General Discussion

Silent Type

(6,652 posts)

30. Sadly, original Medicare covers only 20 days of nursing home care, after that you pay $204 or so for next 80 days.

Reply to question everything (Original post)

Tue Nov 19, 2024, 07:09 PM

Tuesday

After 100 days, Medicare is done. Medigap will pick up that $204 if you have a Medigap policy, but after 100 days they are done too, unless you purchased expensive nursing home insurance.

https://www.medicare.gov/coverage/skilled-nursing-facility-care

And, nursing homes and rehab facilities aren't covered if docs don't think you will improve. Even under traditional Medicare, Hospitals and Nursing Homes will kick you out when they believe a Medicare audit would deny the care after the fact, which happens frequently if you've worked in a hospital or been hospitalized.

Denials are probably more under MA for most people, but many people cannot afford a Medigap policy and Part D plan. It's a trade off. And, we are likely stuck with it.

Heck, even ACA relies on private health plans.

Edit history

Please sign in to view edit histories.

105 replies

= new reply since forum marked as read

Highlight:

The Sickest Patients Are Fleeing Private Medicare Plans--Costing Taxpayers Billions [View all] question everything Tuesday OP

THAT'S when they find out what a fucking scam it is Skittles Tuesday #1

You can warn them Hope22 Tuesday #2

"too good to be true" seems lost in the wind Skittles Tuesday #4

Are they quitting or are they intentionally being kicked out? ... aggiesal Tuesday #50

either way it's more proof what a fucking scam they are Skittles Tuesday #52

I agree, but if they were kicked out, if I was running the government ... aggiesal Tuesday #53

LOL Skittles Tuesday #54

I agree with that too. It's what I would do. n/t aggiesal Tuesday #55

My wife was on Medicare Advantage plan until the end of her life at140 Tuesday #56

of course there are always the exceptions Skittles Tuesday #57

you are right about the goal of MA at140 Tuesday #60

it is odd that they do not specify in the article Skittles Tuesday #61

The first paragraph- which I snipped to keep the allowed ones -mentioned United Healthcare question everything Tuesday #71

Humana isn't much better Skittles Tuesday #72

A friend recently received notice that her Advantage care was being cancelled. Lonestarblue 14 hrs ago #101

B-I-N-G-O, this is what I'm referring to. ... aggiesal 13 hrs ago #104

Yep. Medicare Advantage was great for my mom -- until she really needed it. W_HAMILTON Tuesday #62

I am sorry about that. She should have been able to switch during open enrollment question everything Tuesday #74

She could have switched, but wouldn't have been able to afford... W_HAMILTON Tuesday #82

When you go back to original medicare Henry203 13 hrs ago #103

Medicare "Advantage" was George W. Bush's attempt to privatize Medicare. OMGWTF Tuesday #3

it's an ONGOING EFFORT Skittles Tuesday #5

That would be because he's basically a pimp. dchill Tuesday #48

Part C started in Clinton. Silent Type Tuesday #27

Exactly! surfered Tuesday #46

Another GOP grift of the public and especially their MAGA base. Jit423 Tuesday #59

This is an important article. Thanks. spooky3 Tuesday #6

not only the "free stuff" rampartd Tuesday #11

And all the admin costs, and profit for the insurer, etc. nt spooky3 Tuesday #13

i can't even fit this into "capitalism." rampartd Tuesday #15

Seniors had better be ready to push back hard if spooky3 Tuesday #16

i am a cancer survivor rampartd Tuesday #19

Hang in there! I have a relative whose care in the last two years has spooky3 Tuesday #20

i've seen the numbers paid out by medicare and my supp. blue cross rampartd Tuesday #24

Totally agree. Nt spooky3 Tuesday #28

there is NO REASON a session of chemo should cost that much Skittles Tuesday #65

And the fact that we as a country allow it to happen. spooky3 Tuesday #79

My wife has had, and survived, cancer twice DFW Tuesday #29

Wow! I hope she is ok now. nt spooky3 Tuesday #64

Amazingly, yes, she is. DFW Yesterday #87

I'm happy for her and your family. Nt spooky3 Yesterday #88

Thanks. We were extremely lucky, and never forget it. DFW Yesterday #89

Congratulations! Nt spooky3 23 hrs ago #90

I have advanced emphysema from a genetic condition misanthrope 17 hrs ago #97

This message was self-deleted by its author Skittles Yesterday #85

? Skittles 10 hrs ago #105

kickbacks for the people who add people to these scams Skittles Tuesday #63

Unless they are in a guarantee issue state how do they do it? Tadpole Raisin Tuesday #7

