Medicare
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease (ESRD).
Medicare only covers medically necessary care and focuses on medical acute care, such as doctor visits, drugs, and hospital stays. Medicare coverage also focuses on short-term services for conditions that are expected to improve, such as physical therapy to help you regain your function after a fall or stroke.
Medicare does not pay the largest part of long term care services or personal care—such as help with bathing, or for supervision often called custodial care. Medicare will help pay for a short stay in a skilled nursing facility, for hospice care, or for home health care if you meet the following conditions:
If you meet all these conditions, Medicare will pay for some of your costs for up to 100 days. For the first 20 days, Medicare pays 100 percent of your costs. For days 21 through 100, you pay your own expenses up to $140.00 per day (as of 2013), and Medicare pays any balance. You pay 100 percent of costs for each day you stay in a skilled nursing facility after day 100.
To learn more about what is and is not covered under Medicare, click here.
To access the online Medicare application, click here.
For a list of contacts in New York State who can assist with Medicare-related questions, click here.
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease (ESRD).
Medicare only covers medically necessary care and focuses on medical acute care, such as doctor visits, drugs, and hospital stays. Medicare coverage also focuses on short-term services for conditions that are expected to improve, such as physical therapy to help you regain your function after a fall or stroke.
Medicare does not pay the largest part of long term care services or personal care—such as help with bathing, or for supervision often called custodial care. Medicare will help pay for a short stay in a skilled nursing facility, for hospice care, or for home health care if you meet the following conditions:
- You have had a recent prior hospital stay of at least three days
- You are admitted to a Medicare-certified nursing facility within 30 days of your prior hospital stay
- You need skilled care, such as skilled nursing services, physical therapy, or other types of therapy
If you meet all these conditions, Medicare will pay for some of your costs for up to 100 days. For the first 20 days, Medicare pays 100 percent of your costs. For days 21 through 100, you pay your own expenses up to $140.00 per day (as of 2013), and Medicare pays any balance. You pay 100 percent of costs for each day you stay in a skilled nursing facility after day 100.
To learn more about what is and is not covered under Medicare, click here.
To access the online Medicare application, click here.
For a list of contacts in New York State who can assist with Medicare-related questions, click here.
Medicaid
Medicaid is a joint federal and state program that helps people with low income and assets pay for some or all of their health care bills. You may qualify if you have high medical bills, receive Supplementary Security Income (SSI), and/or meet certain financial requirements.
Medicaid covers nursing home services for all eligible people age 21 and older. Medicaid also covers home and community-based services for people who would need to be in a nursing home if they did not receive the home care services. In most states, Medicaid will also cover services that will help you remain in your home, such as personal care services, case management, and help with laundry and cleaning. Medicaid will not pay for your rent, mortgage, utilities, or food.
You may apply for Medicaid in the following ways:
For more information on how and where to apply for Medicaid in New York State, click here.
Medicaid is a joint federal and state program that helps people with low income and assets pay for some or all of their health care bills. You may qualify if you have high medical bills, receive Supplementary Security Income (SSI), and/or meet certain financial requirements.
Medicaid covers nursing home services for all eligible people age 21 and older. Medicaid also covers home and community-based services for people who would need to be in a nursing home if they did not receive the home care services. In most states, Medicaid will also cover services that will help you remain in your home, such as personal care services, case management, and help with laundry and cleaning. Medicaid will not pay for your rent, mortgage, utilities, or food.
You may apply for Medicaid in the following ways:
- New York State of Health, The Official Health Plan Marketplace (855-355-5777)
- Online website
- Managed Care Organization (MCO)
- Navigators and Certified Application Counselors
- Medicaid Helpline (800-541-2831)
- Local District Social Services Offices
For more information on how and where to apply for Medicaid in New York State, click here.
Private Pay/Insurance
Just as there are many kinds of long term care services and supports, so is there a wide range of costs for them. And while some people may qualify for a public program to help pay for these expenses, most people use a variety of options, including long term care insurance, personal income and savings, life insurance, annuities, and reverse mortgages. As our population ages, new financial products are continuously offering more options.
For more information about private payment options, click here.
Just as there are many kinds of long term care services and supports, so is there a wide range of costs for them. And while some people may qualify for a public program to help pay for these expenses, most people use a variety of options, including long term care insurance, personal income and savings, life insurance, annuities, and reverse mortgages. As our population ages, new financial products are continuously offering more options.
For more information about private payment options, click here.
