Glossary

From staff, to management to our local Board of Directors, the Altenheim St. Louis senior living facility provides a comfortable, safe and secure home. Altenheim residents enjoy the individualized support and health care services, encouragement of maximum independence, and an emphasis on freedom of choice and protection of privacy.

Terms Used in Medicare

Medicare
Medicare Supplement Insurance
Medicaid
Independent Living
Custodial Care
Supportive Living
Skilled Nursing Facility (SNF)
Intermediate Care Facility (ICF)
Multi-Level Facility
Long-Term Care Insurance
Short Term Stays
Hospice Care
For Profit
Not-for-profit

Medicare


Medicare is a Federal health insurance program for:

  • People age 65 or older
  • People under age 65 with certain disabilities, and
  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant.)

Medicare Part A (Hospital Insurance)


Covers inpatient hospital, Medicare-Certified Skilled Nursing Facility, Home Health and Hospice. These Skilled Nursing facilities cover short-term periods of care, usually after a hospital stay. Overall, Part A pays for approximately 80% of Medicare-approved services. Costs of Part A services are paid for by Social Security withholding taxes.

 

Medicare Part B (Medical Insurance)


This is an optional program, but most eligible people enroll. Part B also covers 80% of Medicare-approved services for doctor visits, laboratory, radiology and outpatient therapy. This therapy is short-term and is no longer covered when the patient has regained functioning or has stopped improving. Premiums for Part B are set annually and paid for by the covered person, and are usually deducted from monthly Social Security payments.

 

Medicare Part C


Part C is an option for Medicare-eligible people in some areas of the country. It includes HMOs (Health Maintenance Organizations) and other private insurance plans similar to employee group benefit plans and private health insurance plans. These programs replace Original Medicare (Part A and Part B), and must cover the same services as Original Medicare does, but may also offer additional benefits. Most Medicare Part C plans charge nominal fees for doctor visits and other services. The main benefit is cost, since total out-of-pocket expenses are usually lower than with Medicare and a Medicare supplement policy. The main disadvantage is that the choice of doctors and other healthcare providers is limited.

 

Medicare Part D (Prescription Drug Coverage)


Part D are Medicare drug programs offered by private insurers. Program premiums are paid by the enrolled person. Premiums and covered drugs vary among insurers.

 

Medicare Supplement Insurance


These are Federally-regulated plans that pay for the 20% of Medicare-approved services not covered by Part A or Part B. They are offered by private insurance companies. The Plans range from Plan A, which covers the fewest services to Plan L which covers the most services. Premiums reflect the extent of the coverage. Premiums are paid by the covered person.

 

Medicaid


Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay the eligible person; instead, it sends payments directly to the health care providers. Medicaid is a state-administered program and each state sets its own guidelines regarding eligibility and services. Medicaid does not provide medical assistance for all poor persons. Low income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds.

 

Independent Living


Generally refers to a facility for elders who need little or no care, but want security, activities, room and board, and the companionship of peers. Independent living costs are not covered by Medicare or Medicaid.

 

Custodial Care


Care provided to assist with activities of daily living: dressing, bathing, toileting, cooking, transferring into and out of bed. The cost of custodial care is not covered by Medicare. Medicaid (the state program) may cover these expenses if the person meets state-defined disability criteria.

 

Supportive Living


Supportive Living communities provide housing, supportive services, personal assistance and health care for individuals who need help with activities of daily living. Typical services include meals, laundry, housekeeping, activities, and assistance with dressing, bathing, toileting and medications. The cost of supportive living generally is not covered state or financial aid programs.

 

Nursing Facilities


In Missouri, nursing homes are licensed as either Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF). A Skilled Care Facility (SNF) may be certified by Medicare to provide short-term/rehabilitation care after a hospital stay. They may also provide Long-Term Nursing care.

 

Intermediate Care Facility (ICF)


Intermediate Care Facilities provide long-term nursing care. They do not provide short-term Medicare approved rehabilitation stays.

 

Multi-Level Facility


A facility that offers two or more levels of care to the elderly, based on the person’s health status. These levels can range from independent, supportive living, nursing care, dementia care, and hospice. A multi-level facility may be Medicare-certified or not, and be non-profit or for-profit. The advantage of these communities is convenience to the resident – he or she can move in at one level and later “move up” to a more intense level of health care and custodial care. These facilities are sometimes called Continuing Care Retirement Communities.

 

Long-Term Care Insurance


Private insurance that helps to cover nursing or supportive living care expenses not covered by Medicare.

 

Short Term Stays


This is short-term care for the patient to provide relief to the primary caregiver, usually a family member or close friend. The patient is admitted to a hospital, nursing home, or supportive living community for a short period of time. Medicare will only pay for short term stays that meets their guidelines.

 

Hospice (Palliative Care)


A program which provides comfort and supportive care for terminally ill patients and their families, either at home, in long-term care facilities or within hospitals.

 

For-Profit


A for-profit organization that includes an individual, or group of individuals or shareholders who own a company with the expectation of a return on their investment.

 

Not-For-Profit


A not-for-profit organization that has a Board of Directors responsible for guiding the direction of a company. Excess income after expenses is put back into the company.

 

If you have additional questions not listed here, please give us a call 314-353-7225.

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For more than a century, seniors have made the Altenheim their choice for supportive living in St. Louis. With exceptional care, treasured friendships and an abundance of activities, the Altenheim offers opportunities for seniors to remain active and independent.

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