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Long Term Care Insurance  ▪  Group Plans  ▪  Medicare & Medicaid

Medicare Requirements for a Nursing Home Stay

1. You must be hospitalized for at least three days.
2. You must enter a Medicare approved Nursing Facility.
3. You must be in a Medicare approved bed within the approved facility.
4. You must be receiving skilled care on a daily basis.

If one meets the above requirements, Medicare will pay all eligible expenses for the first 20 days. For days 21-100, Medicare will pay after the $155 co-payment has been met (usually picked up by a Medicare supplement). After the 100th day, neither Medicare nor the Medicare supplement will pay for any Nursing Home Care.

 

Premiums for 2010

Part A (Hospital Insurance) Monthly Premium

• Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
• The Part A premium is $254.00 per month for people having 30-39 quarters of Medicare-covered employment.
• The Part A premium is $461.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

 

Part B (Medical Insurance) Monthly Premium

If Your Yearly Income is		You Pay*
File Individual Tax Return	File Joint Tax Return
$85,000 or less	$170,000 or below	$96.40
$85,001-$107,000	$170,001-$214,000	$154.70
$107,001-$160,000	$214,001-$320,000	$221.00
$160,001-$214,000	$320,001-$428,000	$287.30
Above $214,000	Above $428,000	$353.60

* If you pay a late-enrollment penalty, this amount is higher.