Depending on what kind of coverage you have, Medicare may pay for your health care and prescription drugs while you're in a nursing home.
Medicare covers nursing home care in 2 ways:
- Original Medicare
doesn't pay for most nursing home care. Most nursing home care helps with . Medicare covers very limited and skilled care at a nursing home or in your home (with home health care) if you need short-term skilled care for an illness or injury and you meet certain conditions.
- Medicare Advantage Plans and other Medicare health plans
If you're in a (like an HMO or PPO) or other , check with your plan to see if it covers nursing home care. Usually, plans don't help pay for this care unless the nursing home has a contract with the plan. Ask your plan about nursing home coverage before you make any arrangements to enter a nursing home. If the nursing home has a contract with your health plan, ask the health plan if they check the home for quality of care.
Medicare prescription drug coverage (Part D)
If you have
and live in a nursing home or other institution, you’ll get your covered prescriptions from a long-term care pharmacy that works with your plan.
If you have Medicare & live in a nursing home or other institution, you should know:
- If you move in or out of a nursing home or other institution, you can switch Medicare drug plans at that time.
- You can switch Medicare drug plans at any time while you’re living in the institution.
- If you aren't able to join a drug plan on your own, your authorized representative can enroll you in a plan that meets your needs.
- If you're in a skilled nursing facility (SNF) getting Medicare-covered , your prescriptions generally will be covered by Part A.