We recognize transitioning to senior living often comes with a change in financial circumstances. Below you will find information on some of the most commonly used financial solutions along with some resources to answer questions. When evaluating financial options, we understand each individual’s circumstances are different, so it’s best to have a conversation by setting up a tour to determine your needs and interests. Then meet with our business office to evaluate what’s the best solution for you and your family.
Out of Pocket, or Private Pay
Residents often use their personal income or savings when paying for senior housing. This may include the use of savings, funds from the sale of a house or vacation property, or cashing in personal investment portfolios. However, if your resources don’t allow for private pay, there are other options.
Medicare is a federal program for people who are disabled or of retirement age. In a skilled nursing setting, the patient must have a daily skilled service such as therapy, and be admitted in the hospital for a minimum of three overnights. Please note, if the patient is in an emergency room or considered to be under observation status in the hospital, those days do not count toward the hospital stay requirement to access Medicare benefits.
Medicare does cover up to 100 days of skilled nursing (also known as transitional care or rehabilitation care) at Saint Therese, which is called a spell of illness. The patient must continue to meet the coverage criteria of having a daily skilled service for Medicare coverage to continue. Medicare covers the first 20 days 100%. During days 21-100 of the patient’s Medicare coverage, there is a daily coinsurance payment that is set by Medicare. The co-insurance can be billed to the patient’s supplemental insurance if available.
Important: 30 Day Window with Medicare Coverage:
If you discharge home from a skilled nursing facility and things are not going well and you require continued therapy, Medicare may allow you to re-admit to the skilled nursing facility without requiring another hospitalization. The prior spell of illness then continues in the skilled nursing setting allowing the patient to continue on their Medicare coverage.
For more information, see the Medicare & You 2016 Handbook: https://www.medicare.gov/Pubs/pdf/10050.pdf
Third Party Payers: Health Plans
If you have insurance that is primary over Medicare coverage, such as a Medicare advantage plan or county health plan, Saint Therese can work with your plan provider to understand the benefits available following hospitalization. Health plans may have some out of pocket cost such as a co-pay and/or deductible. Contact your health plan for specific coverage questions.
Saint Therese accepts various types of VA benefits. Types of benefits may vary by location. The VA makes the decision on the benefits available for each veteran.
VA Health Care Application to Apply for Benefits: http://www.va.gov/HEALTHBENEFITS/apply/
VA DD-214 Request / Discharge Paper: http://www.va.gov/HEALTHBENEFITS/apply/
Hennepin County Veteran’s Services Location/Information: http://www.hennepin.us/residents/human-services/veterans-service