Part A

While in a skilled nursing facility, Medicare Part A (Hospital Insurance) will pay for up to 100 days of skilled care, provided that the resident requires a daily skilled service as defined by Medicare guidelines and the admission to the facility is within 30 days of a three day or more hospital stay. For the first 20 days, Medicare pays 100% of the covered charges and for the next 80 days, Medicare pays all but $133.50 per day of covered charges, provided the resident continues to require skilled care.

Medicare Part A pays for the following services except when another payment source is primary:

• Semi-private room and board (excluding internal feeding)
• Specialized rehabilitation services: Physical, Occupational, and Speech Therapies
• Medications ordered by physicians
• Ancillary central supply items including certain special equipment such as air fluidized beds
• Oxygen, IV Fluids, Braces
• Personal laundry services

The following chargeable services are not covered by Part A if they should be requested by the patient:

• Beauty and Barber shop services
• Telephone or Television
• Services provided at a physician office, Physician ordered consultations
• Private duty nurses or sitters
• Payment to hold bed when patient is hospitalized
• Services determined not to meet Medicare coverage criteria, and the patient has been notified in writing by the center.

Part B

If the resident is not eligible for Part A benefits, the resident may receive services under Medicare Part B (Medical Insurance). Part B will pay for an unlimited time frame after the resident meets an annual deductible of $135.00. Part B pays 80% of allowable charges. Services covered include:

• Physician fees
• Specialized rehabilitation services when Part A is unavailable
• Physician ordered consultations
• Prosthetic items such as urological and internal feeding supplies

Part D

Medicare Part D helps pay for prescription drugs not covered by Medicare Hospital Insurance Part A.

How to Apply for Medicare:

To apply for Medicare benefits, contact your local Social Security Office. The toll free number is 1-800-772-1213. You may also visit the Medicare website by clicking on the link Medicare.

Medicaid

If a resident is approved for nursing home Medicaid, his/her charges are based on personal income. This amount is determined by the Department of Health and Human Services (DHHS).

The State Medicaid plan pays for following:

• Room and Board
• Specialized rehabilitation services
• Prescription medications for up to three months
• Basic personal laundry services
• Payment to hold bed up to ten days when patient is discharged to the hospital

Services not paid for under the state plan include:

• Private room accommodations
• Beauty and Barber shop services
• Telephone and Television
• Private duty nurses and sitters
• Over the counter drugs not ordered by a physician

To apply for Medicaid benefits or determine assessed liability amount, contact your local Social Security Office. The toll free number is 1-800-772-1213. You may also visit the Medicaid website by clicking on the link Medicaid.

Hospital / Clinic Network

At NHC HealthCare, Scott, we have a large acute care provider network. We routinely receive referrals from area hospitals and clinics.