许多成年人在一生中需要某种类型的长期护理。但是，并不总是清楚它是否被覆盖。如果您或亲人有Medicare，您可能会想知道如果您需要在路上需要它的长期护理方案。

Here, we’ll address what type of long-term care is covered, who is eligible to receive coverage, and how to get help paying for it.

在讨论Medicare涵盖的内容之前，重要的是要知道长期护理的含义。长期护理是指在很长一段时间内照顾您的健康和医疗需求所必需的各种服务。这与短期护理不同，例如参观doctor’s officeor急救室。

Here are the following long-term care services that Medicare covers:

Skilled nursing facilities

熟练的护理设施（SNF）可以向专业或技术人员提供与医疗或健康相关的服务，以监控，管理或治疗健康状况。SNF的员工包括：

Examples of when someone might need SNF care include:

Medicare Part A covers short stays at an SNF. Here is the breakdown of covered costs depending on length of stay:

  • 第1至20天：Part A pays the entire cost of any covered services.
  • Days 21 through 100:Part A pays for all covered services, but you’re now responsible for a daily coinsurance payment. For 2020, this is每天$ 176。
  • After 100 days:Part A pays nothing. You’re responsible for the entire cost of SNF services.

Medicare Part C (Medicare优势) and Medicare Supplement (Medigap) plans may cover some of the costs not covered by Part A. When you’re deciding what type of Medicare plans to enroll in, it’s important to consider these plans as well.

在家护理

家庭护理涉及您在家中获得的任何医疗服务，而不是去医院或医生办公室。通常，这些家庭护理服务与家庭医疗保健机构协调。Medicare A部分A和B可以涵盖此类护理。

家庭护理期间提供的服务示例包括：

  • 兼职熟练的护理或动手护理
  • 物理疗法
  • occupational therapy
  • speech-language therapy
  • injectableosteoporosis女性药物

Medicare仅涵盖医学上必要的服务。没有涵盖托管保健，准备和清洁。

如果您有原始的Medicare，则不会为有保障的家庭医疗保健服务支付任何费用。他们也会付款20％of the cost for any necessary耐用的医疗设备（DME）。Examples of DME include wheelchairs, walkers, or hospital beds.

Hospice care

Hospice careis a special type of care that someone receives when they’re terminally ill. Hospice focuses on managing symptoms and providing support.

Examples of services provided during hospice care include:

  • care from doctors and nurses, including exams and visits
  • medications or short-term inpatient care to manage symptoms and ease pain
  • 医疗设备或供应，例如轮椅，步行者或绷带
  • physical and occupational therapy
  • 短期暂时护理，涉及在没有照料者的时间内在疗养院或医院进行护理
  • 为您的家人和亲人的悲伤咨询

Medicare部分一般covers all costsof hospice care, with the possible exception of small copays for respite care or prescriptions. Medicare also doesn’t pay for room and board while you’re receiving hospice care.

In addition, there are some expenses that Medicare will no longer cover after hospice benefits start. These include any medication or treatment intended to cure a terminal illness. It’s important to coordinate a plan with a hospice care team to make sure everything is organized and covered.

至receive benefits, you must first be eligible for original Medicare (Part AandPart B) by meeting one of the followingrequirements：

  • Be 65 years or older.You can enroll beginning 3 months before your 65th birthday.
  • Have a disability.You can enroll beginning 3 months before you reach the 25th month of receiving disability benefits.
  • Have end stage renal disease.Enrollment times can depend on your individual situation.

Once you have注册in original Medicare, you’re eligible to receive coverage for long-term care.

Am I eligible for a skilled nursing facility?

至qualify for coverageto stay at an SNF, you must first have a qualifying hospital stay: your stay must last at least 3 consecutive days and be classified as “inpatient.”

In addition, your doctor must document that you need daily inpatient care or supervision that can only be given at an SNF. You’ll typically need to enter the SNF within 30 days of leaving the hospital.

Am I eligible for in-home care?

如果你有原始的医疗保险,你有资格申请,home care if your doctor classifies you as “homebound.” This means that you have trouble leaving home without assistive equipment (such as a wheelchair) or the help of another person.

Your doctor must also certify that you need skilled medical services that can be provided at home. Examples include part-time skilled nursing care, physical therapy, or occupational therapy. Your doctor will create a plan of care for you.

我有资格获得临终关怀吗？

至be eligible for hospice care coverage, you must:

  • 被证明为绝症。这通常意味着您的估计寿命少于6个月，尽管您的医生可以在必要时扩展。
  • Choose to accept姑息治疗而不是治疗您的病情。姑息治疗专注于提供舒适和支持。
  • Sign a statement indicating that you’ve chosen hospice care for your condition instead of other Medicare-covered treatments.

Although Medicare covers some services of long-term care, there are many others that it doesn’t cover.

例如，Medicare不涵盖托管保健，这需要在饮食，穿衣和厕所等日常活动中提供帮助。这是提供的重要组成部分nursing homesorassisted living facilities。

与长期护理,没有额外的帮助covered by Medicare, consider the following options:

  • Medicare优势。私人保险公司提供这些计划。一些Advantage plansmay offer more long-term care benefits than original Medicare.
  • Medigap。Like Advantage plans, private insurance companies sell these policies.Medigap计划can help with coinsurance and copayments costs associated with long-term care.
  • 医疗补助。Medicaid是一项联合联邦和州计划，可免费或低成本提供医疗保健。可用的收入资格计划和要求可能因州而异。通过医疗补助网站。
  • 长期护理保险。一些保险公司出售一种称为“长期护理保险”的保单。这些政策旨在涵盖长期护理，包括保管护理。
  • 对老年人的全包护理计划（速度）。PACE is a program that’s available in some states to help cover costs associated with medical or long-term care provided at home. Visit the步伐网站了解更多。
  • Department of Veterans Affairs (VA).VA可能有助于为一些退伍军人提供长期护理。要了解有关潜在利益的更多信息，请联系您当地的VA健康中心或访问VA site。
  • Out of pocket.如果您选择掏腰包，这意味着您将自己支付所有长期护理费用。

Medicare covers some types of long-term care including in-home care, hospice care, and short stays at skilled nursing facilities. To be eligible for coverage, you must meet certain rules.

长期护理的某些方面并未涵盖Medicare。其中包括在疗养院和辅助生活设施中通常提供的非医疗服务，例如托管保健，房间和董事会。

There are several additional ways to get assistance for the costs of long-term care. Some of these include enrolling in an Advantage or Medigap plan, using Medicaid, or buying a long-term care insurance policy.