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nursing homesMedicare, Medicaid and Nursing Homes

Its an option for a nursing home, but not a requirement. A nursing home might participate in both programs, or just one, or neither.

Medicare

Medicare is the federal health insurance program for people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD).

Medicare usually pays for nursing or rehab care according to very limited restrictions, and for only a short time (usually limited to 100 days). Medicare is NOT a provider for long-term care in a nursing facility, nor for someone who doesn't need medical treatment as part of their care.

Medicaid

is a joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you quality for both Medicare and Medicaid.

The Medicaid program is the largest single source of payment for nursing home costs in most states. It can pay for most of the cost of nursing home care if the resident qualifies under the medical and financial requirements of their state Medicaid program. Medicaid program rules differ from state to state, and the program is not always called 'Medicaid'. In Pennsylvania, for instance, the medicaid program is called 'Medical Assistance'.

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