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INSURANCE & PAYMENTS

At Good Samaritan, we can assist you in identifying your options to pay for services. We can answer questions about qualifying for Medicare, Managed Care, Insurance, and Private Pay funding options.  Please contact us to speak with an admissions coordinator who can help you get the answers you need.

Additional Insurances can be evaluated for Skilled Services Benefits

Medicare:

 

As defined in Title XVIII of the Social Security Act, Medicare ("Health Insurance for the Aged and Disabled") is a Federal health insurance program for aged (65+) and certain disabled individuals regardless of income.

 

The majority of individuals admitted to a skilled nursing facility have not met requirements of a Medicare-covered stay. The following criteria must be met in order for a person to be eligible for Medicare Part A benefits in the skilled nursing facility:

 

  • A physician must certify that you need skilled nursing care

  • You must be admitted to the facility within 30 days of discharge from a hospital stay of 3 or more qualifying days (not including your discharge day)

  • You must require some type of skilled nursing or therapy services that meet Medicare criteria. For example: someone having suffered a stroke who needs skilled therapy and nursing services for rehabilitation.

 

If you have met these criteria, you will be eligible for a maximum benefit period of 100 days. There are no guarantees that you will receive this maximum, you only continue to receive the benefit if you are continuing to progress with the skilled services being provided. When a person is no longer showing progress or has met their goals, the Medicare Part A coverage will end.

 

During the first 20 days of this benefit period, Medicare pays all costs including semi-private room charges, any skilled therapy or nursing services, medications, and any other ancillary charges.

 

The next 80 days of the benefit period, Medicare Part A will pay all the above costs, with the exception of a required co-pay amount. Private insurances or private funds can meet these amounts.

 

At any time during the 100-day benefit period, coverage can end if the recipient is no longer meeting skilled care criteria. Prior to Medicare coverage ending, the resident and/or his agent will be notified in advance to allow time to transfer to another payment source.

Please contact us for more information. We look forward to your call.

 

 

Medicaid

 

Medicaid is the payer of last resort. You must meet Medicaid’s clinical as well as financial criteria. If you believe you may qualify for Medicaid we recommend you contact an elder law attorney to assist you in that process. Good Samaritan does accept Medicaid based upon bed availability. Any patients applying to Good Samaritan for admission for long-term care must be approved by Medicaid prior to admission.

Private Insurance

 

If you are a subscriber to a Managed Care or Private Insurance product, you may have benefits which would assist in paying for skilled services received in the Healthcare Center. We accept many Managed Care / Private Insurance carriers. Click for more info.

 

A majority of individuals with Managed Care or Private Insurance have pretty straight forward requirements if skilled nursing care is a covered benefit for the enrollee. We encourage you to speak directly with your provider to ensure you understand what your coverage parameters and options are. If you are uncertain about what to ask, we are happy to assist you as needed. Each Managed Care or Private Insurance is different regarding the amount of coverage, deductibles, and co-payment requirements.

 

Typically some or all of the below are required:

 

  • A physician must certify that you need skilled nursing care

  • You must require some type of skilled nursing or therapy services that meet the Managed Care / Insurance Provider’s criteria. For example: someone having suffered a stroke who needs skilled therapy and nursing services for rehabilitation

  • Most have a pre-authorization approval process step that must be met to ensure coverage.

  • Many have continued stay re-authorizations periodically throughout the stay to ensure skilled services meet the criteria of the coverage plan.

  • Discharge planning is typically coordinated with the Managed Care / Insurance Case Manager to ensure smooth transition from the Healthcare Center to home.

 

At any time during the benefit period the coverage can end if the recipient is no longer meeting skilled care criteria. Prior to Managed Care / Insurance coverage ending, the resident and/or his agent will be notified in advance to allow time to transfer to another payment source.

Private Pay

 

Good Samaritan Rehab & Nursing Center does accept private pay admissions. Those wishing to apply for admission must verify their ability to meet the financial responsibilities prior to admission. Please contact the Admissions Department with any questions.

Payment Sources We Accept:

  • Medicare

  • Medicaid

  • Private Pay

  • Humana

  • Peoples Health

  • Blue Cross Blue Sheild

For the most up-to-date information on our accepted private health insurance plans contact our center directly at 504-246-7900

We understand that this is an extremely overwhelming time and making the right decision could be the difference between your recovery to home or a hospital re-admission. Rest assured you have come to the right place.

 

Our Director of Admissions is here to answer your questions and provide you with recommendations during your onsite consultation. Tours are available by appointment.

 

We recommend when you visit to bring copies of the following items:

 

  • Medicare Card

  • Insurance Card

  • Social Security Card

  • Driver’s License

  • Medical Information – History & Physical, list of medications and treatments, therapy records and progress notes

  • Advanced Directives

 

Once you arrive to our location, our compassionate staff will make you feel at home. We spend time during your visit learning more about the potential patient and share with you how we can help them through recovery or stabilization.

At Good Samaritan, we understand that entering a long-term care facility can generate an overwhelming amount of questions. For this reason, we have compiled a list of useful links that might help you become better informed about your care choices.

 

 

Good Samaritan cannot guarantee the accuracy or content of the above links and we encourage you to seek information from more than one source. Should you have questions about the above links please contact us.

GOOD SAMARITAN

Rehab and Nursing Center

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