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: Long-Term Care Plans & Skilled Nursing
Q: Can Medicaid cover my skilled nursing long-term care plan in Florida?
A: Yes, Medicaid can cover certain long-term care services for eligible individuals, including skilled nursing care. Coverage depends on income, medical need, and program requirements. It’s important to confirm eligibility with your local Medicaid office or Atlantic Care Services to understand which services are covered.
Q: What is the difference between private duty nursing and skilled nursing?
A: Private duty nursing provides one-on-one care tailored to a patient’s specific needs, often in the home. Skilled nursing is focused on medical interventions, such as medication administration, wound care, or ventilator management. Some long-term care plans may include both, depending on the patient’s condition.
Q: How long does it typically take to get approved for a long-term care plan?
A: Approval timelines vary by state and agency. Once all required documents are submitted, processing often takes several weeks. Delays can occur if paperwork is incomplete or additional assessments are needed.
Q: Can I switch skilled nursing providers after my long-term care plan is approved?
A: In many cases, yes. If you’re not satisfied with your current provider, most long-term care plans allow you to request a change. Always check with your insurance provider or care coordinator for any specific requirements or notice periods.
Q: Are there financial assistance programs available for long-term care costs?
A: Yes. In addition to Medicaid, some states and organizations offer grants, subsidies, or sliding-scale payment options to help offset long-term care expenses. Atlantic Care Services can help guide families to available financial resources.
Q: Can skilled nursing care be provided temporarily while waiting for long-term care plan approval?
A: In certain cases, temporary or out-of-pocket skilled nursing services may be available while your long-term care plan is being processed. Discuss options with your care provider to ensure your loved one’s needs are met during the waiting period.
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.
