| Available Resource Requirements for a Single Person |
| Medicaid will pay for medically necessary care in skilled or intermediate care nursing homes. Medicaid is jointly funded by the federal and state governments, and individual states have their own methodologies for administering their Medicaid programs. More... |
| Medicare - Limiting Charges and Assignment |
| Medicare limits the amount it will pay for some services, supplies, and medical equipment. This is called the Medicare limiting charge. Whether a limiting charge is available to help limit the cost of services or supplies, however, depends upon who is rendering the service, whether the provider has agreed to accept assignment, what type of item or service is at issue, and whether the physician and the patient executed a private contract. Assignment means that a provider has agreed that it will accept the Medicare-defined reasonable and customary fee for its services. A full discussion of assignment appears in a separate article.More... |
| Mandatory Services - Nursing Facility Services |
| Medicaid is a federal entitlement program that provides health care coverage to Americans with low income and assets. Although the states administer Medicaid for their residents, there is a core group of services, known as mandatory services, they must provide. One of these services is the provision of nursing facility services for individuals who are at least 21 years old. The federal government dictates that only certain types of costs may be charged to residents of these facilities.More... |
| The Nursing Home Reform Act |
| As people age, many succumb to debilitating illnesses or physical infirmities that preclude self-care and self-maintenance. Families are often confronted with difficult and painful decisions when an elderly loved one can no longer take care of himself without assistance or safely stay at home alone.More... |
| Cost Sharing |
| Several financial assistance programs exist to help certain individuals obtain Medicare and Medicaid coverage: the Qualified Medicare Beneficiary (QMB) program; the Specified Low Income Medicare Beneficiary (SLMB) program; and the Qualifying Individuals (QI) programs. These programs are available to qualifying individuals who do not meet the income requirements for Medicaid. More... |
Honesty, Integrity & Results
