HMO Guide for Seniors - Office of the Patient Advocate - State of ...
HMO Guide for Seniors - Office of the Patient Advocate - State of ...
HMO Guide for Seniors - Office of the Patient Advocate - State of ...
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54 Nursing Home Care<br />
M<br />
edicare <strong>HMO</strong>s cover some nursing home care. Each<br />
Medicare <strong>HMO</strong> has a different way to pay <strong>for</strong> this care.<br />
Your costs can be high.<br />
Medicare <strong>HMO</strong>s have rules and limits <strong>for</strong> nursing home care.<br />
You must have a referral from your doctor.<br />
You must go to a nursing home that is in your <strong>HMO</strong>’s network.<br />
While you are in <strong>the</strong> nursing home, you must need skilled care<br />
daily. This could include nursing care, physical or occupational<br />
<strong>the</strong>rapy, or o<strong>the</strong>r rehabilitation services.<br />
The amount <strong>of</strong> time you can stay may be limited to 100 days.<br />
Some <strong>HMO</strong>s require a 3-day hospital stay be<strong>for</strong>e you can go to<br />
a nursing home.<br />
Mr. Tang visits<br />
his wife every day<br />
in <strong>the</strong> nursing<br />
home.<br />
Medicare <strong>HMO</strong>s do not cover long-term care. This is care people<br />
need because <strong>the</strong>y can no longer feed <strong>the</strong>mselves, ba<strong>the</strong>, or care<br />
<strong>for</strong> <strong>the</strong>ir daily needs. If you have a low income,<br />
you can apply <strong>for</strong> Medi-Cal, which does<br />
pay <strong>for</strong> long-term care.<br />
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