They aren't switching to another private plan; they spooky3 Tuesday #10

I know they aren't switching to another M.A. plan. That wouldn't help at all. Tadpole Raisin Tuesday #17

So your earlier post was commenting about supplemental plans? spooky3 Tuesday #18

If they were in an Advantage plan they didn't have a supplement. Tadpole Raisin Tuesday #23

If their income is low enough... littlemissmartypants Tuesday #45

True! Although when over 65 sometimes the asset test knocks you out Tadpole Raisin Tuesday #51

Already there... littlemissmartypants Tuesday #58

Sorry about that. Can the manufacturer help? They often do for expensive drugs question everything Tuesday #70

Thanks for the suggestion. There's a manufacturer discount card. ... littlemissmartypants Tuesday #83

A system that makes it normal for people to stress out over this DFW 14 hrs ago #100

Dr Ozis gonna fix it 🙃 Deuxcents Tuesday #8

there are youtube videos with the hack Oz pimping for Advantage Skittles Tuesday #9

Social Security Advantage. The Musk/Swarmy Plan Traildogbob Tuesday #12

Once you really need care.. Macrophylla Tuesday #14

I work in Neurosurgery Horse with no Name Tuesday #32

There will be no more traditional Medicare mnhtnbb Tuesday #21

no Skittles Tuesday #25

You'll be wheeled into the alley behind the hospital awaiting doom. erronis Tuesday #38

That's what I mean. mnhtnbb Tuesday #39

it will all eventually be turned over to private insurance Skittles Tuesday #40

This is exactly what I think, too XanaDUer2 21 hrs ago #93

They're already screwed by then. If you join Advantage you will likely be locked out of traditional Medicare supplements tritsofme Tuesday #22

Hubs and I would pay 800 per month on original Medicare. And I have had excellent care... Demsrule86 Tuesday #33

The concept of a plan has always been the same... Moostache Tuesday #26

Sadly, original Medicare covers only 20 days of nursing home care, after that you pay $204 or so for next 80 days. Silent Type Tuesday #30

Not all Medigap policies pay this...most folks go on Medicaid. Demsrule86 Tuesday #34

This is why we need long term insurance except they are getting so expensive question everything Tuesday #78

Unfortunately, I see no chance of nursing home coverage in next 20 years at least. Good point about those who are Silent Type Tuesday #80

This is bullshit. You can't go back to orginal Medicare after Advantage...unless you Demsrule86 Tuesday #31

You can go back to original Medicare, buy you'll pay 20% out of pocket unless you qualify for a Medigap policy, which Silent Type Tuesday #35

That is false. totodeinhere Tuesday #68

Better go read that again. 63-day window applies to the FIRST YEAR you go on MA. After that, underwriting applies Silent Type Tuesday #73

Thanks for the correction. n/t totodeinhere Tuesday #75

It's overly complicated. I don't see how anyone keeps up with it. Silent Type Tuesday #77

That is not true! Liberal In Texas Tuesday #36

If your advantage plan is canceled that may set up a special circumstance Tadpole Raisin Tuesday #66

Wall Street Journal Cirsium Tuesday #37

Switching? Jill Hanson Tuesday #41

So did I, though in some case you can IF you have a lot of money. Auggie Tuesday #42

During open enrollment as is right now question everything Tuesday #44

You can definitely go back to original/heritage Medicare. But, there is no guarantee you can get a Medigap policy, Silent Type Tuesday #76

False fact upstream..... Granny Blue Tuesday #43

I think... littlemissmartypants Tuesday #47

For 2025, Medicare Advantage plans have cut benefits and raised premiums and copays, across the board dlk Tuesday #49

Kick dalton99a Tuesday #67

I'm so damn sick of this crap soandso Tuesday #69

I thought wryter2000 Tuesday #81

You can during open enrollment see 44, above question everything Tuesday #84

no you CAN go back Skittles Yesterday #86

I don't know why everyone is so worried Zorro 23 hrs ago #91

Humana is terminating 560,000 members because they are not profitable enough dalton99a 22 hrs ago #92

This happens with for profit companies. Their fiduciary is for their shareholders who expect them question everything 21 hrs ago #94

With Dr. Oz sabbat hunter 18 hrs ago #95

I don't get it. The premium for my plan is $36/month. milestogo 18 hrs ago #96

This is how the story started question everything 15 hrs ago #98

I'm enrolled in both milestogo 15 hrs ago #99

GOP evil julmur 14 hrs ago #102