The last thing a family wants to worry about is how their senior loved one will afford care, but, unfortunately, it is a consideration when planning for the later stages of life. Medicare and Medicaid can help cover some healthcare costs, depending on the situation. Here are a few things to consider when looking for a Plymouth area Medicare nursing home and determining how costs will be covered.
When considering the costs of a Plymouth area nursing home, and senior care within it, Medicare and Medicaid are often programs on which people rely. There is a difference between the two assistance programs and how they cover nursing home costs.
Medicare is government-funded health insurance for all Americans over age 65. Disabled Americans under 65 can also apply for Medicare without paying premiums. In the context of a nursing home, Medicare only covers short-term care such as rehabilitation or in-home therapy as prescribed. Medicare will not cover assisted living, long term care at a nursing home, a residential care home, or any kind of long-term care.
Medicaid is an assistance program for long term care. Applicants must be US citizens or permanent residents, low-income earners, or have medical-related care expenses that exceed income. This type of assistance covers nearly every kind of healthcare cost and also can be used to pay for long-term nursing care, assisted living, and in-home care.
3620 Phillips Parkway
St. Louis Park, MN 55426
Phone: (952) 935-6311
Conveniently located near Saint Paul’s Highland Park neighborhood, the Rossy and Richard Shaller Family Campus – Sholom East offers a full-range of senior housing options and services – just blocks from the picturesque Mississippi River.
740 Kay Ave
Saint Paul, MN 55102
Phone: (651) 328-2000
To qualify for nursing home coverage through Medicare, patients have to meet several conditions. They must begin their stay in a skilled nursing or rehabilitation facility within 30 days of an inpatient hospital stay of at least three days. They must be prescribed daily skilled nursing care or physical rehabilitation, and they can only stay in a Medicare-approved facility until their condition is stabilized.
Medicaid covers nursing homes that meet its federal standards without the conditions of Medicare. The program will pay for a semi-private room, food, nursing care, activities, grooming and hygiene services, and medications. Anything deemed “non-essential” is covered by the resident.
Custodial care is otherwise known as care that supports daily living activities, such as bathing, dressing, or eating. Medicare typically does not cover custodial care if it is the only care a senior might need. However, it can cover custodial care in a skilled nursing facility, if this care is medically necessary. Medicaid will cover custodial care, and pay for residence in a nursing home, solely to provide that custodial care to seniors who need it.
Medicare Part A coverage will pay for hospice care if it is done in a Medicare-certified location. A doctor must certify that the patient is eligible for hospice care. It will not, however, cover room and board fees.
Medicaid will cover hospice care for patients determined by a physician to be terminally ill. The program will consider a facility such as a nursing home to be the patient’s home for the purposes of coverage.
Medicare will not pay for any form of adult day programming. However, Medicaid will provide this coverage, especially as an alternative to nursing home care. Transportation may also be covered by the Medicaid program ensuring participants are able to attend the day programming.
Our adult day program is a combination of therapeutic programming, community outings, spiritual growth, health monitoring and education, skilled nursing, medication assistance, and meals/snacks. Additional services such as therapies or personal care are available for an additional fee.
For seniors needing an affordable, comfortable place to live without an untenable financial burden, HUD-subsidized housing can be a good option. HUD-supported senior housing keeps rent affordable while offering benefits and features like controlled entry, specialized care, and activity programming. Seniors requiring additional medical or care services might be able to pay for those with Medicare or Medicaid, depending on their needs.
To qualify for HUD subsidized housing seniors must be a single person or couple where the head of household or spouse is 62 or older. Annual income must not exceed limits set forth by HUD, and applicants must be able to maintain lease requirements. For seniors living in our HUD supported housing, rent will be approximately 30 percent of adjusted income.
HUD subsidized housing does not pay for medical services or rent itself, but can be helpful in making a budget work for seniors. Our staff is happy to help seniors and their loved ones find solutions to ensure quality of life and appropriate care. Simply let us know about your situation and we will collaborate to ensure your needs are met.
Sholom is pleased to work with residents and their loved ones to determine how Medicare and/or Medicaid will impact their programming at our campuses.
Our East Campus is well-rated within the US government’s nursing home database. It is graded as above average overall, and also above average for health inspections, staffing, and quality measures. This means there are fewer health risks, a better level of staffing per resident, and better quality of care than the National and Minnesota averages. We offer 118 certified beds and participate in both Medicare and Medicaid on this campus.
Our West Campus is also ranked well, listed as above average overall. The health inspection rating is average and staffing and quality measures are above average. Here, we offer 139 certified beds and participate in both Medicare and Medicaid programming.
Sholom is a full-service organization to support adults across the continuum of care. We are dedicated to care, compassion and community. We will help you find your place with Sholom.