Question

1)Identify possible sources of payment for care received in the following settings:

Acute care:

Skilled care:

Long-term care:

Assisted living:

Home health:

2) Discuss requirements, if any, to qualify for 3rd party payers, such as health insurance, managed care, Medicare, Medicaid, and private pay.

Answer 1

1) Acute care: Hospital insurance (Medicare) provides payments for hospital services, room charges, general nursing care and drugs. They do not cover for private rooms or private nursing care.

2)Skilled care: Usually hospital insurance but they are limited to time and conditions .They only provide coverage if one is admitted as in patient from the beginning or else one has to pay from his own.

3)Long term care:Personal resources include your or your loved one’s savings, investments and assets. These resources are used to pay expenses out of pocket and other includes forms of insurance, long term care insurance allows a person to pay a known, affordable premium cost to protect against the risk of much larger care expenses. Long term insurance is designed to meet long term care needs that may include a variety of medical, personal, or social care services.

4)Assisted living: Commercial pay and private insurances are the most common source of payments.

5)Home health: One can apply for health insurance (Medicare) but they provide only about a week care for 8 hours.

Requirements for health care insurance like medicare few examples.

1)Be age 65 or older and eligible for Social Security

2)Be permanently disabled and receive disability benefits for at least two years.

3)Have end-stage renal disease (ESRD) (permanent kidney failure that requires dialysis treatment or a kidney transplant)