Core Insights - The article discusses the challenges faced by individuals, particularly the elderly, in securing coverage for skilled nursing care under Medicare, emphasizing the financial implications of being classified as a private pay patient [1][4][8]. Medicare Coverage - Medicare covers skilled nursing care for up to 100 days under specific conditions, such as following a hospital stay, but does not cover routine custodial care [3][6]. - If a denial of skilled nursing care is issued, appealing the decision with support from healthcare providers is recommended [2][11]. Financial Implications - The median cost of a semi-private room in a nursing home in the US was reported at $111,325 per year in 2024, highlighting the financial burden of long-term care [5]. - If a patient cannot pay for nursing home care, the facility can request the patient to leave with appropriate notice, especially if they are not in the process of applying for Medicare or Medicaid [6][8]. Medicaid Considerations - Medicaid can cover nursing care, but eligibility requires individuals to have countable resources below $2,000, and beneficiaries must send their Social Security checks to the nursing home [7][10]. Long-term Care Planning - The article stresses the importance of long-term care insurance to mitigate the financial risks associated with nursing home care, suggesting that planning should begin well before care is needed [9][10]. - It is advised to consult with an elder law attorney for assistance in appealing Medicare denials and protecting assets [11].