Moving Mom to a care home near you, in another state? Check these three things first

Moving an older parent from a West Virginia hospital to a Virginia care facility raises two separate questions. First, is the care itself covered? Second, does her current Medicare plan cover that facility? Check both before agreeing to the transfer.

Medicare Part A covers skilled nursing facility care for a limited time when the eligibility rules are met. Medicare does not pay for most long-term custodial care, including ongoing help with bathing, dressing or using the bathroom.

1. 1.Ask the hospital to state whether she needs daily skilled nursing or skilled therapy after discharge.
2. 2.Confirm whether she had a qualifying inpatient hospital stay of at least three days in a row. The admission day counts, but the discharge day does not. Emergency room and observation time before inpatient admission do not count.
3. 3.Ask whether she is expected to enter the skilled nursing facility generally within 30 days after leaving the hospital.
4. 4.Ask the Virginia facility to confirm that it is Medicare certified and that it can provide the skilled services ordered for her.

Call the Virginia facility directly. Ask whether the skilled nursing unit is Medicare certified, whether it has a bed and what covered and uncovered charges it expects. A nursing home may offer both short-term skilled nursing care and long-term custodial care.

Call the member services number on her plan card before transfer. Give the representative the facility's exact name and address. Ask whether it is in network, whether the stay will be covered and what she is expected to pay. Ask for the answer in writing or request a reference number for the call.

Medicare Advantage plans may waive the three-day inpatient requirement. They may also charge copayments during the first 20 days. Her plan must explain the rules that apply to her stay.

Under Original Medicare in 2026, days 1 through 20 cost $0 per day after the $1,736 Part A deductible. Days 21 through 100 cost $217 per day. After day 100, the person pays all costs. These amounts can change each January. Medicare Advantage costs may differ.

If the Virginia address is outside her Medicare Advantage or Part D plan's service area, she may qualify for a Special Enrollment Period. If the plan is told before the move, the period begins the month before the move and continues for two full months afterward. If it is told after the move, the period begins when she moves and continues for two full months afterward. People who live in an institution, such as a nursing home or rehabilitation hospital, may join, switch or leave Medicare Advantage or drug coverage while living there and for two full months after moving out. Call 1-800-MEDICARE at 1-800-633-4227 to ask which rule applies before changing coverage.