What Does Skilled Nursing Care Mean And Why Does It Matter?

Our Oklahoma City Medicaid planning attorneys provide assistance with making a Medicaid plan so you can afford the costs of care  you may need if you get sick or as you get older. It is very important to understand the rules for getting your care covered, as nursing home care or in-home care could cost thousands of dollars every single month.  If you are not aware of the coverage rules, you could end up spending your entire life savings on nursing home care. 

Parman & Easterday can explain to you what the rules are for when nursing home care is paid for by most private long-term health care insurance policies, and when Medicare might provide (very) short-term assistance. We can also help you understand how you can get qualified for Medicaid, which may be your only source of paying for nursing home services or for long-term care provided at home.

One of the key factors you need to understand is the definition of skilled nursing care. Our legal team will explain to you what skilled nursing care is, why it matters, and whether the care you are receiving is likely to be considered skilled care or not. You should give us a call today to find out about how our compassionate and knowledgeable legal team can help you to make sure you are able to get the care you need as a senior without having to spend your life savings.

What is the Definition of Skilled Nursing Care and Why Does this Definition Matter?

When you need nursing home care or long-term care at home, you may want to find a way to get this care covered by a third-party payer,  like an insurance company, if it is possible to do so.  If you cannot get the care covered, you will likely spend your life savings very quickly due to the high costs of care.

Unfortunately, Medicare and supplementary Medicare plans like Medigap and Medicare Advantage do not typically cover nursing home care. The only time that care is covered is if it is classified as skilled nursing care.  In addition, Medicare has a very specific and narrow definition of skilled nursing care and pays for a very short period of time.  Our advice is always the same – don’t depend on it.

Skilled nursing care includes care that can be provided only by someone who has received medical training. Examples may include changing surgical bandages.  Care is not covered if it is necessary simply because you require basic help with routine activities of daily living (ADL’s) such as help showering, bathing, or eating.  Most people who need nursing home care because they get sick or because they have gotten older require this type of basic help with routine activities of ADL’s.  This is called custodial care.  Providing assistance with ADL’s typically does not require skilled nursing care.

If your care is classified as skilled nursing care, Medicare will pay for not only a semi-private room in a skilled nursing facility but will also cover many associated costs at the facility, including medical equipment used.   However, if your care is classified as custodial care, you should not expect financial assistance from Medicare. Unless you have long-term care insurance coverage, you will have to pay for your care privately or you will need to get covered by Medicaid.

Unfortunately, Medicaid is available to you only if you have limited financial resources — which could mean you are forced to impoverish yourself before qualifying.  If you work with an experienced attorney to design a Medicaid plan, you can protect your wealth and get Medicaid to cover you when you need care.

Getting Help from Oklahoma City Medicaid Planning Attorneys

Our Oklahoma City Medicaid planning attorneys can help you plan ahead in case you need custodial care at some point in the future.  Proper planning, started far enough in advance of your need, can position you to have this care covered by Medicaid without having to impoverish yourself.  It then affords you the opportunity to qualify for Medicaid without losing the chance to leave your desired legacy. You should make your Medicaid plan early because you want to ensure that you do not put your assets at risk and take a chance on losing your financial security or the security you want to provide to your loved ones.

To find out more about the Medicaid planning process or about how Parman & Easterday can help you prepare in case you need nursing home care or long-term care at home, join us for a free seminar. You can also give us a call today at (405) 843-6100 or (913) 385-9400 or contact us online at any time to talk with a member of our expert legal team about how to make the right plans for your specific situation.