Medicare coverage for Nursing Treatment, Long-Term Treatment and Expert Nursing Care

What is the amount of coverage that the current Medicare plans offer for nursing home treatment, long-term treatment and expert nursing care?

Normally, Medicare does not offer any help for long-term treatment and care. Treatment on a long-term basis is referred to as “custodial care,” as it can be carried out in various forms and locations. Long-term treatment and care can be rendered at a nursing home, another location in the community and even at home.

Personalized care, which cannot be categorized as skilled care, includes supportive service for daily activities like bathing, eating and other general support which does not fall under the category of skilled medical treatment. Therefore, Medicare will not pay for this type of care.

Medicare offers monetary help only for treatment, classified as vital and proficient medical or nursing care. If you are ill and need constant care under the eye of trained medical personnel who will have the responsibility for your remedial care, you would fall into this category.

Trained medical personnel like doctors and nurses managing your treatment differ from the long-term care given at home or elsewhere by your family members or care-givers. Medicare will only pay for treatment given at a medical facility by qualified and experienced staff.

To make sure you will be protected, call Cohen & Oalican, LLP to discuss your long-term care and Medicaid Plan.

Cohen & Oalican : New Health Care Law and Presciption Drugs

Cohen & Oalican answer:

Does the new health care law have any provisions to deal with the coverage gap in prescription drugs?

Medicare’s drug coverage was inadequate for approximately 8 million people in 2007. Most Medicare plans have a prescription drug coverage gap or “donut hole” , which forces you seniors to pay out of pocket for your prescription medicines to a certain limit before the plan will begin to cover medication costs. Coinsurance, private payments and annual deductible amounts are all taken into account for each plan’s limit within the coverage gap, however, even these high costs do not always translate to cost savings for many Medicare recipients.

2010: Coverage Gap Rebate of $250

In March, the President signed a new health care law, which offers discounts and savings for seniors during the coverage gap period. The rebate is designed to assist Medicare recipients with prescription drug costs while in the donut hole.

Here’s how it works—Beginning in 2010, Medicare will send you a check for $250 as a one-time payment, three months after the end of the quarterly period when you reached your prescription drug coverage limit. It is important to note that the coverage gap rebate only applies to Medicare recipients who are eligible for the drug coverage and are not currently receiving assistance from another source. Seniors should also be advised that no personal information has to be provided to receive the rebate check, like the number of your bank account, your Social Security number or your Medicare information. If you are contacted by regarding the rebate payment who asks for personal information, please do not divulge any
essential or pertinent facts about yourself. For more information about the coverage gap rebate check, call the designated location dealing with your particular plan.

If you have further questions please contact Cohen & Oalican LLP, elder law attorneys in Boston, Andover and Raynham.