This series highlights the eligibility rules for Maine Medicaid (MaineCare) nursing home benefits and dispels certain myths the families that work with our office often hear.

Myth1: Medicare Will Cover My Nursing Home Bill.

The Truth: Medicare pays for only a small amount of the nursing home care provided in the United States. In general, Medicare covers the full cost of the first twenty days in a skilled nursing facility if the individual is admitted following at least a three-day hospital stay and is receiving skilled care as opposed to custodial care. Medicare will cover a portion of the cost of the facility for up to eighty more days; the deductible for 2019 was $170.50 per day, which is sometimes covered by Medigap insurance. When the Medicare coverage ceases, the patient must pay out of pocket unless he or she has adequate long-term care insurance or qualifies for government benefits under the Medicaid program.


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