What are the circumstances for being admitted to the nursing home? Is it for rehab after a hospital stay or a long-term custodial placement because the person needs care that they cannot get at home with family support? It is treated quite differently. With more info, you get better answers. Medicare pays for rehab after hospitalization under specific circumstances for up to 20 days at 100% full pay and with copay of approximately 20% with Medicare paying 80% from days 21-100. If a patient doesn't "improve", nursing home will not be paid by Medicare for custodial care that is not related to a covered rehabilitation stay. Medicare does not pay for custodial care in a nursing home for long-term at all (i.e. dementia, Parkinson's, general age decline, etc). This type of care is paid privately by patient or family, by private or state provided long term care insurance or by qualifying for Medicaid according to your state's rules. It is often an unpleasant surprise for families that thought medicare would pay for the long-term care of family members. It does not.
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Medicare pays for rehab after hospitalization under specific circumstances for up to 20 days at 100% full pay and with copay of approximately 20% with Medicare paying 80% from days 21-100. If a patient doesn't "improve", nursing home will not be paid by Medicare for custodial care that is not related to a covered rehabilitation stay.
Medicare does not pay for custodial care in a nursing home for long-term at all (i.e. dementia, Parkinson's, general age decline, etc). This type of care is paid privately by patient or family, by private or state provided long term care insurance or by qualifying for Medicaid according to your state's rules. It is often an unpleasant surprise for families that thought medicare would pay for the long-term care of family members. It does not.