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Nursing Home Medicare Rules in Arizona

Medicare does not have extended benefits for nursing home stays. However, it does have some benefits because of the extensive cost of nursing home care. Although Medicare does not offer many benefits, its sister program Medicaid does. These two programs often get confused, and it is important to differentiate between them. Medicare is a federal program, whereas Medicaid is a state-funded program with guidelines provided by the federal government.

  1. Medicare Benefits

    • Medicare may offer some benefits after a hospital stay in Arizona. These benefits are for short stays, and are usually to help rehabilitate a patient after a surgery or other major event. A patient must be hospitalized for at least three days before she is eligible for this benefit. The patient has to be transferred to the skilled nursing facility within 30 thirty days of his discharge from the hospital. The Medicare benefits for skilled nursing care is not for extended stays, but instead to help with mobility or respiratory problems that can be improved with therapy and nursing care.

    Medicaid Benefits

    • Medicaid is a program that helps with the health care costs of low income and disabled people. Medicaid is one of the most widely used resources to help pay for nursing home costs. After a patient in Arizona uses up her personal resources she then can be eligible for Medicaid. Medicaid does not have limits on the amount that can be used for nursing home costs, and so will fund the nursing home for as long as it is needed. Medicaid will recoup its expenditures from the patient's estate after the patient has passed away. For example, it may place a lien on a house if the patient is a property owner.

    Medicaid Eligibility

    • About 70 percent of all nursing home stays are paid by Medicaid, but eligibility for the Medicaid program can be an issue. To apply for the Arizona Long Term Care System a person must be at least 65 years old, have a Social Security number, be blind or disabled and need nursing facility care. His income level cannot exceed 300 percent of the Supplemental Security Income. This is for disabled people, and a portion of their income can be used to help fund the cost of the nursing home stay. Other low income patients should contact a local Medicaid office to verify eligibility requirements.

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