Hudson Valley Senior AdvisorDoes Medicare pay for a nursing home after a stay at Vassar Brothers or Garnet Health?
Medicare pays for skilled nursing facility care only after at least three midnights as a hospital inpatient, for skilled care related to that stay, covering days 1 through 20 in full and days 21 through 100 with a daily coinsurance, and only while skilled care is still needed.
Observation days do not count toward the three, even when the patient spends them in a hospital bed. Ask the hospital, whether Vassar Brothers, MidHudson Regional, Montefiore St. Luke's Cornwall or Garnet Health, to confirm inpatient status in writing before planning a rehab stay.
Does Medicare cover assisted living in New York?
No: Medicare does not pay rent or personal care in any assisted living residence, though it can pay for covered home health visits, therapy, doctor visits and hospice delivered to someone who lives there.
Families often discover this after a hospital stay. The realistic payers for assisted living are private funds, long-term care insurance, VA pension benefits, and Medicaid in Assisted Living Program beds.
What home health care does Medicare cover?
Medicare covers intermittent skilled nursing, physical, occupational and speech therapy, and some home health aide time for a homebound patient under a doctor's plan, at no cost to the patient, through a Medicare-certified home health agency.
It does not cover round-the-clock care or hourly help with chores and errands. The state roster shows 4 certified home health agencies, 33 licensed home care services agencies and 2 hospice licenses with office addresses in Dutchess or Orange; most travel well beyond their office town, so ask each one whether it covers your parent's address.
When does Medicare cover hospice?
Medicare covers hospice when a doctor certifies a life expectancy of six months or less and the patient chooses comfort care over curative treatment, paying for the hospice team, medications and equipment related to the illness at home, in a residence or in a nursing home.
Hospices with New York licenses and offices in the two counties: Hospice of Orange & Sullivan Counties Inc, Hudson Valley Hospice. Room and board in a facility is not part of the hospice benefit.
At a glance
| Medicare pays for | Medicare does not pay for | |
|---|---|---|
| Rehab | Up to 100 days after a qualifying inpatient stay | Long-term nursing home care |
| Home | Intermittent skilled home health | Hourly or overnight aides |
| Assisted living | Covered medical services delivered there | Rent or personal care |
| Hospice | The team, drugs and equipment | Room and board |
Rules and dollar amounts on this page come from New York law and regulation (the Social Services Law, Public Health Law, 18 NYCRR and 10 NYCRR), Department of Health GIS messages and directories, CMS, the VA, CareScout or the county agencies named in the text. Our sourcing rules: editorial standards.
