Best Nursing Homes That Accept Medicare in 2021
When looking for nursing homes that accept Medicare and Medicaid, it can be difficult to find a facility that offers long-term care versus short-term. Most Medicare facilities only offer short-term care, but with Medicaid nursing home coverage, you are able to qualify for long-term care.
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UPDATED: Nov 27, 2021
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- Medicare and Medicaid are both great programs that allow for qualified, skilled care for you or your loved one
- Asking friends or family members who also have elderly family members in nursing homes is a great way to grab personal testimonies about long-term care
- Pre-existing conditions may limit your coverage, but veterans, government employees and other qualifying groups may be eligible for a discount
Are you shopping for the best nursing homes that accept Medicare in 2021? It’s important to remember that, while these programs can cover a majority of first-time expenses, long-term care will end up costing you. It’s important to consider what you can afford.
We all want to care for family members, making sure they’re comfortable in their golden years. Unfortunately, this isn’t always possible with Medicare alone, which can be devastating to seniors and their families.
If you can’t afford private care, know that there are also alternative financing options you can apply for.
Each type of health insurance will pay for different kinds of care. When using Medicare or Medicaid, there will be specific requirements and eligibility differences. You will need to meet these in order to qualify.
Keep reading to find out where you can find nursing homes that accept Medicare and Medicaid, what they pay for, and how to qualify. Enter your ZIP code into our free and easy-to-use tool to get started by comparing quotes in your area today.
Which nursing homes will accept Medicare and Medicaid?
There are plenty of ways to find nursing homes in your area. The majority of them will accept both Medicare and Medicaid. What most people don’t know, however, is that Medicare will only cover nursing homes for short stays.
Once Medicare stops paying, you’ll need to find other solutions. Medicaid does work a little bit differently in this regard. You may even need to pay for the best nursing homes that accept Medicare on your own.
Medicare Plans Available
Under Medicare, there are three different options to choose from: Part A, Part B, and Part C.
|Medicare Part||Coverage||Pays For||Prescription Medication Coverage|
|Part A (Original Medicare)||Short-term services with skilled nursing facilities (or at home care)||Nursing home care up to 100 days maximum||✓
|Part B (Original Medicare)||Room and meals; unskilled services (bathing, dressing, bathroom use)||Nursing home care up to 100 days maximum||X|
|Part C (Medicare Advantage)||Room and meals; unskilled services (bathing, dressing, bathroom use)||Partial coverage for nursing home care|
(with specific contract with nursing home)
Medicare will only cover a limited number of services within nursing homes for patients who meet specific criteria. Unskilled services and some skilled services (if deemed medically necessary) coverage will be determined based on which plan you choose.
Medicare also does not cover:
- Long-term, custodial care
- Dental care
- Routine eye exams
- Cosmetic procedures
- Hearing aids and related exams
- Routine Podiatry
To enter a Medicare-approved facility within 30 days, you must stay as a hospitalized inpatient for three or more days for evaluation, unless otherwise waived.
A physician will determine your daily care needs and treat any hospital-related medical condition during the qualified stay.
What does Medicare cover?
This will depend on the plan you choose and how long the rehabilitation stay is. Medicare only covers a maximum of 100 days, so once that time period is up, your out-of-pocket cost will need to cover any long-term care needed.
|1-20||$0, Medicare covers 100 percent
|21-100||$185.50 per day, coinsurance
|101 and beyond||All expenses, Medicare covers 0 percent
It’s in your best interest to know your long-term care options. When Medicare stops paying, you’ll need to apply for different HMO (Health Maintenance Organization) health insurance plans or PPO (Preferred Provider Organization) insurance.
What does Medicaid cover?
Medicaid pays for nursing home care. Medicaid pays for 100% of all qualifying individual’s nursing home costs in any Medicaid-certified facility. However, your income and assets cannot exceed your state’s limits for the Medicaid nursing home coverage program.
Medicaid does take into account your assets, including bank balances, stocks and bonds, secondary property, and non-primary vehicles.
While every state’s Medicaid program covers nursing home care for all eligible applicants who need it, some states have expanded their coverage. It can now include other types of long-term care, such as home and community-based services (HCBS) and assisted living.
|Medicaid also covers||Medicaid does not cover|
|Nursing services||Private rooms (unless medically necessary)
|Room and board||Private rooms (unless medically necessary)
|Dietary services||Special food (beyond what the facility already prepares)
|Medically related social services||Telephone, TV, radio, computers, reading materials, tobacco or alcohol
|Pharmaceutical services||Extra grooming products
|Routine hygiene products and assistance||Social activities beyond the facility’s activity program
|Dental (routine and emergency dental up to state limit)||Special care outside Medicaid-contracted coverage
|Professionally directed activities|
|Specialized rehabilitation (for mental illness or disability)|
It is also possible to qualify for dual coverage for both Medicare and Medicaid. With dual eligibility, Medicare will pay for covered medical services first, and Medicaid will cover any remaining expenses.
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How do I find Medicare or Medicaid nursing homes near me?
The best way to answer: “where to find nursing homes that accept Medicaid near me?” is first to start talking with your doctor. Many service providers have vast networks of care facilities and doctors they can refer you to.
All 50 states offer Medicare and Medicaid, but nursing home services, cost coverage, and eligibility requirements will all vary.
Best Nursing Homes That Will Accept Medicare: Key Takeaways
Understanding the costs of nursing homes, and what is and isn’t covered under each plan, will help you determine which plan is right for you and your family.
Medicare and Medicaid plan pricing, coverage, and provider networks can change on an annual basis, so be sure to review your selections every year for the best rates.
Now that you’ve learned how to find nursing homes that accept Medicare and Medicaid, take the time to enter your ZIP code into our free and easy-to-use tool and start comparing quotes in your area today.