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No. Many people in assisted living are not yet on medicare. In fact most admit people starting age 60. Some even earlier. Everything depends on the facility and their own rules. Do check with them. They are always happy to give tours and explain things.
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Reply to AlvaDeer
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My question is, why isn't Medicare your primary and the commercial secondary now? My husbands Union switched his insurance to a suppliment when he turned 65 and started receiving Medicare. Is someone still working?

Like said ALs are private pay so it probably doesn't matter. If things don't get paid thats your problem. NH would probably be the same if ur private pay. Now if ur are on Medicaid for ur care, Medicare is primary and Medicaid secondary.
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Reply to JoAnn29
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Not to my knowledge for nursing homes. Commercial pays use nursing home services too.

Now Assisted Living is not paid by Medicare- it’s usually private pay or paid by a person’s long term care insurance if they have it.

In some cases AL can be paid by Medicaid but this is usually only if agreed on after a resident was a private pay for a period of time (up to the AL) and if it is legal in that state (in New York it is not).

Yes its a quagmire.
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Reply to Shane1124
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Are you asking about payments or how to admit? Most facilities need a doctor note plus the person will get an interview to see if they fit in with the proper care. The facility will hand you the paperwork.

To pay, whether private insurance or Medicare, payment will last up to 21 days after a hospitalization. For Assisted Living, the majority are self pay. The exceptions offered by the State and have long lists, some with 3 year waits. Nursing home is also self pay until the patient is down to about $2000. Then you can apply for Medicaid.

There is no difference between insurances except by age or disability. Each nursing home or assisted may have an on site doctor. You find this out when you visit facilities and ask and then you can change enrollment at the end of a calendar year.
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Reply to MACinCT
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In addition, each state regulates ALs and Nursing Homes differently.

For example...

In NYS, if you are a 2 person assist or need a Hoyer lift, those services cannot be provided in an AL only in a NH. In Connecticut, you cam be in AL if you require that level of support.
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Reply to BarbBrooklyn
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As opposed to?

I think it really depends upon the facility.

When someone tells you something like this, the best course of action is to say "why?", "show me where that is written down in regulation/law" or " what makes you think that?".
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Reply to BarbBrooklyn
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