Why does Medicare run out when you go to a nursing home?

Most in a NH are there from being discharged from a hospital stay (hospitalization is a MediCARE benefit) to a rehabilitation facility for rehab. Usually this is in a NH with rehab ability. Rehab is paid for by MediCARE with the first 21 days fully covered by Medicare. Then after that point it will depend on their "progressing" in their rehab and could go for up to 100 days with a pretty substantial co-pay for those days. For most elderly they just flat cannot do the rehab really needed to benefit from it, so they become ineligible for the benefit. Then family either has to spend-down the elder's assets to private pay so they can apply for MedicAID; or family private pays or they have long term care insurance which pays.

Medicaid is state run and will have specific income & asset limits to be eligible.
Most states have it at 2K in non-exempt assets & 2K in monthly income as that it the benchmark for being "at-need" or impoverished. If dad has a home, he can keep it as a exempt asset. But he will not have any income to pay for anything on the house as medicaid requires him to do a co-pay or an "SOC" share of cost in Medicaid-speak of all his monthly income to the NH less a small personal needs allowance (varies by state from $ 35 - 90 a month). For most, having the home is just not feasible and home gets sold with funds used in spend-down. Renting the home will have all sorts of problems as it could make them ineligible for Medicaid as it could make the home a non-exempt asset as it is income producing. If your state's program allows for rental, the rent would be a part of his months income steam and have to be used in his co-pay. imho the only way keeping their home works is if family has the financial resources to pay for everything on the home for the possible years & years of the rest of their elder's life and then either has a specialized deed situation or other exclusions to estate recovery so that Medicaid cannot place a claim or a lien on the property after their death (done by MERP and required to be done if they are on Medicaid). So really think hard about the long view on all this. None of this is simple or easy, good luck.

You have to go to your local Medicaid office and apply for Medicaid on the person's behalf. As long as you're in the process of applying for Medicaid nursing home's usually let the person stay until the person has been approved by Medicaid.

When someone goes into a nursing home on Medicare the clock starts ticking that first day. Eventually Medicare ends and this is where the Medicaid will pick up as long as you're applying for it.

The rules of Medicare are that it continues to only 90 - 100 days, I believe. And that is only if the person is improving. If they stop improving - Medicare ends. This happened to my mother and I had to do the paperwork, etc. for Medicaid. First, I paid the NH privately until funds ran out and my mother was allowed to stay at NH until Medicaid was approved.

The social worker at the NH was truly wonderful and helpful. This makes all the difference. And also as previously mentioned, the local Elder Care Services are a wealth of knowledge and support. Take care.

Most covered Medicare services of all types -- not just coverage for skilled nursing -- is time limited. It does not cover custodial care in a nursing home for any length of time. Medicare is a national program and the rules are mostly the same throughout the United States.

Medicaid does not "take over" from Medicare. Medicaid is a different program for the poor in every state so hard to tell what your particular rules are. Check with a local senior center. Almost every senior center in the US has a volunteer that will help answer your questions.

If he gets total workmens comp probablly wouldn't be able to rent his home to help with his bills?