Medicare

To receive Medicare benefits for room and board, the resident must have had an inpatient hospital stay of at least 3 days and receive a skilled level of service while in the nursing home. The number of days covered by Medicare Part “A” will is determined by the level of care required by the resident, and the number of days approved by Medicare.

To receive Medicare Part “B” benefits, the resident must have Part “B” coverage. Part “B” services in a nursing home include therapies such as physical therapy, occupational therapy, and speech therapy. These are covered at 80% with the 20% covered by private insurance or Medicaid will be billed to the resident.

Other Medicare plans such as Medicare Plus Blue may have different rules than standard Medicare. Our billing office can assist with questions regarding a Medicare covered stay at our facility.

Private Insurance

If your private insurance is primary to Medicare, prior authorization may be required for coverage in a nursing home. The facility will bill your private insurance for you. The resident is responsible for payment should services be denied.

Medicaid

If the resident has Medicaid coverage on admission, the case worker must be notified of the admission. The facility will also send notification. A patient pay deductible will be billed on a monthly basis. This amount is set by the Department of Human Services, not by the nursing home. This amount is paid from the resident’s monthly income including social security benefits, retirement income, etc.

If the resident does not have Medicaid coverage on admission, the family or responsible party must apply for Medicaid on the resident’s behalf. The status of the resident will be private pay for all services until Medicaid approval is obtained.

Please contact the business office for further information, if needed.

Paulette (906) 485-1061 ext. 101 or Ruth ext. 7179