Fifteen Myths Regarding Medicaid Nursing Home Benefits in Maine

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.

Rachel Trafton, Esq
Maine Elder Law Firm