Medicare Open Enrollment is an important time for older adults and their families to review healthcare coverage, understand their options, and prepare for the year ahead. But choosing the right Medicare plan involves more than reviewing prescriptions and doctor visits. It’s also important to understand how your coverage may affect future healthcare needs, including rehabilitation after a hospital stay, skilled nursing care, and home health services.
At Nye Health Services, we understand that navigating Medicare can feel overwhelming, especially when you or a loved one is facing a change in health. Knowing what Medicare covers, what it doesn’t, and which questions to ask can help you make more informed decisions.
When is Medicare Open Enrollment for 2027?
During Medicare Open Enrollment, eligible beneficiaries can:
Switch between Original Medicare and Medicare Advantage.
Change from one Medicare Advantage plan to another.
Join, drop, or change Medicare Part D prescription drug coverage.
Medicare offers different coverage options, and understanding the differences can help you choose the one that best meets your healthcare needs.
Traditional/Original Medicare
Medicare Advantage (Part C)
Part A (hospital insurance) and Part B (medical insurance)
Private Medicare-approved plans providing Part A and Part B benefits
Generally allows visits to any provider nationwide who accepts Medicare
Often uses provider networks and service areas
Can add separate Part D prescription drug coverage
Most plans include prescription drug coverage
May purchase Medigap supplemental coverage, subject to eligibility and enrollment rules
Cannot use Medigap to pay Medicare Advantage costs
Generally no prior authorization for Traditional/Original Medicare-covered services
Likely requires referrals or prior authorization for certain services
When comparing plans, consider more than monthly premiums. Review deductibles, copayments, prescription drug coverage, provider networks, and potential rehabilitation or home health needs. Helpful resource: Compare Medicare plans on Medicare.gov.
Does Medicare Cover Short-Term Skilled Rehabilitation?
Yes. Medicare Part A may cover short-term skilled nursing and rehabilitation services when specific eligibility requirements are met. Following a hospitalization, some individuals need additional time and specialized care before safely returning home. Short-term skilled rehabilitation may include physical therapy, occupational therapy, speech therapy, wound care, and skilled nursing services. Under Original Medicare, eligibility generally requires a qualifying three-day inpatient hospital stay, admission to a Medicare-certified skilled nursing facility, and a medical need for daily skilled care. Medicare Advantage plans do not require a qualifying three-day inpatient hospital stay, but generally prior authorization is required.
How much does Traditional/Original Medicare pay for skilled nursing care?
This visual represents traditional/original Medicare plans only. It’s important to understand that 100 days is a maximum benefit limit, not a guarantee of 100 days of covered care. Medicare coverage depends on continued eligibility and medical necessity. For the latest eligibility requirements and costs, visit Medicare’s Skilled Nursing Facility Coverage guide.
One of the most common misconceptions about Medicare is that it pays for long-term nursing home stays. Medicare generally does not cover long-term custodial care, which includes ongoing assistance with daily activities such as bathing, dressing, eating, and personal care when skilled medical services are not required. Long-term care may be necessary when an individual needs continuous support or supervision beyond a temporary rehabilitation stay.
Short-Term Skilled Care vs. Long-Term Care
Short-Term Skilled Care
Long-Term Care
Primary purpose
Recovery, rehabilitation, or management of a condition requiring skilled services
Ongoing care and assistance
Typical duration
Temporary, based on medical need
Extended or ongoing
Medicare coverage
May cover qualifying skilled services for a limited period
Generally does not cover custodial care
Payment options
Medicare, Medicare Advantage, other insurance, or private pay, depending on coverage
Private pay, qualifying Medicaid benefits, long-term care insurance, or other resources
Families considering long-term care should begin exploring financial options early. Medicaid may help eligible individuals pay for long-term nursing home services, but eligibility and covered benefits vary by state. At Nye Health Services, we also offer long-term skilled nursing services for individuals who need ongoing medical care and support. Our team can help families better understand the available care options and discuss payment considerations. For more information, visit Medicare.gov: Long-Term Care Coverage
Does Medicare Cover Home Health Care?
Yes. Medicare Part A and/or Part B may cover medically necessary home health services for eligible individuals. Home health care can be an important option for people recovering from illness, managing chronic conditions, or transitioning home after a hospital or rehabilitation stay. Medicare-covered home health services may include:
Skilled nursing care, such as wound care, medication education, and monitoring of medical conditions.
