Important Covid-19 Updates Related to Medicare

As you know, seniors, especially those with underlying health conditions, are most at risk for serious illness resulting from exposure to COVID19. In response to this health care crisis caused by the pandemic, Medicare has stepped up to help those who need it most by waiving certain requirements for skilled nursing facility care. This is BIG. Generally, you need a “qualifying hospital stay” of 3 inpatient days before Medicare will pay for a portion of your rehab stay in a skilled nursing facility (SNF). Some people during this time may be able to get renewed SNF coverage without first having to start a new benefit period. Also, if you’re not able to be in your home during the COVID-19 pandemic or, are otherwise affected by the pandemic, you can get SNF care without a qualifying hospital stay.

Some Medicare-covered services can include:

  • Semi-private room
  • Meals
  • Skilled nursing care
  • Physical therapy 
  • Occupational therapy 
  • Speech-language pathology services 
  • Medical social services
  • Medications
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary counseling
  • Swing bed services

Skilled Nursing Care vs. Nursing Homes

Skilled nursing care is a service that provides high-level care for seniors who are unable to care for themselves, and need 24/7 monitoring and medical assistance for chronic conditions or short-term rehabilitation from an illness or injury. This service can be provided in a variety of senior care settings.

A nursing home – more commonly known as a skilled nursing facility – is a licensed residential facility that offers on-site skilled care for those who need a higher level of care than an assisted living facility can provide. These can be stand-alone facilities or part of a continuum of care at a senior living community.

Skilled nursing staff typically include RNs, LPNs and certified nurse aides who are available 24/7 to provide injections, monitoring of medical equipment and medications, wound care and physical therapy.

Common services include:

  • Private or semiprivate rooms
  • Three meals per day
  • Housekeeping and laundry service
  • Social programs and activities
  • Exercise and physical therapy programs

Costs for skilled nursing vary depending on the length of stay, size of the room, and what region of the country you’re in. The latest Genworth Cost of Care Survey shows that the national average monthly cost for a semiprivate room is $7,148. A private room averages $8,121 per month. Our recent experience indicates that the costs are considerably higher in the state of Massachusetts.

If you or a loved one is in need of care in a skilled nursing facility, call our office at 508-994-5200 for assistance. We may be able to help qualify your loved one for MassHealth benefits that will cover the facility costs without creating a negative impact on the spouse and potentially protecting assets.

The Executive Office of Health and Human Services is pleased to announce the launch of the Nursing Home Family Resource Line – a dedicated phone line to connect family members of nursing home and rest home residents with the information and resources they need. This new phone line provides one central contact for families and community members who have questions about the nursing home or rest home care their loved one is receiving during the COVID-19 outbreak. The Nursing Home Family Resource Line is staffed from 9:00 AM – 5:00 PM, seven days a week. Staff will field questions on a range of topics and coordinate across state agencies to help provide answers. These are unprecedented times and, understandably, families and community members have questions. We remain committed to providing relevant and timely information, and the Nursing Home Family Resource Line is another important resource. Massachusetts Nursing Home Family Resource Line: 617-660-5399 Open Every Day – 9:00 AM – 5:00 PM