We understand and appreciate the concerns surrounding the cost of health care and how it gets paid for. At Clairidge House, we’ll review with you how the billing and payment process will work prior to your admission. For now, we’ve included a brief overview of the various pay source options available to people depending on eligibility. The Wisconsin Insurance Commissioner’s Office website summarizes this information for you as well.
Medicare Part A – Federally funded and managed program that covers many qualifying short-term stays in skilled nursing and rehabilitation facilities. Click here for Medicare’s coverage guidelines.
Medicaid – Federal and state-funded program. Also known as Medical Assistance, this entitlement program has asset and income eligibility rules that vary state by state. It’s primary purpose is to fund long-term care stays as deemed necessary by your physician in various settings such as a nursing home. Wisconsin’s Family Care program handles the primary expenditure of Medicaid dollars through Managed Care Organizations located throughout the state. Eligibility for Medicaid services is managed through the use of Aging and Disability Resource Centers located in every county in Wisconsin. Click here for more information on Family Care.
Insurance – Insurance can play different roles in helping you pay for costs of short or long-term care. Primarily, it is broken down into two types: Medicare Advantage Plans and long-term care insurance. Medicare Advantage Plans replace traditional Medicare Part A if selected by the consumer. Click here for more information on Medicare Advantage Plans. Long-term care insurance policies vary by company and structure, but serve as a means to pay for your long-term care needs privately. Generally speaking, the more costly the premiums, the better the monthly benefit amount will be, as well as how long the benefit will last. Click here for further information on long term care insurance.
Private Pay – Absent coverage by any of the above methods of third-party payment, we will bill you monthly for your care. Rates are on a per-day basis and are billed accordingly one month in advance. For current rates, please contact the facility and ask for the admissions coordinator, administrator or billing office.