Will Medicare Pay for Care in a Rehabilitation Facility?

Medicare will pay for skilled nursing care in a skilled nursing facility if a senior has a qualifying hospital stay and the patient needs the services of professional personnel. A qualifying hospital stay is one where the senior was admitted as an inpatient to the hospital for 3 consecutive days or more. Make sure that the senior isn’t admitted for “observation” only and was actually admitted to the hospital as an inpatient. For a period of time in the skilled nursing facility, Medicare will cover a semi-private room, meals, skilled nursing care, medical social services, medications, medical supplies and equipment and other services such as physical therapy, occupational therapy, or speech-language pathology if those services are needed to meet the patient’s health goal. Medicare will pay the full cost of the skilled nursing facility for only the first 20 days. Medicare will pay all but the daily coinsurance for days 21-100 and the patient would need to cover up to $157.50 per day for the care. Medicare will not pay for anything beyond 100 days in the benefit period. It is important to know a senior’s rights to care. Medicare will continue to cover the skilled nursing care if the care is necessary to help improve a senior’s condition or to maintain their condition and prevent or delay it from getting worse. The patient does not necessarily have to keep making improvements for Medicare to continue coverage. If the care will keep the patient from slipping, the senior has Medicare coverage for the first 100 days in the benefit period.

Written by Heather W. Winter, Esquire

What Are Some Legal Considerations Senior Couples Should Think About Before Marrying?

As people live longer, multiple marriages are more common and proper elder law planning is important. Couples who marry should consider the legal implications of marriage at any age, but especially later in life marriages. Marriage creates certain rights and obligations and it is important to understand those rights and obligations. It is important to understand that married couples owe each other certain duties, such as the duty to support one another. If one spouse has medical issues and incurs high hospital expenses, the other spouse’s income and assets may be used to pay for them.

Senior couples may want to consider entering into a prenuptial agreement. Seniors may have assets to protect, children from prior marriages whom they’d like to provide for, and other concerns that can be addressed in a prenuptial agreement. The prenuptial agreement can address spousal support, division of debts and property, inheritance rights, and other issues. However, if one spouse needed to qualify for Medicaid to provide long-term institutionalized care, all assets of both spouses are considered available for the care of either and Medicaid will ignore the provisions of the prenuptial agreement.

Finally, after the wedding, the senior couple should ensure that their estate planning documents are updated, including any wills, trusts, durable powers of attorney, and advance medical directives, to make sure the documents reflect his or her wishes and any new decisions he or she has made.

Written by Heather W. Winter, Esquire