Health Insurance Plans

Health Insurance Plans

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MEDICARE INSURANCE PLANS

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medicare insurance plans
is the sterling Medicare advantage insurance plan a Hmo?

does it pay nursing home payments and how much

The Sterling plans are Private Fee For Service plans. The difference between a PFFS and an Hmo is with the PFFS you can see any doctor that accepts Medicare and is willing to accept the plan. With an HMO you can only go to a doctor that is in the network.

Medicare, and therefore any Medicare Advantage plans of all types, do not pay for nursing homes. They will pay for skilled nursing services in a Medicare certified skilled nursing facility up to 100 days and only if there is a possibility of improvement. For example, if after 10 days the doctor states that you will not get better and will need nursing services for a long period of time the plans will stop paying for the services even if you have not reached the 100 day mark.

Sterling requires a three day hospital stay before they’ll pay for a skilled nursing facitity. If you’ve been in the hospital for the required three days you will have a $35 per day co-pay in the facility.

Medicare Supplement Insurance Plans – Where Do I Start?

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