Posted by:  Heinz Brisske

Good news around the holidays is always welcome. This item in the blog written by the Center for Medicare Advocacy comes at a great time.

Nursing home residents often want to participate in holiday gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Residents and their families and friends can put their minds at ease.

According to Medicare law, nursing home residents may leave their facility for family events without losing their Medicare coverage. However, depending on the length of their absence, beneficiaries may be charged a “bed hold” fee by their skilled nursing facility (SNF).

The Medicare Benefit Policy Manual recognizes that, although most beneficiaries are unable to leave their facility, “an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care. . . .   Decisions in these cases should be based on information reflecting the care needed and received by the patient while in the SNF and on the arrangements needed for the provision, if any, of this care during any absences.”

That means that you can help a loved one celebrate the holidays “off-premises” without fear of them losing benefits.

Source/more: Center for Medicare Advocacy