FAQ's
Insurance Questions
How much does skilled nursing cost?
The cost of skilled nursing varies depending on where you live, what level of care is provided and what type of accommodations you choose. Most seniors do not usually meet their long-term care needs from any one source. Instead a combination of support—private funds, long-term care insurance and government assistance is used to foot the bill.
Medicare covers post-hospital, short-term skilled care only—and may not cover the cost of ongoing nursing home care. For low-income seniors who meet eligibility requirements, Medicaid might pay a portion of the cost.
The cost of skilled nursing varies depending on where you live, what level of care is provided and what type of accommodations you choose. Most seniors do not usually meet their long-term care needs from any one source. Instead a combination of support—private funds, long-term care insurance and government assistance is used to foot the bill.
Medicare covers post-hospital, short-term skilled care only—and may not cover the cost of ongoing nursing home care. For low-income seniors who meet eligibility requirements, Medicaid might pay a portion of the cost.
What is Medicare?
Medicare is a health insurance program for people 65 or older or people under 65 with certain disabilities or end-stage renal disease. Medicare does not cover all expenses and is not designed to pay for long-term custodial care. So it is important to understand the program. For patients meeting requirements, Medicare helps cover the costs for hospital stays, skilled nursing home stays up to 100 days and hospice care. Our admission team members will be happy to provide you with current rates and coverage.
Medicare is a health insurance program for people 65 or older or people under 65 with certain disabilities or end-stage renal disease. Medicare does not cover all expenses and is not designed to pay for long-term custodial care. So it is important to understand the program. For patients meeting requirements, Medicare helps cover the costs for hospital stays, skilled nursing home stays up to 100 days and hospice care. Our admission team members will be happy to provide you with current rates and coverage.
What does Medicare pay?
Traditional Medicare (the red, white and blue card) typically pays 100% of the covered charges in a skilled nursing facility for days 1 through 20. A daily co-payment will apply on days 21–100. If you have a secondary insurance, often times the insurance will pick up (pay) the co-pay amount for the remaining 80 days covered by Medicare.
Traditional Medicare (the red, white and blue card) typically pays 100% of the covered charges in a skilled nursing facility for days 1 through 20. A daily co-payment will apply on days 21–100. If you have a secondary insurance, often times the insurance will pick up (pay) the co-pay amount for the remaining 80 days covered by Medicare.
Do I only have 100 Medicare days for the rest of my life?
No, Medicare will pay for skilled care after there is a 60 day break, meaning there was no skilled care received for a period of sixty days, if you have used the Medicare benefit for a nursing facility stay in the past.
No, Medicare will pay for skilled care after there is a 60 day break, meaning there was no skilled care received for a period of sixty days, if you have used the Medicare benefit for a nursing facility stay in the past.
What is Medicaid?
The Medicaid program provides medical benefits to low-income people who have no medical insurance or inadequate medical insurance. The federal government establishes general guidelines for the program, but each state establishes the program’s requirements including eligibility. You can find out more about the Medicaid program through the Maryland Health Connection or by talking to our admissions team.
The Medicaid program provides medical benefits to low-income people who have no medical insurance or inadequate medical insurance. The federal government establishes general guidelines for the program, but each state establishes the program’s requirements including eligibility. You can find out more about the Medicaid program through the Maryland Health Connection or by talking to our admissions team.
What does Medicaid pay?
Services covered include room and board, nursing care, and meals. A list of supplies covered by Medicaid is available from our financial office.
Services covered include room and board, nursing care, and meals. A list of supplies covered by Medicaid is available from our financial office.
Payment Options
Peak Healthcare facilities accept the following payor types:
Please see our page that discusses insurance questions as well by clicking here.
Peak Healthcare facilities accept the following payor types:
- Private Pay
- Private Insurance
- The admissions team will contact your insurance plan and discuss with you your benefits and coverage.
- Medicare
- Medicare A – coverage of skilled nursing care while receiving daily nursing or therapy services following a qualifying hospital stay.
- Medicare B – partial coverage of therapy if no qualifying hospital stay.
- Medicare D – pharmacy coverage
- Medicare Advantage Plans
- The admissions team will contact your provider and discuss with you your benefits and coverage.
- Medicaid
- A Peak Healthcare representative will be available to discuss your qualifications for Medicaid and, in some situations, allow admission while your Medicaid is pending. The facility’s social services designee will be available to assist with your Medicaid application, as well as your annual Medicaid recertification, when you are already a resident.
- Long-term care insurance
- If needed, your provider will be contacted to check benefits and assistance will be available to help with the necessary paperwork to obtain payment.
