Medicaid will cover the cost of high quality care.
Medicaid and Medicare are both federal health insurance programs that may help pay for nursing home care, but they do not provide the same coverage. Medicare covers skilled care services that are needed daily for up to 100 days. Typically, seniors will stay in a skilled care facility until they can recover and be moved to a traditional nursing home setting. A skilled care facility is often a stop for seniors from the hospital into a more long-term nursing home solution. Some seniors may need to stay longer, but the cost will need to come out-of-pocket.
Medicaid, or Title 19, is the joint Federal and State program that provides health coverage to nearly 60 million Americans. It pays medical bills for people and families with low income and few resources. In Connecticut, the state Department of Social Services (DSS) runs Medicaid. The rules are very complicated, and there are special rules for people who are 65 or older, disabled, under 21, or in a nursing home. The Medicaid program was instituted in 1965 as a safety net to assist seniors with the financing of their long term care.
What does Medicaid pay for?
Medicaid pays for medical care for people who do not have enough money to pay their medical bills. Nursing home care is only one type of care paid by Medicaid. If you qualify, Medicaid will pay for your nursing home care and most of your costs while you are in a nursing home, including
- doctor visits;
- hospital care;
- your room (shared);
- tests and treatments; and
- equipment your doctor says you need.
CT Medicaid Specialists LLC Provides Application Assistance
You should apply for Medicaid if Medicare does not cover your situation, or you do not have enough money to pay for nursing home care. Medicaid covers people and families with low income and few resources. To decide if you qualify, DSS will look at your situation, including how much income, money, and property you have. Because of the sheer size of the organization, and the fact that is a joint Federal and State program, there are myriad rules and regulations governing Medicaid eligibility. The Connecticut Medicaid application process is unduly frustrating and complex. The decision to commit a loved one to a skilled nursing facility often propels a family into crisis. The exorbitant costs associated with long term care are staggering, and a denial in Connecticut Medicaid coverage can result in huge financial losses.
CT Medicaid Specialists LLC focuses on helping families prepare documents and apply for Medicaid benefits. We offer assistance to our clients as we navigate Medicaid’s labyrinth of regulations and rules. Our aim is to achieve maximized coverage and benefits. From the initial consultation through the final approval, CT Medicaid Services is there every step of the way. We assist in completing Connecticut Medicaid forms, gathering documentation, assisting in the spend down procedures, and following up with your caseworker at the Department of Social Services.
We go beyond just providing our clients with information and helping them understand the Medicaid CT eligibility requirements. Our staff walks the families through the entire planning and application process until the best possible outcome is achieved. CT Medicaid Specialists are here to help you prepare the documents needed whether you qualify for benefits under Title 19. Call us today (860)-490-6772.