⚠️Warning! - When Medicare DOES NOT Pay for Skilled Nursing Care!⚠️

Medicare does not cover Skilled Nursing care without certain requirements. Find out so you don't pay thousands 💲💲💲
Nursing home care can be very expensive.
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[kellymac]

My mom is an in ALF getting PT and OT. I asked her doctor if he could add nursing services? My dad was homebound and a nurse came weekly for 6 months before he died. The ALF has their own in house home health. About a year ago mom told me someone came in asking about her history, the person said they had spoken with me the day before, they had not. This was about the time I asked the doctor to add the nurse visits. I looked online at the Medicare MSN's and Medicare is paying most every month 3 units of RN direct skilled nursing services and LPN 3 units direct skilled nursing services. She's also being billed 2 units of surgical dressings every other month. She has no wounds since over a year ago. She's 87, has age related dementia and needs the nursing visits. She always tells me when PT comes so she would remember a nurse coming. Can Medicare bill for skilled nursing services without actually seeing her? Medicare pays the home health about $1300-$2000 a month. I've called, asked to schedule an appointment to see her plan of care.By the end of the year it will be about $26, 000 in home health.

[maryfousek]

What are the criteria Medicare uses to gauge improvement in a rehab facility

[MrJeffMaloney]

America health care takes a long time to explain. The government has so many loop holes to get out of paying. Freedom is not free. It cost America their health care.

[italianforme]

What would have been the bill for you patient in the example, if she had Plan F, G or N? Thank you!

[elmahenderson]

The case manager in the acute hospital who planned the discharge should have advised the family that there was no inpatient acute 3 day qualifying stay. Also during the COVID 19 public health emergency the 3 day qualifying inpatient stay requirement is waived using the DR condition code. Yay!

[ReginaBarnett]

It only pays if you can afford to pay part A. Some can’t and are fired to take state help and if you are forced into nursing homes, they take all you’ve worked for to leave your children. Sell and divvy up what’s left to the kids.