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How Do I Pay for Long-Term Care?What Does Medicare and Medicaid Cover in the Nursing Home Setting?Coverage by Medicare and Medicaid are very different within a nursing home setting. The following information will provide you with an overview of what is covered through each payer and where to get additional information should you have further questions. MedicareMedicare is a health insurance program for people over the age of 65 and certain disabled individuals. There are a number of Medicare stipulations that limit its long-term care coverage.
The limitations of Medicare can be explained by the fact that the Medicare insurance program is intended to cover services that will help an elderly person recover from a medical problem. It may not extend coverage for people with chronic care needs, for example Alzheimer's patients. For more information visit www.medicare.gov MedicaidMedicaid pays for the majority of nursing home costs, covering nearly 65 percent of all nursing home residents. Medicaid is a joint state-federal program that aids individuals who fall under a certain poverty level determined by the state. Medicaid was originally intended for low-income individuals but because many private pay nursing home residents "spend down" their assets in under a year, it covers elderly people from all walks of life. Each state Medicaid office sets reimbursement rates that are lower than the nursing home private pay rates. Medicaid does not generally cover assisted living or continuing care retirement communities (with the exception of their skilled nursing units). It pays for care only at nursing homes and Individuals with Intellectual Disability Facilities. In Kansas, Medicaid may cover home and community-based services. Kansas MedicaidAll nursing homes are required to provide the following as routine services and/or supplies:
The above list is not intended to be all-inclusive. For additional information contact the Kansas Department of Health and Environment. |