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Ways to Get Medicare If I Need Nursing Home Care and Have Medicaid Already

Medicaid and Medicare coverage can both be challenging programs not only to get enrolled into but even to understand as a whole. They each come with so many facets and coverage options that it can be confusing and near impossible to figure out the coverage options you need to go with. Both programs are designed to help senior citizens and the disabled that need extra help in covering medical expenses.

These are the differences: Medicaid is both a state and federal health coverage program that provides coverage to people who qualify as low-income adults while Medicare provides additional coverage to adults who are at least 65+ or if the person has a severe disability and does not take into consideration income. So, when it comes to nursing home care, how does one receive all of the health coverage they need, and how do they apply for extra health coverage if they need it to help with a nursing homes expenses, housing options, medications, round the clock care, etc. What can seniors do if they already have Medicaid but need additional coverage from Medicare, and what will Medicare pay for that Medicaid does not cover? Below is a guide to help field the questions and make the process as simple and painless as possible.

Partial CoverageImage result for medicare partial coverage illustrations

There are facilities that are not paid for in-full because of Medicare. They may require extra payments because of the price of the facility, but Medicare will be used to pay for a majority of the bill. The bills that are sent out by the facility are managed by Medicare as they must determine how much is covered. Medicare may not pay for particular sorts of care in the facility, and the user must be aware of how much is paid for when they enroll.

Special Services

The special services that are offered in nursing homes are particularly interesting as they may or may not be covered by Medicare. Someone who is searching for the finest care in the nursing home, and there are many different people who are looking for a better way to help their elderly loved ones given what Medicare will cover. The facility will have a list of services that they know are covered by the plan, and they will find it quite simple to help the client learn how much they will receive.

Filing ClaimsImage result for medicare partial coverage illustrations

The facility will file claims for the patients, and they will ensure the claims are filed in a timely manner. There are many people who cannot file their own claims, and they are not capable of keeping up with all the paperwork that is needed. The facility will come up with a claims system that sends out the money to the proper channels. The customers may receive bills if there are things that are not covered, and the nursing home will keep up with what Medicare has paid for.

Nursing Home Care

Nursing home care for seniors and severely disabled use Medicare to help cover costs and that is because they use it for the long term care and Medicare helps pay for the stay in facilities for aging relatives.
Even if you have Medicaid, nursing homes will accept Medicare as additional coverage, though the level of coverage they choose will depend on what the nursing homes accept. Facilities for aging relatives manage the Medicare system and choose from the many levels of coverage it offers to find the best level for patients. They do their best to make sure patients and their families are covered as much as possible and know what will Medicare pay for. When a senior citizen or their relatives begin looking for long term nursing home care for themselves or their loved ones, the person looking into the housing options needs to ask if they accept Medicare coverage or not so they know for certain that they will be covered.

Housing For the Elderly

Some housing options or facilities for aging relatives are not fully paid off by Medicare and the resident or loved ones can still be responsible for some of the facilities prices. If you already have Medicaid, you can use your existing application to add Medicare to your existing coverage which will more than likely cover all of the bills. Medicaid and Medicare may not pay for every facility fee, but the applicant and/ or their family will be informed of the final coverage when they finish enrollment.

Dual Enrollment Help

When you have Medicaid and use your enrollment to get Medicare as well to help cover nursing home expenses, you need to ask about the special services that the facility provides their patients. You need to be aware of what will Medicare pay for when it comes to special services because some may not be provided by Medicare, not your Medicaid coverage. When you are being enrolled onto Medicare, they will inform you as to what your facility of choice does and does not accept in terms of their special services.

Going To The Office To Get Clear AnswersImage result for medicare office

As is already evident, the entire process of enrolling into Medicare, even if you already have Medicaid, can be an overwhelming and stressful process. Choosing the right coverage options, figuring out what will and will not be paid for in the facility can be intimidating for a senior citizen trying to get long term care, and for the families who are trying their best to take care of their family members and make sure they are well looked after. Facilities can help cover the overwhelming side of the paperwork and filing of the enrollment process for all of their patients. They make sure the claims from the patients are filed quickly and that all the bills are paid and the money is sent to the right places. This includes making sure the Medicaid and Medicare premiums, as well as any copays, are paid in full and on time. The nursing homes will also keep a file on what the two programs have paid for and what they have not.

When Does Coverage Kick In?

When does Medicare kick in, especially if the patient is already enrolled in the Medicaid program? Medicare will kick in as soon as the person applying turns 65 as long as they did not miss their specified open enrollment period. If they already have Medicaid, the application process is much easier as you are already enrolled in a program. As soon as they turn 65 it is highly recommended that the senior citizen begin using the state and federal health coverage, whether it be Medicaid or Medicare as soon as they can and for as long as they can. When you have used your health coverage for a long period of time before you need to go into a nursing home, then the system will have a long record of any health issues you may have so they will be easier to cover when they need to go into the nursing home. This process ensures that the prices for all the special services you require are completely worked out so you do not encounter any surprises. Once you are enrolled in either the Medicaid and Medicare program, or even both, the system goes to work to make sure you are as well provided for and taken care of as possible so that you do not have to worry about the costs of being taken care of as you age and need extra care in a nursing home.

When You Enroll With A DisabilityImage result for medicare disability insurance

If you are already enrolled in Medicaid as a senior citizen or disabled patient, you will receive short term health care coverage that can help with hospital bills, prescription drugs, and other incurred medical costs until you are better. If you, as a senior citizen, are already enrolled in the Medicaid program, then that means you are in the system and your medical history is in the system. Once in the system, it should be easy to get on the Medicare program as well and not have to worry about all of their files and history being taken care of as their lives transition to a new start in a nursing home.

Extending Care To Family Members

As much as they may want too, families cannot take care of all of their elderly or disabled loved ones. They need extensive medical attention, and to be cared for and looked after with as much care and respect as possible. That being the case, it will never be easy for a family to put the one they love into a nursing home, no matter how great the facility may be. Not having to worry about medical costs or keeping up with paperwork for Medicare and Medicaid purposes can take some of the burdens off of the shoulders of the family members and the patient as well. You should be able to be well taken care of and age gracefully with the least amount of stress possible.