Dear Resident (& Family/Representative):

Your admission into The Hebrew Home’s Subacute Neighborhood entails a financial situation that you must be aware of. At the very start of your stay, we would like to advise you of the following in order that you could prepare the necessary documents required by the Home, depending on your insurance coverage and/or financial capability:

1. Medicare could cover your stay in the Neighborhood for a maximum of one hundred (100) days from the date you are admitted. It could be less than 100 days if you already used some of your Skilled Nursing Facility (SNF) Medicare-covered days/benefits prior to your recent hospital stay. It could also be less than 100 days if our Rehabilitation Department and/or the Medical/Nursing Team determines along the way that you no longer qualify for Medicare coverage as per the Guidelines established by Medicare.
2. Assuming that you have not used any of your Skilled Nursing Facility Medicare-covered days (at the time of your admission), your first twenty (20) days in the Neighborhood would be covered in full by Medicare. From the 21st day going forward (up to possibly the 100th day), Medicare will not cover your stay in full; there is a co-pay of $141.50 per day for the year 2011 (this rate increases every January 1st ).
3. The above-mentioned co-pay could be supported by the following:

              a) A third-party health insurance (TPHI) such as AARP, Blue Cross, etc., or
              b) Your (that is, resident’s) own personal funds/resources, or
              c) Medicaid benefits

Your TPHI coverage must include “skilled nursing” benefits for (Medicare-covered) days 21 to 100. You must provide pertinent TPHI information to the Finance Unit of the Access-Admissions Department within seven (7) days of your admission (please refer to the information at the end of this bulletin for details).

If you do not have TPHI or are not qualified to apply for Medicaid benefits because you have enough/substantial assets/resources, then you must use your personal funds to pay for the co-pay to remain in the Subacute Program. However, the Home must have proof that you have the capability to pay on your own. You must, therefore, submit to the Finance Unit a copy of the last three (3) months of your bank and/or investment account(s) statements also within seven (7) days of your admission.

If you do not have a TPHI and your assets/resources are within the maximum allowed by Medicaid for you to retain, then we will help you apply for Medicaid benefits, provided that you submit to our Finance Unit the documents required for the Medicaid application. You must tell our Finance Unit no later than the 5th day of your admission that you wish to apply for Medicaid so that the appropriate personnel could guide you through the process and work with you until Medicaid is approved. Yes, we will even file it for you as long as you submit all the required documents.

The foregoing information and your awareness thereof will help both you and the Home ensure a positive Subacute experience. You must meet the defined time frames stipulated above as they are critical in financially approving your length of stay in the Home. Please bear in mind that without your initiating contact with our Finance Unit and conveying the related information as described above, your financial approval for receipt of Subacute services may be limited.

Please call the following at our Finance Unit (Monday thru Friday from 9:00 a.m. to 5:00 p.m.) to set up an appointment, discuss financial concerns, and submit documents:

Janine Sotero (718) 581-1324 or Doreen Gizzo (718) 581-1332

It is our goal to help you go through the financial process as smoothly as possible, and your cooperation is necessary.

Medicare Coverage Information