Using Medicare to Help Pay for a Short Term Rehabilitation Stay
Unless Veterans Benefits can be used to help defray the costs of your healthcare, many need to rely on Medicaid to pay for these costs. However, you may have the ability to use Medicare, rather than Medicaid, to help pay for a short term rehabilitation stay in a nursing home. Generally, the basic requirements are as follows 1) a 3 day hospital stay 2) a "spell of illness" and 3) daily skilled nursing care is needed. If these requirements are met, the patient can have the first 20 days paid in full. However, days 21-100 a copay will be required unless supplemental insurance or other veterans benefits can be used to cover the additional cost.
Many have heard of the "improvement standard", where if the patient is failing to show improvment with rehabilitation, then Medicare coverage will cease. However, pursuant to the Jimmo vs. Sebelius Settlement, the "improvement standard" no longer applies. Therefore, so long as skilled care is needed, the patient should have Medicare coverage through a full 100 days. Please see the following link for an detailed explanation regarding this topic: https://www.medicareadvocacy.org/medicare-info/improvement-standard/
Even though you may have coverage with Medicare it is very important to review Medicaid Planning options at the same time. Contact our office today to set an appointment to discuss your questions.