For residents who have Long-Term Care Insurance, Masonic Pathways will assist in initiating a claim and submit monthly statements to your provider. Long-Term Care Insurance benefits are made payable to the insured.

Medicare Part A coverage is provided to all qualifying seniors and helps to pay for hospitalization or short-term skilled nursing home stays. There is no premium for Part A coverage.

Medicare Part B coverage is offered to qualifying seniors for a monthly premium. It provides coverage, subject to deductibles and co-pays, for many outpatient services.

Medicare Part C, or Medicare Advantage Plans, are available in many areas as an alternative to traditional Medicare Part A and B coverage. They are administered on behalf of the government by private insurance companies and, as with Part B, enrollees pay a monthly premium, deductibles, and co-pays. Masonic Pathways participates with several, but not all, Medicare Advantage Plans. Please check with the Admissions manager to make sure that your Medicare Advantage Plan is accepted at Masonic Pathways.

Medicare Part D coverage is prescription drug coverage for everyone with Medicare. The program is designed to protect against future drug costs and to give enrollees access to necessary medications. Medicare drug plans are run by insurance companies and other private companies approved by Medicare.

Medicaid is an assistance program that is jointly funded by the federal and state governments and administered by the states. One aspect of the program helps to cover the cost of nursing home care for people who have exhausted their assets. Recipients must meet a variety of requirements to qualify for Medicaid Skilled Nursing Facility (SNF) assistance. They include, but are not limited to:

A demonstrated need for Skilled Nursing Facility (SNF) placement.
“Countable assets” of less than $2,000 (usually excludes a home and one car).

A monthly income that is less than the cost of his/her nursing home care.
Upon qualifying, the recipient receives benefits to make up the difference between the rate that the facility will accept for his or her care and what he or she is required to pay out of his or her income (the “Patient pay Amount:”). Patient Pay amounts are determined by Medicaid and typically allow for a limited amount of personal funds as well as funds to support a spouse who remains outside the facility, if necessary.

Veterans and their spouses may qualify for health care benefits applicable to their stay at Masonic Pathways. Veterans are encouraged to contact their local Veterans Affairs office for additional information.