Some people assume that Medicare will cover long-term care, such as a stay in a nursing home. But in reality, it doesn’t cover much long-term care. So if you’re planning for yourself, or caring for an older relative, here’s what you need to know.
Understanding Medicare Coverage
Many people are surprised to learn that Medicare does not cover long-term nursing care. Medicare does not provide coverage for people who need to go into nursing homes indefinitely because they are disabled or can no longer take care of themselves. Medicare also does not cover assisted living or adult daycare. Medicare also does not cover daily custodial care, such as assistance with eating, bathing and dressing.
What Types of Care Does Medicare Cover?
- Home health care. If you are homebound by an illness or injury, and your doctor says you need short-term skilled care, Medicare will pay for nurses and therapists to provide services in your home.
- Hospice. Medicare covers hospice care. Hospice is care you get to make you more comfortable when you are in the last stage of life with a terminal illness. You’re eligible if you are not being treated for your terminal illness, and your doctor certifies that you probably will live no longer than six months. You can get care for longer than that, as long as your doctor says you are still terminally ill.
- Skilled nursing care. Medicare helps to pay for your recovery in a skilled nursing care facility after a three-day hospital stay. Medicare will cover the total cost of skilled nursing care for the first 20 days, after which you’ll pay $164.50 coinsurance per day (in 2017), for each benefit period. After 100 days, Medicare will stop paying.
If Medicare Won’t Pay for Long-Term Care, What Should I Do?
Long-term care insurance from private insurance companies can help cover some of the costs of long-term care and can help you preserve your assets. There are also new hybrid options, like a long-term care rider to your existing life insurance policy. Contact us to learn more about long-term care insurance options. The earlier you buy a policy, the more affordable it’s likely to be.
Sources: LongTermCare.gov, Medicare & You 2018, Skilled nursing facility (SNF) care