Physical therapy to improve strength, balance, and mobility.
Occupational therapy to support independence with everyday activities.
Speech therapy to address communication or swallowing difficulties.
Certain medical social services and part-time home health aide services when eligibility requirements are met.
To qualify, individuals generally must be under the care of a healthcare provider, need qualifying intermittent skilled services, meet Medicare’s homebound criteria, and receive care through a Medicare-certified home health agency.
Under Original Medicare, eligible beneficiaries generally pay $0 for covered home health services, although durable medical equipment may require coinsurance. Medicare generally does not cover around-the-clock care at home or personal care alone when skilled services are not needed.
Continuing Your Recovery at Home with Nye Health Services
Nye Home Health Care helps individuals receive professional healthcare services in the comfort of their own homes. Our team provides skilled nursing, physical therapy, occupational therapy, and speech therapy to support recovery, independence, and quality of life. Whether you’re transitioning home after short-term rehabilitation or need skilled care to manage an ongoing health condition, home health services may help you remain in familiar surroundings while receiving appropriate medical support.
How Different Types of Senior Care May Be Covered by Medicare
Does Medicare Cover Outpatient Therapy?
Yes! Medicare Part B covers medically necessary outpatient therapy services, including physical therapy, occupational therapy, and speech-language pathology services. These services can help individuals recover from an injury or surgery, manage chronic conditions, improve mobility, and maintain independence. Unlike short-term skilled rehabilitation, outpatient therapy does not require an inpatient hospital stay. Individuals can receive therapy while living at home or in a senior living community.
How Much Does Medicare Pay for Outpatient Therapy?
Under Original Medicare, beneficiaries generally pay 20% of the Medicare-approved amount for covered outpatient therapy services after meeting their annual Medicare Part B deductible. Medicare Advantage plans must cover medically necessary services covered by Original Medicare, but copayments, provider networks, and authorization requirements may vary. Medicare does not have an annual dollar limit on medically necessary outpatient therapy services, although additional documentation requirements may apply.
Five Questions to Ask During Medicare Open Enrollment:
Are my preferred healthcare providers covered? Check whether your physicians, hospitals, rehabilitation centers, and home health agencies accept your plan and are in-network when required.
What happens if I need rehabilitation after hospitalization? Review skilled nursing facility coverage, copayments, eligibility requirements, and prior authorization rules.
Will my plan cover home health services? Understand coverage for nursing and therapy services if you need care at home.
Have my prescription drug costs changed? Review your current medications, pharmacy network, formulary, and expected out-of-pocket costs.
What are my total healthcare costs? Compare premiums, deductibles, copayments, coinsurance, and annual out-of-pocket limits where applicable.
Even if you’re satisfied with your current plan, reviewing coverage annually can help you identify changes that may affect your care or expenses.
Where Can I Get Free Help Understanding Medicare?
You don’t have to navigate Medicare enrollment alone. Several reputable resources offer information and assistance.
Medicare.gov — Official federal Medicare information, coverage details, and plan comparisons.
Medicare Plan Finder — Compare available Medicare health and prescription drug plans.
Medicaid.gov — Information about Medicaid eligibility and long-term care benefits.
Planning for Your Healthcare Needs with Nye Health Services
Choosing Medicare coverage is an important part of planning for your health, but understanding where to turn when your care needs change is equally valuable. At Nye Health Services, we offer a range of healthcare services designed to support individuals and families through different stages of care, from short-term rehabilitation following hospitalization to ongoing skilled nursing care and home health services. Whether you’re planning ahead or exploring care options for a loved one, our team is here to help you understand the services available and take the next step with confidence. Call us at (402) 753-1400 to speak with a team member!
Disclaimer: Nye Health Services does not provide Medicare insurance enrollment or plan selection services. Medicare eligibility, benefits, and costs vary based on individual circumstances and insurance coverage. Please verify coverage with Medicare or your insurance provider.
Fremont, NE – Nye Health Services announces that Kristin Harris, RN, BSN, has been named President of the family-owned senior healthcare organization, effective September 30, 2026. Harris, who most recently served as Chief Operating Officer, brings more than 20 years of leadership experience within Nye Health Services to the role.
