Understanding Medicare Benefits for Senior Care in New Hampshire
More than 345,000 Granite Staters rely on Medicare—about one in five residents. That share is higher than the national average, so getting the details right has real impact for New Hampshire seniors and their families.
What Original Medicare Covers
| Part | Key Senior‑Care Benefits | 2025 Cost‑Sharing* |
|---|---|---|
| Part A | Up to 100 days of skilled‑nursing‑facility (SNF) care per benefit period after a qualifying three‑day hospital stay | Days 1‑20: $0 |
| Days 21‑100: $209.50/day | ||
| Beyond 100 days: all costs | ||
| Part B | Outpatient rehab therapies, doctor visits, durable medical equipment | Standard monthly premium: $185.00; 20 % coinsurance after annual deductible |
| Part D | Prescription drugs (often critical for post‑acute recovery) | Premiums vary by plan; new $2,000 annual out‑of‑pocket cap begins in 2025 |
*Figures are for Original Medicare in 2025. Advantage plans set their own copays.
Medicare Advantage in New Hampshire
- 31 Medicare Advantage contracts serve the state for 2025, ranging from $0‑premium HMOs to broad‑network PPOs.
- Recent NH Insurance Department guidance warns that several plans changed networks and copays this year; beneficiaries should review coverage closely during annual enrollment.
Advantage plans must cover everything Original Medicare covers, but they can bundle extra perks—dental, vision, gym memberships—and limit facility networks. Always confirm that any skilled‑nursing center you may need is in‑network before you sign.
How Maple Leaf Health Care Center Works With Medicare
- Medicare‑certified SNF: Maple Leaf is fully certified by CMS, which means Medicare Part A will pay for your post‑hospital rehab stay here when you meet eligibility rules.
- Short‑term rehabilitation: We provide physical, occupational and speech therapy seven days a week, billed under Part A for inpatients and Part B for outpatients.
- Dedicated billing team: Our admissions staff verifies benefits, explains expected copays and handles claims so you can focus on healing.
- Care‑transition planning: Before day 20, we meet with you and your family to outline costs that would start on day 21 and explore options—Medigap, Advantage, Medicaid waiver or private pay—to prevent surprises.
Maximizing Your Medicare Benefits
- Know the 100‑day clock. Days accumulate across facilities within the same benefit period. A gap of 60 days with no inpatient care resets the clock.
- Pair Part A with Medigap or Advantage. A Medigap Plan G can cover the $209.50 daily coinsurance after day 20; some Advantage HMOs charge lower—or higher—copays, so read the Evidence of Coverage.
- Use your “wellness” visits. Annual Part B wellness visits help catch issues early and keep documentation current should you need skilled care later.
- Tap free counseling. New Hampshire’s Aging & Disability Resource Centers offer unbiased SHIP counselors who can walk you through plan choices at no cost.
- Plan for drugs. Verify that your rehabilitation or long‑term medications are on your Part D or Advantage formulary—especially if you take brand‑name therapies.
- Ask about therapy caps. Medicare no longer imposes hard therapy caps, but plans still apply “medical necessity” rules. Our therapists document progress every visit to keep coverage flowing.
Other Programs That Can Help
- Medicare Savings Programs: Income‑qualified seniors can get Part B premiums paid by the state and gain automatic Part D Extra Help.
- NH Medicaid Long‑Term Services & Supports: For custodial care beyond Medicare’s 100‑day limit, Medicaid may cover room, board and services once financial and medical‐necessity tests are met.
- Veterans Affairs & TRICARE: Veterans may layer VA benefits with Medicare; our admissions office coordinates directly with VA case managers.
Bottom Line
Understanding Medicare’s moving parts—Part A hospital and skilled nursing coverage, Part B outpatient services, Part D drugs and Advantage alternatives—lets you make confident choices when health needs change. Maple Leaf Health Care Center stands ready to translate those regulations into real‑world care, guiding you from hospital discharge to full recovery or long‑term support right here in Manchester.
Ready for answers tailored to your situation?
Call Maple Leaf Health Care Center today at 603‑669‑1660. Our admissions specialists will verify your Medicare benefits and craft a care plan that fits your goals—no obligation, just clear guidance.
