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Long Term Care

Long term care insurance policies cover all or a portion of a resident’s stay in a long term care facility. Long term care insurance goes beyond medical services and nursing care to include all the assistance required for chronic illnesses or disabilities that may leave a resident unable to care for his/her self for an extended period of time.

Long term care insurance policies offer coverage to supplement what is covered by Medicare and/or Medicaid. These policies vary greatly and require that residents meet very specific eligibility standards before any benefits are paid out. Policies vary depending on coverage and service limitations.

Please contact us with any questions concerning payment and billing policies. The  White House Health Care staff is happy to assist you.

Private Pay / Private Insurance

Private Pay is the primary funding source for most long term care products and services. This refers to costs that are not covered by Medicare, Medicaid or private insurance and are therefore borne by the resident or his/her family. Individuals without long term care insurance and who do not qualify for Medicare or Medicaid must pay for these services themselves.

White House Health Care is also a qualified provider of nursing facility care and services under many third party private insurance companies. If a resident is entitled to benefits under insurance offered by a non-Medicare/non-Medicaid insurance program, and if we participate as a provider under their program, White House Health Care will accept payment from the program. The resident will, however, be responsible for paying all co-payments, co-insurance, deductibles and charges for items and services that the program does not cover.

Please contact us with any questions concerning payment and billing policies. The White House Health Care staff is happy to assist you.

Medicare

Medicare is a federal health insurance program for people 65 and over and people with certain disabilities under age 65. To be eligible to receive Medicare coverage, residents must require skilled nursing care or rehabilitative care on a daily basis. They must have spent three consecutive nights in a hospital and be admitted to a skilled nursing home within 30 days of discharge from the hospital. Also, a physician must certify that the services required from the skilled nursing home are needed for the same illness for which the resident was hospitalized.

Medicare Part A covers care provided by a skilled nursing home to help residents recover from an acute illness or injury. Medicare provides complete coverage for the first 20 days of skilled care and a portion of the cost for days 21 to 100. During this time frame, residents are required to pay a daily coinsurance rate.

Skilled nursing home services covered by Medicare include:

• a semi-private room
• meals
• regular nursing services
• rehabilitation therapy services
• drugs furnished by the facility
• medical supplies

Medicaid

Medicaid is a health insurance program in which the federal and state governments share the cost of payments to nursing facilities on behalf of eligible residents. Medicaid is for low-income people 65 and over, people who are disabled, people who are blind, and people who need nursing home care. Some people qualify for both Medicaid and Medicare; and Medicaid is sometimes used to help pay for Medicare premiums. People who qualify for both programs are called ‘dual eligible’.

To be eligible to receive Medicaid coverage, residents must meet a state-determined poverty level and certain health criteria. Because Medicaid is based on financial need, extensive information on income and assets is required for qualification.

For qualifying individuals, Medicaid pays for nursing facility services in certified skilled nursing homes.

Skilled nursing home services covered by Medicaid include:

• a semi-private room
• meals
• regular nursing services
• rehabilitation therapy services
• drugs furnished by the facility
• medical supplies