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Insurance

MassHealth an Incredible Program for Many of Our Residents

May 30, 2019 by Steven Tyer

MassHealth is a safety net for many of our residents. The state agency oversees Medicaid, the federal program that provides health coverage for low-income individuals. That includes nursing homes, assisting individuals with the monthly cost of their care that they would not have otherwise been able to afford.

However, there has been an alarming trend in MassHealth funding lately. Perhaps you’ve heard that the rates paid to nursing homes are based on 2007 costs. That means despite rising costs, all nursing homes caring for MassHealth residents still receive payments calculated on costs that they’ve incurred over 12 years ago. Copley has the same cost increases in labor, utilities, and food that you have in your own home – just on a much larger scale.

Tara Gregorio, the president of the Massachusetts Senior Care Association, and Naomi Prendergast, president and CEO of D’Youville Life and Wellness Community in Lowell have “sounded the alarm” about rates being too low. “This is a severely underfunded system,” Gregorio told CommonWealth Magazine’s The Codcast. They are calling for a restructuring of the program and funding based on more current costs. You can listen to the whole podcast and read an article based on their conversation here.

Copley at Stoughton fully supports this initiative. We see the tremendous impact MassHealth has for our residents and their families. But many nursing homes in Massachusetts are on the verge of bankruptcy, which will have an impact on many more residents and the industry as a whole.

Thankfully, that’s not the case for Copley at Stoughton. I credit our staff 100% for the great job they do ensuring our residents receive the care they need. In a previous blog post, I talked about how our staff routinely goes above and beyond budgets to provide outstanding care. This is part of the reason why we are consistently ranked one of the “Best Nursing Homes in the United States.” 

We believe in a strong skilled nursing home industry. We are optimistic that MassHealth will adjust their payment structure soon, thanks to the hard work of people like Tara Gregorio and Naomi Prendergast. But no matter what the outcome, Copley will remain a strong community partner providing care that goes above and beyond.

You can find out more about applying for MassHealth for your skilled nursing care home needs HERE. 

How Well Do You Know Your Insurance?

November 15, 2016 by By: Steven Tyer

Are deductibles, coinsurance, co-payments and out of pocket maximums all terms that make your head spin? If so, you are not alone. Believe it or not, many people are uninformed about their insurance coverage, particularly those approaching retirement.

Every day we discuss insurance with our guests and their families.  Upwards of 50% are shocked to know that their insurance has a deductible, coinsurance or co-pay.  More often than not we find ourselves explaining that it is not a Copley policy, but a policy of the insurance coverage they voluntarily choose.

Most commercial insurers such as Blue Cross Blue Shield and TUFTs as well as Medicare have some out of pocket cost.  These costs can range anywhere from $20-$100 per day for commercial policies and in 2016 $161.00 per day for days 21-100 under the Medicare program.  Supplementary insurance coverage such as Medex are plans that cover these types of charges but are an additional plan and premium on top of your original policy.

Whatever your insurance coverage is, please take some time to read all of the coverage details.  The last thing you need is any extra anxiety after an unplanned hospital stay caused by not knowing what your insurance covers.  If you are planning an elective surgery that may require post hospitalization rehabilitation care, Copley’s admission staff would be happy to assist you in verifying what your out of pocket costs would be.

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Copley at Stoughton - license, certification & accreditation

Licensed by the Department of Public Health

Accredited by The Joint Commission as a skilled Nursing and Rehabilitation Center .

Medicare and Medicaid certified.

Contracted by many HMO's.

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