What is long-term care insurance?

Long-term care insurance (LTC or LTCI) helps cover the cost of long-term care in a skilled nursing facility, beyond a certain predetermined period and is meant to pay for care not covered by other insurance, Medicaid, or Medicare.

What does Medicare usually cover for a skilled nursing facility?

Medicare Part A (Hospital Insurance) provides time-limited coverage for skilled nursing care that is provided in a skilled nursing facility (SNF) when certain conditions are met. Learn more.

All of the following criteria must be met for the skilled care to be Medicare Part A eligible:

  • Patient must have Medicare Part A with days remaining in benefit period
  • There must have been an inpatient hospital stay of three consecutive days or more and the patient must enter the SNF soon after being released from the hospital.
  • A physician has prescribed care that requires the skills of RNs, LPNs, or speech/language, occupational or physical therapists.
  • The skilled care is needed daily on an inpatient basis.
  • The care is for the condition that was treated during the previously discussed three-day hospitalization, or began during care for another condition that received treatment during the qualifying 3-day stay

Daily rate for skilled nursing must include room and board:

  • Three daily meals plus snacks
  • Special diets if ordered by the doctor
  • Assistance with activities of daily living (bathing, personal hygiene, dressing, etc.)
  • Housekeeping daily
  • Linens for bed and bath
  • Administration of prescribed medications
  • Round-the-clock supervision by licensed nurses and nurse assistants
  • Feeding assistance
  • Regular Weekly Activities
  • Occupational and recreational programs
  • Medication review
  • Social services consultation
  • Rooms that federal and state guidelines
  • Planning and referral upon discharge

DAILY RATE DOES NOT INCLUDE:

  • PHYSICIAN VISITS,
  • DENTIST CARE,
  • MEDICATION,
  • SUNDRIES,
  • MEDICAL SUPPLIES AND MATERIALS,
  • SUPPLIES AND LINENS FOR INCONTINENCE
  • DOCTOR ORDERED THERAPIES INCLUDING PHYSICAL, OCCUPATIONAL & RESPIRATORY THERAPY,
  • DIAGNOSTIC TESTS,
  • OTHER SPECIALIZED CARE PROCEDURES, ETC.

What might Medicare pay for long term elder/senior care?

Most long-term care isn’t medical care but rather is a range of support services for personal care. Medicare pays for skilled nursing care in a SNF up to 100 days per qualifying spell of illness.

Do you accept private health insurance?

Yes, we accept individual health insurance or private pay.  Please see our admittance staff for more information.

Do you accept Medicaid patients?

Yes, we do. For additional questions, please ask our admitting staff.

Come See for Yourself

Our top-quality care creates results.  In fact, our discharge to home rate is above the national average.  And our beautiful, comfortable surroundings make guests feel right at home. Come see what makes Victoria Gardens of Allen so special.

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