Issue link: https://www.newlifestylesdigital.com/i/749280
102 $ ADDRESSING THE GAP IN MEDICARE Are you surprised to learn that Medicare is limited and does not meet your complete care needs once you've left the hospital? The cost of that care may come as a complete shock and surprise. How can we can help you address the gap in care? Perhaps the most important part is that we set your expectations from the beginning by reviewing some of the Medicare FAQS: Q: What does Medicare cover? A: Medicare will cover care of a skilled nature; that is provided mostly by nurses, physicians and other licensed personnel when your condition dictates that level of care. This care can be provided in a Skilled Nursing Facility or by Medicare Home Health Agencies and is limited in days or by number of intermittent nursing visits. Q: What happens when care becomes "custodial" or simply to maintain your status? A: Once you no longer qualify for skilled care, Medicare coverage stops, you pay privately, and are likely relocated into a different section of the skilled facility suited for long term residents or your home health coverage ends and you or your family will be responsible for your care. Q: How will you pay for care in the "Gap"? A: 1. Pay Privately: If you have the resources you will have to pay privately for your care. 2. Long Term Care Insurance: If you have a LTC policy, accessing those benefits will be based upon meeting the policy criteria. There are specific issues that must be covered in the processing of your LTC claim in terms of documentation and limitations within your specific policy. It may be very important for you to work with an agency that has experience handling the claims process. Coverage may not cover the total care you need but will make a dent in it. 3. Family to Provide Your Care: If you have limited resources, you will likely, receive care in your home or a family member's home with a family member providing most of your direct care.