Medicare and Medicaid Coverage

Medicare and Medicaid Coverage

In general, Medicare and most other health insurance plans do not cover long-term care costs such as room and board at a nursing or assisted living facility. What Medicare does and does not cover is based on federal and state laws, national coverage decisions made by Medicare, and local coverage decisions made by companies in each state that process claims for Medicare. Medicare covers costs such as:

  • Hospital care
  • Home health care
  • Inpatient/outpatient care
  • Hospice care
  • Ambulance services
  • Clinical research
  • Medically necessary services
  • Preventive services
  • Skilled nursing facility care (under certain conditions and for a limited time)

Medicaid, however, can cover part of your nursing or assisted living facility costs depending on whether or not the community accepts Medicaid as payment. Grand Oaks of Jensen Beach and Palm City unfortunately do not accept Medicaid as payment, however Grand Oaks of Okeechobee does. Grand Oaks of Okeechobee uses third party agencies that offer a med waiver program for residents with Medicaid. The third party agency pays for a portion of the assisted living costs and the resident pays for the remaining portion.

For more information on financial options at Grand Oaks, click here.

For more information on Medicare coverage, visit
https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/your-medicare-coverage-choices.html.

For more information on long-term care coverage with Medicaid, visit
https://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/long-term-services-and-supports.html.

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