I found a residence run by the Carmelite Sisters for the Aged and Infirm that has Medicare Eligible beds. Without Medicare, their fee runs up to $97,400 per year or $267.00 per day.
For a Medicare Eligible resident, Medicare Part A will pay (for 2012), $144.50 toward the per-diem (per day) charge.
Have any of you encountered this situation and know what it takes to become Medicare Eligible?
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Between day 21 and day 100, if the patient has a supplemental insurance policy, in addition to their Medicare, the supplemental policy may pick up the difference.
If the patient is in need of physical therapy (rehabilitation) and reaches a point where the PT staff feel the patient is no longer making progress, Medicare will no longer pay for the PT, even if the patient has only been there for 30 days. It's possible the patient could continue on, under Medicare if they still needed the skilled nursing, but Medicare coverage ends regardless at the 100 day mark.
After the 100 days, if a patient needs to stay on as a resident, then they will have to cover the full cost of the nursing home until their assets are reduced to around $2,000.00. The patient would then have to apply for MEDICAID, which covers nursing home costs for low income people who meet certain qualifications.
As to what it takes to become Medicare Eligible, most people apply for Medicare at age 65. It is there for all Americans, so no special qualifications other than age and making the application.
If a person is under 65 years of age and is disabled, it is possible they can qualify for Medicare.
If you are asking how does an individual on Medicare qualify to enter a nursing home, there is a requirement that they be in need of hospitalization and have been in the hospital for 72 hours in order to be sent to a facility for necessary continued care.
This is the the short story. I hope it is helpful to you. More information from you with specifics would be helpful to us understanding your personal situation.
Good Luck, Cattails
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