Temporary Change to Medicare Rules for Nursing Homes makes admission easier

Due to the Coronavirus, the Trump Administration implemented a change to the rules related to Medicare coverage for short term stays at skilled nursing homes for rehabilitation, which will make it easier to obtain Medicare coverage for short term stays.

Usually Medicare requires a 3 day stay at a hospital before Medicare covers any short term rehabilitation at a skilled nursing home. However, this rule is temporary changed due to the Coronavirus, for those people who need to be transferred as a result of the effect of a disaster or emergency, so that they will no longer need to spend 3 days in the hospital before going to a nursing home to receive Medicare benefits.

Medicare will then will pay for up to 100 days at a skilled nursing home, as long as the person continues to make progress towards his/her rehabilitation. In my experience over the past twenty years, most clients won't receive the full 100 days of Medicare coverage, since they are considered to "plateau" and are no longer making progress towards their rehabilitation. At this point the person is considered in need of "custodial care", and the nursing home will provide a notice stating that the Medicare will stop paying and the patient must now pay privately for his/her care. In the Boston area, nursing homes can cost $15,000 per month or more.

This is the point, where many clients want to find out if they can qualify for Medicaid (also called "MassHealth" in MA) to help pay for their care. (Please note that Medicare is different from Medicaid. Medicaid is a needs based program that requires you to meet certain financial and medical requirements).

For married clients where one spouse needs nursing home care and the other spouse is still living at home, we are often able to help protect the assets for the spouse at home. For single individuals who need nursing home, we may have options for spending down in a way that is most beneficial to you. If you are concerned about the high cost of nursing home care, your best option is to consult with an Elder Law Attorney as soon as possible. The attorneys at Senior Solutions in Boston, MA, are caring Elder Law and Estate Planning attorneys who are ready to help you navigate through the maze and help you protect your assets from the high cost of nursing home care. Please reach out to us so we can help you.