Please see our page that discusses insurance questions as well by clicking here.
General Questions
What steps are necessary to complete before you or your loved one can be admitted to long term care?
- Pre-screening from a community senior services agency, physician office or hospital. We can refer you to an agency in your area. This screening is required by the State for any facility. This agency determines the level of need for nursing home care. Once the screening declares long-term care is necessary, you have a 90-day grace period in which you must be admitted to a long-term care setting. If a decision is made after the grace period, a new screening is required.
- Submission of a physical taken within 30 days prior to your admission to our center. Your physical must include a current medical history to help us better understand your needs.
- Chest x-ray must be done within 30 days of admission.
- A list of current medications you are taking.
- Upon receipt and approval of the above submitted information, we will contact you to set a time and date for admission.
- Upon the day of admission, or any time prior to that day, your review and signature of the Admission Agreement contract is required for all long-term care facilities. This contract allows us the consent to provide treatment and care. We prefer to meet with you in advance so that we can address your concerns and answer any questions you may have before joining our family.
What information do I need to bring?
Prior to or upon admission, please bring the following documents and information:
Prior to or upon admission, please bring the following documents and information:
- Any advance directive, living will or power of attorney documents
- Medicare card
- Medicaid card or application
- Insurance card/information
- Photo ID
- Contact information for next of kin/family
- Supplemental and/or other insurance information
- Social Security card
- Financial information including your assets and income
Are pets allowed?
Check with the facility you are considering and ask them about pet policies. Some residences have pets on site that all of the residents can enjoy and interact with.
Check with the facility you are considering and ask them about pet policies. Some residences have pets on site that all of the residents can enjoy and interact with.
Can couples live together?
In some skilled nursing facilities, yes, couples can live together. Assisted living facilities, skilled nursing and memory care residences offer options for couple to live in the same residence, while each receives the care they need, and pays for only the services they need.
Can I stay at the facility with my loved one?
While we do allow visitors 24 hours a day (pre-COVID), we do not allow a family member to sleep at the facility and we cannot make accommodations for a friend or family member to stay at the facility.
In some skilled nursing facilities, yes, couples can live together. Assisted living facilities, skilled nursing and memory care residences offer options for couple to live in the same residence, while each receives the care they need, and pays for only the services they need.
Can I stay at the facility with my loved one?
While we do allow visitors 24 hours a day (pre-COVID), we do not allow a family member to sleep at the facility and we cannot make accommodations for a friend or family member to stay at the facility.
Are there social activities?
Yes. Skilled nursing residences have a full calendar of activities and social events for residents, including art classes, ice cream socials, bingo and game night, prayer service, movie night and guest speakers. In addition, many have wellness centers, beauty parlors, restaurant-style dining and other amenities that make the skilled nursing facility feel more like resort living.
Yes. Skilled nursing residences have a full calendar of activities and social events for residents, including art classes, ice cream socials, bingo and game night, prayer service, movie night and guest speakers. In addition, many have wellness centers, beauty parlors, restaurant-style dining and other amenities that make the skilled nursing facility feel more like resort living.
What happens if a resident has an emergency?
Staff and trained personal are available 24 hours a day to handle emergency situations. Skilled nursing facilities have arrangements with local hospitals and health care professionals for assistance with emergencies.
Staff and trained personal are available 24 hours a day to handle emergency situations. Skilled nursing facilities have arrangements with local hospitals and health care professionals for assistance with emergencies.
What safety measures are in place?
One of several reasons people decide that elders with chronic health problems are better off in a nursing home than in their own homes is safety. The obvious point of safety in nursing homes has always been that there are trained professionals on the spot in case of a fall, medication reaction or other health issue. However, with advances in technology, nursing homes have advanced in safety measures over and above what they once provided.
For example, cameras in entrances and locked security systems keep nursing home staff informed about people who come and go. Good nursing homes want to encourage visitors and need to keep security as unobtrusive as possible in order to offer a home-like atmosphere, while still maintaining a safe environment for residents.
One of several reasons people decide that elders with chronic health problems are better off in a nursing home than in their own homes is safety. The obvious point of safety in nursing homes has always been that there are trained professionals on the spot in case of a fall, medication reaction or other health issue. However, with advances in technology, nursing homes have advanced in safety measures over and above what they once provided.
For example, cameras in entrances and locked security systems keep nursing home staff informed about people who come and go. Good nursing homes want to encourage visitors and need to keep security as unobtrusive as possible in order to offer a home-like atmosphere, while still maintaining a safe environment for residents.
