Health Care Benefits For Nursing Facility Members

Nursing Facility All Members:
 
Acute Care:

– preventive care
– primary care
– other medical care provided under the direction of a physician for a condition having a relatively short duration.
 

NF Add-on Services:
the types of services that are provided in the Facility setting by the Provider or another network provider, but are not included in the NF Unit Rate. 

– Emergency Dental
– Occupational Therapy (OT) Rehabilitative Service and Assessment
– Physical Therapy (PT) Rehabilitative Service and Assessment
– Speech Therapy (ST) Rehabilitative Service and Assessment
– Durable Medical Equipment (DME)
– Custom Powered/Manual Wheelchair
 
 
Nursing Facility Medicaid Only:
 
Nursing Facility (NF) Unit Rate: the types of services included in the DADS daily rate for nursing facility providers, such as:

– room and board,
– medical supplies and equipment
– personal needs items
– social services, and over-the-counter drugs.
 

Nursing Facility Dual:
Nursing Facility (NF) Unit Rate: Medicare will continue to be primary for skilled nursing facility (SNF) services, and the MCO will be secondary.