Extended Care

What is Extended Care?

Extended Care bridges the gap between levels of care for patients who are well enough to leave the hospital but not yet able to return home. Whether it’s called a skilled nursing facility, a long-term care facility or a nursing home, these are all facilities that provide extended care for individuals who do not require the acute care provided in a hospital but who need more care than can be given at home. They are licensed, inspected and regulated by a state’s Department of Health Services.

Does Medicare Cover it?

The rules involving Medicare and nursing homes or skilled nursing facilities are more complex.

Medicare will pay for the cost of skilled nursing, including the custodial care provided in the skilled nursing home for a limited time, provided 1) the care is for recovery from illness or injury – not for a chronic condition and 2) it is preceded by a hospital stay of at least three days.

For the first 20 days, Medicare will pay for 100 percent of the cost. For the next 80 days, Medicare pays 80 percent of the cost. Skilled nursing beyond 100 days is not covered.

Individuals who have certain types of Medicare supplemental insurance can get additional assistance towards defraying the cost of nursing home/skilled nursing care. Some plans will cover 100 percent of the coinsurance payment required by Medicare. This means that between Medicare and the Medigap plan, 100 percent of the cost of skilled nursing for 100 days will be covered.

Additional Coverage

You can purchase additional insurance coverage such as a Long Term Plan and/or a Short Term Plan.