Medicare Nursing And Home Care Coverage

Medicare Nursing Home Coverage

Medicare is a project pursued by former President John Kennedy that aims to provide medical insurance for all American seniors. After Kennedys death, President Lyndon Johnson amended it to the Social Security Act. In 1965, Title VII of the amendment established what we have now as Medicare and Title IX established Medicaid.

Medicare Part A and B is health insurance provided for all eligible elders age 65 and above including those people with disabilities. Most states in U.S offer Medicare services, covering almost 40 million American seniors and disabled.
Medicare normally covers for 20 days of skilled nursing care in a facility at full cost. Private Medicare insurance or supplement can pay for 80 days of $114 per day if it is stated in the persons policy. Nevertheless, Medicare discontinues coverage before the 100th day comes. The average Medicare-paid nursing home stay was 23 days in 1997. In 1998, Medicare paid 12% of nursing home coverage.

There are requirements that a person should met before qualifying for Medicare. The individual must shoulder at least 3 days in a hospital and must have skilled care, and then the transfer from a hospital should be done within a certain time period.
Most people believe that Medicare pay up to 100 days of nursing home stay, but they would be disappointed after knowing that this not happen all the time. Elders staying in nursing home care do not automatically qualify for Medicare coverage. As what have been mentioned, they should stay for at least 3 full days in a nursing home or receive skilled care. And whats disappointing of all is that even if you qualify for Medicare does not guarantee youll be covered for 100 days. The average length is 20 days.

Medicare Home Care Coverage

Medicare also provides home health care and hospice care throughout the country. Home health care is often used as alternative to hospital care for patients recovering from join replacement, heart failure, and diabetes. A doctor should advise if a patient can receive home care, and some skilled care is required through the help of either a therapist or a nurse. A home aide services such as bathing, dressing, toileting, and feeding may be provided. Medicare now allows home-based patients to leave home when in need of treatment or therapy. Medicare Part B may also cover some medical equipment such as bed rails, wheelchair, walker, and etc.
In November 1997, Medicare adopted an interim payment system with regard to the implementation of Prospective Payment System for home care. PPS had restrictive rules on eligibility and reimbursement for in-home patients. The benefits for Medicare home health care declined to almost half from $18.3 billion in 1997 to $9.5 billion in 1999, this spurred the demand for more home care benefits since most American elders wish to receive care in their homes. Medicare divvied out only 8.8% budget on home in 1997; 36.6% in 1998; and 4.6% in 1999. The cut in Medicare home health care budget received lots of complaints, and the program seems not suffice the needs of people with chronic illness who require home care.