Hartford Medicaid attorneys provide you with assistance in making plans to protect yourself and your assets in case you get sick. As you get older or if you fall ill, there is a chance you will need to get help from caregivers. You may need intensive assistance on a daily basis, which could necessitate long term care workers come to your home or which could necessitate admission to a nursing home. If you find yourself in need of care, it is vital you know how the care is classified and whether or not it will be covered by Medicare or other insurance.
Medicare is very restrictive in the circumstances under which it will cover long term care. Medicare makes clear it only covers skilled nursing care. As a result, you need to understand what skilled nursing care consists of so you will know the exact circumstances under which Medicare will pay your bills when you need help.
Because the definition of skilled nursing care is a narrow one and Medicare often does not pay for the assistance that you require, you will also need to make a plan to get the care you’ll likely need covered.
Nirenstein, Horowitz & Associates is here to help. We have worked with many clients to ensure they don’t end up impoverished because they need care that Medicare doesn’t considered to be skilled nursing care. Give us a call as soon as possible to find out more about the ways in which we can assist you in protecting your wealth.
What is Skilled Nursing Care?
Medicare indicates that it will cover skilled nursing care at a qualifying facility “under certain conditions” and “for a limited time.” Some of the services that are covered by Medicare include:
- A semi-private room in a skilled nursing facility
- Physical therapy necessary to meet your health goals
- Occupational therapy necessary to meet your health goals
- Speech-language services
- Medications, medical equipment, and medical supplies provided to you in a skilled nursing facility
- Transportation in an ambulance to receive care that the skilled nursing facility cannot provide, if other transport would be damaging to your health or put you at risk
- Medical social services
- Dietary counseling
To have any skilled nursing services covered, you must have Medicare Part A and you must have had a qualifying hospital stay. The skilled care must also be deemed necessary by your doctor. Skilled nursing care is defined as care that can only be provided by someone with medical training. Examples could include IV injections or changing surgical bandages after a procedure.
Why Does it Matter if Your Care is Skilled Nursing Care?
It is very important to determine if care you need can be classified as skilled nursing care or not. If your care is not considered skilled nursing care, but is instead considered custodial care, Medicare will not pay anything for the care at all under any circumstances. Likewise, if you need to go into a nursing home rather than a skilled nursing facility, Medicare won’t pay anything for that either.
Most seniors, unfortunately, end up going into a nursing home, not a skilled nursing facility, as they get older or after they get sick. Seniors who need long term care and who get it at home also typically receive unskilled custodial care.
Custodial care is routine help with normal daily activities that doesn’t require specialized training, such as help eating or bathing. Because Medicare does not cover custodial care at all, you’ll have to pay out of pocket unless you have a source of coverage like long term care insurance or Medicaid. Long term care insurance is generally too costly and not comprehensive enough, so qualifying for Medicaid could be your best and only option.
Getting Help from Hartford Medicaid Attorneys
Hartford Medicaid attorneys at Nirenstein, Horowitz & Associates will provide personalized one-on-one advice in planning ahead to ensure your care costs are covered. If you have an urgent need for care and have not yet made a plan to afford its costs, we can also assist you in determining if the care can be classified as skilled nursing care, in trying to get Medicare to cover your care, and in trying to qualify for Medicaid as quickly as possible while protecting as much wealth as possible.
To find out more about the ways in which our legal team can assist you with the Medicaid planning process, give us a call now. You can give us a call at 860-548-1000 or contact us online to speak with a member of our legal team or can join us for a free seminar to learn more about Medicaid planning.
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