Nye Health Services’ strategy is to build on the organization’s success, strengthen support for its campuses and services, and align capacity for future growth.
“As Nye continues to grow, we have to make sure our leadership structure is positioned for that growth,” said Russ Peterson, Founder and CEO of Nye Health Services. “Kristin understands this organization from nearly every level, and there is no one more committed to our mission, values, and the people we serve. I have complete confidence in Kristin’s leadership, and in the direction we are heading.”
Harris has spent more than two decades serving Nye Health Services in clinical, campus, and executive leadership positions. A registered nurse and licensed nursing home and assisted living administrator, Harris began her Nye career in nursing before serving as Director of Nursing and Executive Director at Nye Square and later Executive Director at Nye Legacy.
In 2018, Harris joined Nye’s Home Office leadership team as Vice President of Operations. She was named Chief Operating Officer in 2022, where she has helped lead Nye’s campuses, services, and Home Office teams while advancing organizational strategy and operational performance.
“I’ve had the privilege of providing leadership in various capacities for Nye for more than 20 years, and am incredibly honored to step into the role of President,” Harris said. “We have an exceptional group of leaders and Team Members who care deeply about the people we serve. I’m excited about the opportunities ahead of us—to strengthen the support we provide to our campuses, continue developing our people, grow our services and bring the Nye experience to even more individuals and families.”
As President, Harris will focus on company leadership, strategic growth, and the overall success of Nye Health Services. The transition provides greater focus on Nye’s long-term strategic priorities while maintaining a strong commitment to the success of its campuses and service lines.
Peterson will continue serving as Founder and Chief Executive Officer, with an increased focus on growth opportunities and long-term organizational development.
The transition comes as Nye Health Services continues to pursue an ambitious long-term growth strategy centered on expanding the number of people it serves through exceptional services. While the organization looks toward new opportunities, its leaders say growth will remain grounded in the culture and purpose that have guided Nye since its founding in 1989.
“Nye has always been a family-owned and family-oriented company built around people,” Peterson said. “Our residents, families, and Team Members deserve to be known, valued, and treated with dignity. ‘Celebrate Life’ is our heartbeat. We do not simply manage aging—we create moments of meaning. We do not just provide care—we elevate dignity. We do not just house residents—we create belonging. The soul of Nye Health Services is not found in our buildings or services—it is found in the way people experience life within them.”
The leadership transition does not change leadership at Nye’s campuses or service lines.
“Our future is about growing our impact while protecting what has made Nye special,” Harris said. “As we grow, our commitment to our residents, families, Team Members and communities will remain at the center of every decision we make.”
About Nye Health Services
Founded in 1989, Nye Health Services is a family-owned senior healthcare organization serving communities across Nebraska. Nye provides a continuum of services including independent living, assisted living, memory care, short-term skilled rehabilitation, long-term care, respite care, outpatient therapy, and home health care. Guided by the vision “People Live Happy Here” and “People Work Happy Here”, Nye Health Services is committed to creating helpful and delightful experiences for the residents, patients, families, and Team Members it serves.
It may be time to consider senior living when living at home becomes harder to manage, less safe, or less enjoyable than it once was. Difficulty with everyday tasks, frequent falls, medication concerns, increasing isolation, changes in memory, trouble maintaining the home, or growing dependence on family members can all be signs that additional support may improve quality of life. Moving to senior living doesn’t necessarily mean giving up independence—it can provide a safer, more comfortable environment while giving older adults the support and freedom they need to enjoy daily life.
7 Signs It May Be Time for Senior Living
1. Everyday Tasks Are Becoming More Difficult
One of the clearest signs that it may be time to consider senior living is when everyday activities become increasingly difficult. Pay attention to whether you or a loved one is struggling with:
Getting dressed or bathing
Preparing meals
Keeping the home clean
Doing laundry
Managing medications
Getting around the house
Shopping or running errands
Needing occasional help doesn’t automatically mean someone needs to move. However, if these challenges are becoming frequent or affecting someone’s ability to live comfortably, it may be time to explore additional support.
