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Rakhi Vasavada
Rakhi Vasavada, Financial and Legal Consultant
Category: Finance
Satisfied Customers: 2571
Experience:  Graduated in law with Emphasis on Finance and have have been working in financial sector for over 12 Years
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My sister (who lives in ) has magi currently and was found

Customer Question

my sister (who lives in KY) has magi currently and was found disable in Dec 2014 (and it was back dated). she was hospitalized 4/28/15 and entered into a convalescent/rehab home in Aug 2015. She is currently still recovering (becoming ambulatory and healing a VERY bad bed wound she received in the hospital) but got her Medicare care on 3/1/2016. She now has to re-enroll for her health care. I was told that there was a medicare or Medicaid regulation that says unless she is hospitalized and leaves the care home for 2 midnight s she should not be switched to Medicare and would stay on the magi plan of medicaid. can you please tell me what that regulations is?
Submitted: 7 months ago.
Category: Finance
Expert:  Lane replied 7 months ago.
Hi yes, what you're being referred to is the "qualifying hospital stay" part of the requirements to be covered under Medicare Part A in a skilled nursing facility,...See this from Medicare.gocv...Who's eligible?People with Medicare are covered if they meet all of these conditions:You have Part A and have days left in your benefit period.You have a qualifying hospital stay. Your doctor has decided that you need daily skilled care given by, or under the direct supervision of, skilled nursing or therapy staff. If you're in the SNF for skilled rehabilitation services only, your care is considered daily care even if these therapy services are offered just 5 or 6 days a week, as long as you need and get the therapy services each day they're offered.You get these skilled services in a SNF that's certified by Medicare.You need these skilled services for a medical condition that was either:A hospital-related medical condition.A condition that started while you were getting care in the skilled nursing facility for a hospital-related medical condition.
Expert:  Lane replied 7 months ago.
If you'll click here, you'll see the details: qualifying hospital stay