Medicare provides up to 100 days of skilled nursing home coverage. However, in order to qualify, you must first have a 3 night inpatient hospital stay – observation status does not count.
In addition, the patient must receive a skilled level of care in the nursing facility. In general, this means the resident must receive daily rehabilitation services.
Coverage is free for 20 days. For 2012, days 21-100 have a daily co-pay of $144.50 per day. If the resident carries a Medicare Supplement policy, then this co-pay may be covered under the policy.
A new 100 day period begins if the patient has not received skilled care for 60 consecutive days.
The Medicaid numbers for 2012 were recently updated.
For a nursing home Medicaid recipient with a spouse living in the community, the numbers are as follows:
- Minimum Monthly Maintenance Needs Allowance: $1,839
- Maximum Monthly Maintenance Needs Allowance: $2,841
- Minimum Community Spousal Resource Allowance: $22,728
- Maximum Community Spouse Resource Allowance: $113,640
- Excess Shelter Standard: $552
- Standard Utility Allowance: $599
For the nursing home resident, the numbers are:
- Monthly Personal Needs Allowance: $40
- Resource Allowance for an Individual: $1,500
For purposes of calculating the penalty for gifts made within five years, the number is as follws:
- Average Private Pay Rate: $6,023
Medicare Skilled Nursing Facility Co-Insurance
- (Days 21 to 100 per benefit period): $ 144.50
We have opened a new office in West Chester, Ohio. We now have 3 convenient locations around Greater Cincinnati. If you are looking for assistance with Elder Law, Estate Planning, or need a Medicaid Attorney, but live North of Cincinnati, please note our new address at:
The Toron Law Firm
9277 Centre Pointe Drive
West Chester, OH 45069
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And be sure to note our other 2 office locations:
4555 Lake Forest Drive
650 Westlake Center
Cincinnati, Ohio 45242
312 Walnut Street
1600 Scripps Center
Cincinnati, Ohio 45202
Give us a call today. If you would like to learn more about Medicaid Nursing Home Benefits or how we can help you plan for retirement, please order our FREE Medicaid Guide today! You will also receive a FREE 1 hour consultation with Moshe Toron, Elder Law Attorney, just for filling out the form.