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Skilled nursing care bnenfits 은 Medicare 가 적어도 60일 이상 지나면 다시 리뉴가 되어서 최고 100일만 커버 합니다.
가지고 있는 메디케어가 아닌 다른 보험의 종류에 따라서 커버리지가 다르니 skilled nursing facility 에 문의하시는것이 가장 좋습니다.

메디케어에서는 양로병원 (LTCS: Long Term Care Services) 는 제공하지 않습니다.
SNF (Skilled Nursing Facility) Service 는 Medicare Part A 에서 제공되는 것으로 LTCS 는 아닙니다.
100일까지만 제공해주는 서비스로 실제로는 30일까지도 제공하지 않습니다.
만약 어머님께서 Medi-Cal (메디케이드) 가 있으시면, 현재 Medi-Cal 이 HMO 로 되어 있으실 겁니다.
Medi-Cal HMO (LA Care, Healthnet, Care1st 등) 을 확인하시기 바랍니다.
만약 Medi-Cal 이 없으시면 Chronic SNP 로 해결하는 방법이 있습니다.자세한 정보가 필요하시면
연락주시기 바랍니다.

AGA (Applied General Agency) Inc.
Bart (Myeon) Cho / Korean Team Manager
Cell. (213)479-0066 Fax (213)402-2069
e-mail : bartcho@bartchoins.com

"혜택 기간 수에는 제한이 없습니다. (혜택 받기위한 기준, 요건을 충족이 될때) . . . "
"SNF care ; intravenous injections and physical therapy (PT, OT,SP) . . . is based on your (Patient) doctor’s orders and information the team gathers when they do daily assessments of your condition. . . .
Your doctor and the SNF staff, Skilled nursing and therapy staff includes: ■ Registered nurses ■ Licensed practical and vocational nurses ■ Physical and occupational therapists ■ Speech-language pathologists ■ Audiologists (with your input) use the assessments to decide what services you need and your health goal (or goals.) . . . . "

"If you don’t agree with your plan’s (care plan) decision, you can then file an appeal , *You’ll be responsible for the cost of the stay if Medicare determines you didn’t meet Medicare’s criteria. (certain conditions ) 메디 케어 (Original Medicare) 혜택 받기위한 기준, 요건을 충족해야합니다."

"Medicare covers care in a SNF up to 100 days if you continue to meet Medicare’s requirements. . .
There’s no limit to the number of benefit periods 혜택 기간 수에는 제한이 없습니다. (혜택 받기위한 기준, 요건을 충족이 될때) . . . .. The skilled services must be reasonable and necessary for the diagnosis or treatment of your condition. . . "

"Medicare doesn’t cover custodial care if it’s the only kind of care you need. Custodial care is care that helps you with usual daily activities like getting in and out of bed, eating, bathing, dressing, and using the bathroom. It may also include care that most people do themselves, like using eye drops, oxygen, and taking care of colostomy or bladder catheters. Custodial care is often given in a nursing facility. . . . "

어머님 medicare/ blue cross 어떤 plan, ‘primary’ insurance,, 에 따라 혜택등 혜택 받기위한 기준, 요건이 다를 수가 있는데. . . .you should contact the health insurance company for a certificate of coverage.. . . copay . . .

60 일 이후 양로병원 (nursing home) 에서 custodial care; daily activities like getting in and out of bed, eating, bathing, dressing, and using the bathroom식사하기, 목욕하기, 옷 입히기, 욕실 사용하기와 같은 일상 활동등에 도움이 24-hour care 이 요구될때 Medi-Cal for Long Term Care 을 신청한다

'(소득must not be greater than $2000…" " What are the income limits? Gross income is counted and computed into the ‘share of cost’’ (SOC), which is the monthly co-pay for the program. There is no limit, but the SOC will go up accordingly. A Medi-Cal recipient living in a nursing facility is allowed to keep $35/month for personal expenses.. . )"

OR 현재 Medi-Cal under management care 를 Medi-Cal for Long Term Care 로 전환한다.

양로원 ;board & care facilities, and assisted living facilitie 으로 퇴원시 Long Term Care MEDI-CAL을
Medi –Cal HMO 로 다시 전환 한다.

http://www.pacer.org/health/pdfs/HIAC-h9.pdf

http://www.seniormedi-benefits.org/Faq.pdf

http://dpss.lacounty.gov/wps/portal/dpss/main/programs-and-services/health-care/seniors-disabilities/long-term-care-medi-cal