Archive for December, 2010

Medicare Myths

Wednesday, December 22nd, 2010

According to a study done by Prudential in 2009 37% of people think that Medicare will cover their long-term care costs. This is false. Medicare does not pay for long-term care. Medicare is also not free, there is a monthly premium associated with Medicare Part B.

Here are the facts about Medicare.  Medicare is for people 65 years of age or older (or people with disabilities). Medicare Part A (also known as hospital insurance) covers hospital stays, short-term skilled nursing care, hospice and home care services. Medicare Part A does not have a premium (if you or your spouse have paid Medicare taxes).

Medicare Part B (also known as Medical Insurance) does have a premium that is paid monthly. Part B covers doctor’s services, outpatient care, home care services and some preventive services.

Back to long-term care, what Medicare does cover, under Part A is Skilled Nursing Facility care on a short term basis. There are several guidelines for that coverage that you should also be aware of. After a 3 day minimum hospital stay, you are eligible under Medicare Part A for a short-term stay in a Skilled Nursing Facility, for rehab and nursing services. The goal is to get the individual strong enough to return home.

What Medicare Part A covers is up to 100 days of this skilled care at a nursing facility. You may not need the entire 100 days. The staff at the nursing facility will estimate the amount of time needed to rehabilitate the patient based on Medicare guidelines for Physical, Occupational and Speech Therapies, as well as, medical interventions given by nursing staff. It is also important to note that there is a benefit period associated with your 100 days of Skilled Nursing Care. This means that if you use your 100 days, you will not be eligible for another 100 days (even if you have another 3 day hospital stay) for 60 days. During those 60 days you must not have received any Skilled Nursing services. So, keep this in mind when planning your discharge from the Skilled Nursing Facility. Another thing to keep in mind is that after 20 days in the Skilled Nursing Facility you are responsible for a 20% co-pay per day. The co-pay is based on the per day rate approved by Medicare. If you have a supplemental or Medi-Gap policy, this may cover your co-pay, call your insurance plan to verify this. It is very important when being admitted to a Skilled Nursing Facility to provide all of your insurance information, including you supplemental coverage.

In closing, Medicare covers many inpatient and outpatient services through Part A & Part B, but they do not cover long term care, also referred to at custodial care. It is important to know what Medicare covers when thinking of your short term and long term health needs.

For more information visit:

 www.medicare.gov – to view the 2011 Medicare and You Handbook,

or call 1-800-633-4227 to request a Handbook.

http://www.medicare.gov/publications/pubs/pdf/10153.pdf – for a handbook on Medicare Coverage of Skilled Nursing Facilities

NJFA Annual Event was a success!

Wednesday, December 1st, 2010

The New Jersey Foundation for Aging (NJFA) held its 3rd Annual Fall celebration on Sunday, November 14th. The event honored NJFA’s four founding trustees, Rosemarie Doremus, Margaret Chester, Carl West and Susan Chasnoff. Guests went to the 3 pm performance, “In the Mood”, at the State Theater in New Brunswick. Guests said the show was riveting, that the music was enjoyable and the salute to our military servicemen and women was heartwarming. Following the show, a dinner reception was held at Daryl Wine Bar and Restaurant. NJFA’s guests enjoyed a family style meal and wine pairing and helped NJFA to thank our Founding Trustees for their commitment to addressing aging issues in New Jersey.

 NJFA’s Annual Fall Celebration featured our First Annual Online Auction. Items included baseball memorabilia, Norman Rockwell Collector Plates, a beautiful Cuban painting, Crystal Wine Glasses and tickets for 4 to a Broadway show followed by dinner in NYC. The winners were announced at the dinner reception. NJFA would like to thank the event sponsors: Silver Century Foundation, Fox Rothschild, LLC, Suplee, Clooney & Company, EISAI, Theresa and Thomas Berry Foundation, Susan and Joseph Bredehoft, CME Associates, New Brunswick Plating, Inc, Reed Smith, LLP, Care One, Wallerstein Foundation for Geriatric Life Improvement, Provident Bank and the Spicehandler Family Charitable Fund.