Contact Information

Phone: (402) 761-3230

Fax: (402) 761-3283

info@sunrisecountrymanor.com



Mailing Address

Sunrise Country Manor
P.O. Box A
610 224th Rd.
Milford, NE 68405


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Medicare

 

Medicare is a federal government health insurance program designed to assist individuals age 65 and older and some disabled individuals under the age of 65 including persons with end-stage renal disease. Click here to visit the official Medicare website.


Eligibility is tied to eligibility for Social Security and unlike Medicaid is not means tested. Medicare is divided into two parts:  Part A (hospital insurance) and Part B (medical insurance).


To be eligible for Part B benefits, an individual must pay a monthly premium and be entitled to Medicare Part A.  Medicare has co-pays and deductibles: A deductible is an initial amount the beneficiary is responsible for paying before Medicare coverage begins.  A co-pay is a percentage or dollar amount covered expense which the beneficiary is required to pay.


Part A pays for:

  • Cost of all normal hospital services
  • Extended-care services in a “skilled nursing” facility
  • Home health services, including visiting nurse physical, occupational or speech therapists, medical supplies (not drugs or biologicals)
  • Hospice services

Part B pays for:

  • 80% of reasonable charges from doctors and other health care professionals, after the annual deductible is met
  • Medically necessary ambulance service
  • Physical, speech and occupational therapy
  • Home health services, doctor certified as medically necessary]
  • Medical supplies and equipment
  • Transfusions of blood and blood components furnished on an out patient basis
  • Outpatient surgery


 

Medical Skilled Nursing Facility (SNF) Care

In order to receive care in a nursing home under Medicare:

  • 3-day prior hospital stay
  • Must be admitted to SNF within 30 days of hospital release
  • Must enter SNF for treatment of same condition hospitalized
  • Must need skilled care on a daily basis
  • The condition must be able to be improved
  • Facility must be Medicare certified
  • Physician must write a care plan and that plan must be carried out

Once the daily skilled care ends, Medicare will no longer pay for the stay.

 

Medicare Home Health Care

There is no deductible – care is intermittent.  Home care services are covered by Medicare under the following conditions:

  • The person receiving services is an eligible Medicare beneficiary
  • The services provides are covered by Medicare
  • The person under the care of a physician who orders home care and establishes a plan of care.
  • The person is considered to be home bound
  • The person requires skilled services that are medically reasonable and necessary.
  • The services are provided on an “intermittent” basis