Medicare And LTC

Question 1

Which of the following types of LTC is covered by Medicare?

1. Skilled Nursing
2. Assisted living
3. Physical or occupational rehab in a SNF
4. Approved in home skilled nursing
5. Hospice care

Answer 1

All except 2.

Assisted living is custodial care and is not covered

Question 2

T or F

Medicare will only pay for Skilled Nursing or rehab at Medicare Certified facilities

Answer 2

True

Question 3

What are the two main requirements for LTC under Part A of Medicare

Answer 3

Must follow inpatient hospitalization of at least three consecutive mid nights

Must enter Skilled Nursing facility within 30 days of discharge

Must be deemed medically necessary by physician

Question 4

T or F

Medicare supplements generally cover the daily out of pocket charge for skilled nursing care under Part A for the 80 days after the first 20 days.

Answer 4

True.

So for those with supplemental policies, the first 100 days in a SNF are essentially free.

Question 5

Describe the LTC coverage provided by Medicare.

Answer 5

MC Part A covers 100% of the first 20 days of SNF care if deemed medically necessary by MD and if resulting from a hospitalization lasting at least 3 days.

If additional care is needed, MC will pay for another 80 days but there is a daily deductible of $140 (2013).

After 100 days, you pay 100% of the cost.

Note this for SNF and rehab care only, not AL.