Nursing home care is a significant concern for Medicare recipients. Retired elderly patients on Medicare — or their children — often don’t consider which sorts of elder care or nursing home care will be covered by Medicare. Also, there is often confusion about which each of the types of care for seniors means that exist. And perhaps more confusing is that while Medicare often covers less, Medicare advantage does cover nursing home care with skilled nursing in certain instances.
What is nursing home care?
Nursing home care is offered by a skilled nursing facility and usually means that the senior has significant ongoing medical needs from a chronic health condition. Theses seniors may require constant care and supervision. Home health care is similar, in that skilled nursing addresses the medical needs of patients. However, home health care usually is less comprehensive, and patients that receive it attend to their own needs otherwise.
Custodial care more often refers to supportive needs. Supportive needs include activities such as helping to bath or dress a patient. Custodial care is often given via long term care for elders. Sometimes this occurs in a facility home where retirees live as residents in a dormitory. Sometimes the custodial care is given duringvisits to a person’s home. Custodial care can also consist of help with the type of self-testing that diabetics may need to do to care for themselves (such as blood glucose testing for a diabetic). Custodial care is usually considered “non-skilled” and is not usually covered by Medicare.
Generally, Medicare will cover stays in nursing homes or custodial care facilities when designated by medical necessity. If a patient has a chronic medical condition with ongoing needs for care for problems like dementia, Alzheimer’s, emphysema or chronic heart failure then Medicare may cover nursing home care.
In many instances, patients with low income may also require state Medicaid services to cover the costs of home care and nursing home care.