Understanding Medicare and Medicaid Eligibility

The U.S. government sponsors programs were designed to provide health insurance for those who meet specific criteria. While Medicare and Medicaid may have similar sounding names, the two programs provide very different coverage. Although you may qualify and receive coverage from both Medicare and Medicaid, there are separate eligibility requirements for each program, and being eligible for one program does not necessarily mean you are eligible for the other. 

What’s the difference between Medicare and Medicaid?

Medicare Basics

Medicare is a federally supported, state-operated health care assistance program that pays for health care services. It typically covers some expenses related to a stay in a skilled facility but only after an inpatient hospital stay of “three midnights” and only for a related illness or injury. Visit www.medicare.gov for more information.

You may be eligible for Medicare if you or your spouse has paid into Social Security for at least 10 years. In addition, you must meet one of these requirements:

Medicaid Basics

Medicaid is a means-tested health and medical services program for certain individuals and families with low incomes and few resources. Eligibility usually is based on extreme financial need and medical necessity. Because each state operates its own Medicaid program, eligibility requirements and coverage may vary from state to state.

Visit www.medicaid.gov  for more information.

Skilled nursing Medicare coverage

Medicare covers skilled nursing care if all of the following are true:

How long does Medicare cover skilled nursing care?

While Medicare covers up to 100 days of skilled nursing care if you continue to meet Medicare requirements, our goal is always to help you return to your highest level of independence as soon as possible.


All services covered


A daily co-payment is required*


No benefit

*Consult with the Admissions Coordinator for your co-pay amount, which is subject to change each year. If you have a Medigap policy with the original Medicare plan or are in a Medicare managed care plan, your cost may be different or you may have additional coverage. Check your plan.

Who will benefit from a SNF?

When a family member is unable to provide the necessary care for a loved one, the responsible decision is to choose a setting where that individual’s unique needs can be met. A SNF is staffed with compassionate and knowledgeable professionals who truly value the individuality and integrity of each resident for whom they care. The following factors may help determine if a loved ones will benefit from skilled nursing care.

Whether for an ongoing health issue or an acute post-operative need, an Abri Health Care Skilled Nursing Facility is the ideal choice for individual needs. Our goal is always to provide the highest levels of skilled and compassionate care during a stay, so our residents can look forward to returning home or transitioning to a new home as quickly as possible.

grandfather with child on shoulders

What are the different parts of Medicare?

When it comes to enrolling in Medicare benefits, seniors have many choices. It can be confusing to know the difference between Medicare Supplement Plans, Medicare Replacement Plans and Medigap Policies.  Read More ›