What Costs Do Medicare and Medicaid Cover?
If your loved one has been abused or neglected while in the care of a long term health care facility, you may be wondering if you should speak with a nursing home lawyer College Park MD provides. You may also be concerned about covering the costs of your loved one’s care if you have to move them to another facility. The legal firm of Cohen and Cohen, P.C. has represented victims of nursing home abuse and other personal injuries for more than 20 years. As a strong and qualified legal team, we have recovered millions of dollars on the behalf of our clients. Our capable personal injury team at Cohen and Cohen, P.C. is proud to represent the College Park, Maryland community.
If you’re looking for a nursing home lawyer College Park MD community members turn to when they need legal assistance, call Cohen and Cohen, P.C. at 301-250-1957 for a free consultation. The following overview of Medicaid and Medicare may be of interest to those who need help paying for the care of their loved one.
Medicare covers short-term medical needs when a patient’s recovery is foreseeable. If your loved one’s recovery time was extended due to an injury in a healthcare facility, a nursing home lawyer College Park MD residents rely on may discuss the following options with you:
Types of medical expenses covered by Medicare include:
- Short-term hospital stays
- Occasional or part-time care from skilled nurses
- Doctors visits
- Occupational therapy, speech language pathology, or physical therapy (i.e. after a stroke or a fall when the patient needs to regain functionality) ordered by a doctor and provided by a Medicare-certified home health agency for a limited number of days. A nursing home lawyer College Park MD clients utilize may stress the importance of getting all doctors’ orders in writing. You will likely need to submit copies of those orders to Medicare.
- Certain medical equipment such as oxygen, walkers, hospital beds, or wheelchairs for which patients are responsible for paying 20 percent of the amount approved by Medicare
- The psychological, cultural, medical, and social challenges of dealing with an illness. A nursing home lawyer College Park MD residents turn to may stress the importance of documenting the challenges your loved one is facing. Medicare coverage may also include:
- Education on using health care and other resources as well as understanding how the patient’s disease will affect them
- Follow-up care
- Assistance with accessing services
Conditional Medicare Coverage
For those who meet the following conditions, Medicare will likely pay a portion of the costs for short stays (up to 100 days) in a skilled nursing facility, for home health care, or for hospice care:
- The patient had a recent stay in a hospital for at least three days
- The patient is admitted to a Medicare certified nursing facility within 30 days of their prior hospital stay
- The patient requires skilled nursing services, physical therapy, or therapy of a different type
- For the first 20 days, Medicare can pay all costs. A nursing home lawyer College Park MD victims turn to for legal help may encourage you and your family to keep careful records of all costs to submit to the agency.
- From day 21 through day 100, the patient must pay up to $140 every day for their own expenses. Medicare can pay for any remaining expenses.
- Patients must pay all of the costs for staying in a skilled nursing facility after day 100.
For those with a terminal illness and a life expectancy of less than six months, Medicare can cover the cost of hospice care. The patient can receive hospice care whether they live in a nursing home, at home, or in a hospice care facility. Covered costs may include:
- Some short-term hospital stays
- Some inpatient care for caregiver respite
- Medications that offer relief from pain and/or control symptoms of the patient’s illness
- Medical and support services from a hospice provider who is approved by Medicare
- Grief counseling
Those who can expect to meet eligibility requirements include:
- People who are age 65 and older
- People who are under age 65 if they have certain disabilities
- People of any age who are suffering from permanent kidney failure and require a kidney transplant and/or kidney dialysis
What Medicare Does Not Cover
Medicare does not cover long term health care such as nursing home stays. It also does not cover personal care such as assistance with bathing or custodial care. If you’re not clear about Medicare restrictions, a nursing home lawyer College Park MD families respect may explain the importance of talking with a Medicare representative to answer your questions.
Medicaid is a joint state and federal government program intended for those under a certain income who need assistance paying for some or all of their health care costs. It covers:
- Medical care such as hospital and physician costs
- Long term health care services provided at home such as assistance with bathing and visiting nurses
- Long term stays in nursing homes
Each state controls how their Medicaid programs are run, but the services they cover are based on federal requirements. This is also true for who is deemed eligible for Medicaid coverage. Each state must cover certain groups of people, but they can optionally cover other groups as well. States must cover certain services, and they can opt to expand that coverage as well.
Medicaid service coverage and eligibility rules vary by state. A College Park MD nursing home lawyer may recommend that you carefully review the requirements before making any major decisions. After qualifying for Medicaid, individuals must meet additional requirements if they want coverage for long term care services. To meet the eligibility requirements of a particular group, both the general and financial requirements for that particular group must be fulfilled. These requirements vary by state.
Has Your Loved One Been Abused or Neglected While in the Care of a Nursing Home?
If so, a nursing home lawyer in College Park MD may be able to help your loved one get the compensation they deserve. Elder care abuse and neglect are serious civil offenses. If your loved one was victimized while in the care of a nursing facility, they may be eligible to receive a settlement for their emotional and physical injuries. Contact the office of Cohen and Cohen, P.C. without delay to find a nursing home lawyer College Park MD is proud to have fighting for its elderly residents.