A Variety of Payment Options

Cost is always an important deciding factor when choosing a skilled nursing facility. Depending on the type of care and the individual covered, you may be able pay for skilled nursing with Medicare, private insurance, long-term care insurance or personal funds.

What is Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with permanent kidney failure requiring dialysis or a transplant, known as end-stage renal disease and sometimes called ESRD.

Medicare’s different parts help cover specific services:

Part A – Hospital Insurance
Part A covers inpatient hospital stays, care in a skilled nursing center, hospice care, and some home health care.

Part B – Medical Insurance
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Part C – Medicare Advantage Plans
This is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

Part D – Prescription Drug Coverage
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

What is Medicaid?

Medicaid, which is different than Medicare, is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, such as long-term care and personal care services.

How can I figure out what kind of coverage I have?

  • Check your red, white and blue Medicare card
  • Check all other insurance cards that you use. Call the phone number on the cards to get more information about the coverage.
  • Check your Medicare health or drug plan enrollment.
  • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

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