2. Falls or Safety Concerns Are Increasing
Safety should be a major consideration when deciding whether someone can continue living independently. A fall can be particularly concerning. Other warning signs may include difficulty using stairs, leaving appliances on, forgetting to lock doors, or having trouble getting around safely. According to the Centers for Disease Control and Prevention, falls are a leading cause of injury among older adults. If you find yourself regularly worrying about whether a loved one is safe at home, that concern deserves attention.
3. Managing Medications Has Become Difficult
Medication routines can become complicated, particularly when someone takes several prescriptions. Missed doses, accidental double doses, confusion about medications, or difficulty keeping track of prescriptions may indicate that additional support is needed. A conversation with a healthcare provider can help determine whether these changes are temporary or part of a larger need for assistance.
4. Memory Changes Are Affecting Everyday Life
Forgetfulness happens at every age, but significant changes in memory can be a reason to reconsider living arrangements. Look for patterns such as:
Frequently forgetting appointments
Getting lost in familiar places
Forgetting to pay bills
Repeating the same questions
Difficulty preparing familiar meals
Trouble following normal routines
Increasing confusion about everyday activities
The National Institute on Aging recommends paying attention to changes in an older adult’s ability to manage everyday activities and considering what type of help may be appropriate. Memory changes don’t automatically mean someone needs senior living, but they can be an important reason to begin exploring options.
5. Your Loved One Is Becoming Increasingly Isolated
Changes in social activity can be easy to overlook. An older adult may gradually stop participating in activities they once enjoyed, spend most of their time alone, or avoid leaving home because transportation or mobility has become difficult. Loneliness and social isolation can affect both emotional and physical well-being. The CDC recognizes social isolation and loneliness as important concerns for older adults. If someone is no longer getting the social interaction they need at home, senior living may provide opportunities to reconnect with others and become more engaged in daily life.
6. Maintaining the Home Has Become Overwhelming
Sometimes the issue isn’t a major health change. It’s simply that managing a house has become too much. Cleaning, cooking, yard work, snow removal, repairs, laundry, and other responsibilities can become physically demanding. If a once well-maintained home is becoming difficult to manage, or your loved one is spending most of their energy keeping up with household responsibilities, it may be worth considering whether a different living environment would make everyday life easier. For some older adults, moving to senior living isn’t about needing more medical care. It’s about having fewer responsibilities and more time to enjoy life.
7. Family Members Are Providing More and More Help
Family support can make it possible for an older adult to remain at home longer. But there can come a point when family members are providing so much assistance that the arrangement is no longer sustainable.Consider how often family members are helping with:
Transportation
Groceries
Meals
Housekeeping
Medication reminders
Personal care
Appointments
Finances
Safety checks
If family members are constantly worried, making frequent trips, missing work, or feeling overwhelmed, it may be time to discuss whether additional support would be better for everyone. The National Institute on Aging provides resources for families who are helping older adults with changing care needs.
Ask These Questions When You’re Unsure
There isn’t a specific age when everyone should move into senior living. The right time depends on the individual.
Instead of asking, “Is Mom or Dad old enough for senior living?”, ask:
Is it still safe for them to live alone?
Consider falls, medication mistakes, accidents, mobility problems, and other safety concerns.
Can they manage everyday life without significant assistance?
Think about meals, bathing, dressing, housekeeping, transportation, and other routine activities.
Are they still enjoying life at home?
Consider whether isolation, boredom, or difficulty leaving the house has changed their quality of life.
Are family members becoming caregivers instead of simply family?
If family responsibilities are steadily increasing, it may be time to look at other options.
Would additional support give them more independence?
Sometimes the best way to preserve independence is to have the right amount of help available.
Don’t Wait for a Crisis
Families often begin thinking about senior living after something goes wrong—a serious fall, hospitalization, medication mistake, or sudden decline. But you don’t have to wait for a crisis. Starting the conversation earlier gives families time to explore options without making decisions under pressure. It also gives older adults an opportunity to express what they want before an emergency limits their choices. The National Institute on Aging’s resources on aging in place can help families think through whether an older adult’s current home environment continues to meet their needs.
How to Start the Conversation
Talking about senior living can be emotional. Approach the conversation as a discussion rather than a decision that has already been made.
Instead of saying:
“You can’t live here anymore.”
Try:
“What would make life easier for you?”
