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Part D covers the cost of some or all of the prescription drugs for people who live long-term in a custodial nursing home. These optional plans do not pay for long-term nursing home care.
The Advantage plans provide the benefits of Original Medicare and often also include prescription drug coverage and supplemental benefits, such as dental and vision care. Humana, a private ...
To qualify for such coverage, the Medicare member would need to have at least a three-day stay as a hospital inpatient before the agency would approve payment for nursing-home care for ...
Part D coverage excludes drugs or classes of drugs that may be excluded from Medicaid coverage. These may include: Drugs used for anorexia, weight loss, or weight gain; Drugs used to promote fertility; Drugs used for erectile dysfunction; Drugs used for cosmetic purposes (hair growth, etc.) Drugs used for the symptomatic relief of cough and colds
Medicare coverage for dual-eligibles includes hospitalizations, physician services, prescription drugs, skilled nursing facility care, home health visits, and hospice care. Under Medicaid, states are required to cover certain items and services for dual-eligibles, including long-term nursing facility services and home health services.
State governments oversee the licensing of nursing homes. In addition, states have a contract with CMS to monitor those nursing homes that want to be eligible to provide care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid.
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