Securing skilled nursing insurance coverage with a long-term care plan is essential for adults over 21 who need these services. This step-by-step guide will show you how to obtain this coverage.
A long-term care plan for skilled nursing ensures access to necessary services, allowing your loved one to get quality medical care in a compassionate environment. Below, we outline the steps to obtain a long-term care plan and the required documentation to help streamline the process.
Understanding Long-Term Care Plans
A long-term care plan outlines the medical and personal care services required for individuals with chronic illnesses or disabilities. It includes various services, including skilled nursing care, personal care support, and assistance with daily activities.
Steps to Obtain a Long-Term Care Plan
Consultation with Healthcare Professionals: Discuss your loved one’s health status with their primary care physicians or specialists. Healthcare providers can give a comprehensive assessment and recommend the necessity for long-term care services.
Complete Necessary Documentation: Gather and complete essential forms, such as informed consent documents and medical evaluation forms. Ensure all medical records, including current medication lists and recent physician notes, are up-to-date.
Submit Documentation to the Appropriate Agencies: Once all forms are completed, submit them to the relevant state department or agency overseeing long-term care services. For instance, in Florida, documents are sent to the Department of Elder Affairs (DOEA).
Download all forms needed for skilled nursing long-term care coverage below.
- Informed Consent Form
- Instructions for Completing the Medical Certification for Medicaid Long-Term Care Services and Patient Transfer Form
- CARES Long-Term Care Transition Referral Form and Instructions
- AHCA 5000-3008 Referral Cover Sheet
Follow-Up: After submission, maintain regular contact with the agency to monitor the status of your application and address any additional requirements promptly.
Skilled Nursing Insurance Coverage
Understanding insurance coverage is vital when planning for skilled nursing services. Many insurance providers offer long-term care policies, including skilled nursing insurance coverage. Review your current insurance plan to determine the extent of coverage, and consider consulting with an insurance advisor to explore additional options if necessary.
Atlantic Care Services: Your Partner in Long-Term Care
At Atlantic Care Services, we specialize in providing comprehensive home health services for individuals of all ages, from newborns to the elderly. Our skilled nursing services aim to meet each patient’s unique needs, ensuring personalized and compassionate care.
Our Services Include:
- Private Duty Nursing: Offering hourly nursing services by Licensed Practical Nurses (LPNs) or Registered Nurses (RNs) for pediatric and adult patients. Our team is trained in ventilator care, tracheostomy, and gastrostomy tube management.
- Personal Care Services: Assisting with daily activities, including light housekeeping, meal preparation, laundry, grocery shopping, and providing transportation to social or recreational activities.
Insurance Plans We Accept
We accept various insurance plans, including Aetna, Cigna, Humana, Sunshine Health, UnitedHealthcare, and Simply Healthcare. Please note that we currently do not accept Medicare, Medicare Supplement plans, or Waiver programs. If your insurance provider is not listed above, contact us, as we continually work with new payers and insurance companies.
FAQ: How to Get a Long-Term Care Plan for Skilled Nursing
Do personal care services fall under long-term care and skilled nursing?
Personal care services are part of long-term care but not skilled nursing. They help with daily activities like meal prep and housekeeping, while skilled nursing provides medical care. Both can be included in a long-term care plan based on the patient’s needs.
How long does it take to get approved for a long-term care plan?
Approval timelines can vary, but once all required documents are submitted, processing typically takes a few weeks. Delays can occur if any paperwork is incomplete.
What happens if my application is denied?
You may be able to file an appeal if your application is denied. Reviewing the denial notice and addressing any missing or incorrect information can help improve your chances of approval.
Can I receive skilled nursing care while waiting for my long-term care plan approval?
In some cases, temporary or out-of-pocket care may be an option while your long-term care plan is being processed. Check with your provider to see what services are available.
What are the out-of-pocket costs for skilled nursing if I do not have coverage?
Costs vary depending on the level of care needed. Private duty nursing is typically charged hourly, and financial assistance options may be available.
Can I change my skilled nursing provider after my long-term care plan is approved?
Yes, many long-term care plans allow you to change providers if you are not satisfied with your current service. Be sure to check with your insurance provider for any specific transfer requirements.
Are there different levels of skilled nursing care available?
Yes, skilled nursing care can range from basic medical monitoring to more intensive services such as ventilator care, wound management, and rehabilitation support. Your care plan will determine the appropriate level of service.
Trust Atlantic Care Services for All Your Private Nursing and Personal Care Needs
For more information on obtaining a long-term care plan for skilled nursing, contact us today. Our dedicated team is available to answer your questions and guide you through the process.