Or:
“How are you feeling about keeping up with everything at home?”
You can also suggest visiting a senior living community simply to learn more. Touring a community doesn’t mean someone has to move. The goal is to understand what your loved one wants, identify where they may need help, and explore options before a decision becomes urgent.
When Is the Right Time to Consider Senior Living?
The right time isn’t determined by age alone. It may be time to consider senior living when safety concerns, difficulty with daily activities, isolation, memory changes, household responsibilities, or increasing family involvement are beginning to affect an older adult’s quality of life. If several of these signs are present, don’t wait for an emergency to start exploring your options. At Nye Health Services, we understand that deciding whether it’s time for senior living is a major decision for older adults and their families. Our team can help you learn more about senior living options and determine what type of support may be appropriate for your family’s needs.
One of the biggest questions older adults and their families have when considering assisted living is: How do you pay for assisted living? The monthly cost of senior living can feel overwhelming at first. But when you compare the cost of assisted living with what it really costs to remain at home—and consider the financial resources that may be available—assisted living may be closer to affordable than you think. At Nye Health Services, we help Nebraska families explore assisted living options in Fremont, Lincoln, Norfolk and Louisville. Understanding how assisted living costs work and how families commonly pay for senior living is an important first step in planning for the future.
How Much Does It Really Cost to Stay at Home?
When comparing the cost of assisted living versus living at home, don’t compare an assisted living monthly rate to a mortgage payment alone. Housing is only one part of the true cost of aging at home. Add up what you or your loved one currently spends each month on:
Mortgage or rent
Property taxes and homeowners or renters insurance
Electricity, gas, water, internet and other utilities
Groceries and dining
Home repairs and maintenance
Lawn care and snow removal
Transportation, car payments, insurance and fuel
Housekeeping
Entertainment and social activities
Emergency response or monitoring services
In-home care or personal assistance
As care needs change, staying at home may also require paid caregivers or additional services. Those expenses can significantly change the true monthly cost of remaining at home. Assisted living can combine many everyday expenses and services into one monthly payment. At Nye Health Services assisted living communities, amenities include three daily meals, utilities except phone, weekly housekeeping and laundry, transportation, social and recreational opportunities, and 24-hour healthcare staff onsite. Amenities and additional fees may vary by location.
Instead of asking only “How much does assisted living cost?”, consider asking: “What am I already spending each month, and what would be included if I moved to assisted living?”
7 Ways to Pay for Assisted Living
There is no single best way to pay for assisted living. Many residents and families use a combination of monthly income, retirement savings, home equity, insurance, and available benefits. Here are seven common options to consider when determining how to afford assisted living.
1. Social Security, Pensions, and Retirement Income
Social Security benefits, pensions, retirement account distributions, and other monthly income can be applied toward assisted living expenses. Remember that income currently used for groceries, utilities, home maintenance, and other household expenses may instead help cover a monthly assisted living payment after a move.
2. Savings and Investments
Savings accounts, certificates of deposit, investment accounts, and other assets are another common way to pay for senior living. A financial advisor can help you determine how to use these resources while considering your expected expenses and long-term financial needs.
3. Home Equity or Proceeds From Selling a Home
For many older adults, their home is one of their largest assets. Selling a home can make equity available to help pay for assisted living while also eliminating expenses such as property taxes, homeowners insurance, utilities, repairs, and ongoing maintenance. If you aren’t ready to sell your home immediately, consider talking with a qualified financial professional about the options available for your individual circumstances.
4. Long-Term Care Insurance
Some long-term care insurance policies may help pay for qualifying assisted living services. Coverage varies significantly by policy, including eligibility requirements, benefit amounts, and waiting periods. If you or your loved one already has long-term care insurance, review the policy before you need assisted living and contact the insurer to understand exactly what benefits may be available.
5. Veteran Benefits
Eligible veterans and surviving spouses may have access to benefits that can help with certain long-term care expenses. One benefit families may want to research is the Department of Veterans Affairs Aid and Attendance benefit. Eligibility is based on specific requirements. Contact the U.S. Department of Veterans Affairs or an accredited Veterans Service Officer for guidance about your individual situation.
