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What are care transitions?

When your care setting situation may need to change to a different care setting this is called a care transition. This usually happens when there is a change in your health and therefore you require a different type of care. For example, depending on your situation you may start with receiving care in an out patient setting then later move to a nursing team and then go back home where you could have in house support too. These transitions can occur between hospitals, assisted living facilities, primary care to speciality care. The transitions are important to ensure you are receiving the correct care and support that you require and that you are being looked with the best services possible.

Is it covered under Medicare?

Everyone with Medicare Part B is covered.
The Part B deductible and coinsurance apply.

For example, if you’re heading back home after staying at a hospital or skilled nursing facility. Your transition will be managed by a health care provider. They will keep in communication and help manage your care for the first 30 days once you return home. You can also do an in person visit at the office within 2 weeks of your return home. Here, your healthcare provider will review the care you got in the facility you were in, answer any questions, provide information on how to transition back to living at home and help with managing new medications.

References:

Meidcare.Gov
NACNS.org

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