6. Life Insurance Options
Depending on the type of life insurance policy, there may be options to access cash value or certain benefits during the policyholder’s lifetime. Because using a life insurance policy can have financial and tax implications, talk with the insurance provider and a qualified financial professional before making changes.
7. Family Contributions
Some families choose to share assisted living expenses. After Social Security, retirement income, insurance benefits, and other resources are applied, family contributions may help cover a remaining monthly difference. Talking about finances before a move becomes urgent can help everyone understand what resources are available and what type of plan is realistic.
Does Medicare Pay for Assisted Living?
This is one of the most common questions families ask when researching how to pay for assisted living. Medicare does not generally pay for the room-and-board cost of an assisted living apartment. Depending on individual eligibility and circumstances, Medicaid or certain private insurance policies may provide assistance with qualifying costs. Because coverage and eligibility can vary, speak with the appropriate benefits administrator, insurance provider, or financial professional before making a decision based on expected coverage.
How to Plan for Assisted Living Costs
You don’t need to be ready to move into assisted living to start planning. In fact, learning about senior living before an urgent health or safety concern arises can give you more time to compare communities, understand costs, and decide what matters most to you. Consider taking these steps as part of your long-term senior living plan:
Calculate your current cost of living. Create a realistic monthly budget that includes housing, food, utilities, transportation, maintenance, and any in-home assistance.
Review retirement income and assets. Understand what you receive from Social Security, pensions and retirement accounts and what savings or investments may be available later.
Consider the future of your home. If you own a home, think about whether you would eventually sell it and how the equity could support future senior living expenses.
Research assisted living communities and pricing early. Compare monthly rates, apartment options, amenities, care services, and potential additional fees.
Talk with your family. Share your preferences for where and how you want to live if you need more support in the future.
Tour communities before there’s an urgent need. Seeing assisted living communities in person can help you understand what senior living is actually like and which environment feels right for you.
Planning isn’t about predicting exactly what will happen. It’s about giving yourself more information, more time, and more choices if your needs change.
What Is Included in the Cost of Assisted Living?
Assisted living pricing can vary by community, apartment, and the services a resident needs. When comparing senior living communities, ask for more than the starting monthly price. Find out whether the monthly cost includes meals, utilities, housekeeping, laundry, transportation, activities, healthcare support and other services. Also ask which services may have additional fees and whether the monthly cost can change as care needs change. At Nye Health Services, assisted living residents have access to amenities designed to make daily life easier while supporting independence, connection and well-being. Nye also offers month-to-month agreements at its assisted living communities, giving residents and families added flexibility without a long-term lease commitment.
Assisted Living Is More Than A Place to Live
The value of assisted living isn’t limited to housing. For many older adults, moving to an assisted living community means fewer household responsibilities and more opportunities to enjoy each day. Meals are prepared, activities and neighbors are nearby, transportation is available for scheduled outings and appointments, and assistance is available when it’s needed. For family members, assisted living can also provide reassurance that their loved one has support and resources nearby. Those benefits may be difficult to put into a monthly budget, but they are an important part of comparing assisted living with remaining at home.
Explore Assisted Living in Nebraska with Nye Health Services
If you’re wondering how to afford assisted living, don’t let the monthly price keep you from exploring your options. Start by calculating what you already spend to live at home, identify the financial resources available to you, and compare the total cost with what’s included in assisted living.
You may find that assisted living is more attainable than you expected. Nye Health Services offers assisted living communities in Fremont, Lincoln, Norfolk and Louisville, Nebraska, including Nye Square, Gateway Vista, The Meadows and Nye Summit. Our team can help you learn more about assisted living services, amenities, apartment options, pricing and availability so you can make an informed decision for yourself or someone you love.
This article is provided for general educational purposes and is not financial, insurance, legal, or benefits advice. Coverage, eligibility, and financial circumstances vary. Consult the appropriate financial, insurance, Veterans Affairs, or other qualified professional regarding your individual situation.
Kathy Kirby has been an occupational therapist with Nye Health Services for more than 25 years, providing care across our Skilled Nursing, Assisted Living, Independent Living, outpatient, and home health settings. Today, she focuses on bringing wellness initiatives to our campuses to enhance the quality of life for residents. Kathy is especially passionate about working with individuals living with Parkinson’s disease and leads our Parkinson’s Support Group.
