Should You Rely on Medicare for Long Term Care?

Will Medicare pay for your long term care? Even if you had the biggest contributions to this national health insurance program while you were still active at work, it will not pay for your long term care (LTC) expenses because it was not designed to do so.

Medicare is simply a hospital insurance that foots the doctor bills of elderly people aged 65 and older. It will also cover their expenses incurred from undergoing medical treatments, therapies and other related health care services.

Medicare will not pay for custodial care which involves provision of assistance with the activities of daily living (ADL) such as eating, bathing, dressing, use of toilet, continence, and transferring. If you’re 65 or older you may receive care from a nursing home through Medicaid following three consecutive days in a hospital.

For your first 20 days in a nursing home, Medicare will shoulder 100% of your expenses but beginning the 21st day up to your 100th day a copayment shall be required. Bear in mind that Medicare will only cover expenses incurred from medically necessary care.

Now younger people are not completely excluded from Medicare assistance. They may qualify for the program’s funding provided that they are disabled or have end-stage renal disease. Before Medicare comes to aid them though, there has to be a written recommendation from their physician which indicates that they need to receive care in a nursing home in conformity with a specific health care plan that has been designed for their recovery.

How Long Will Medicare Pay for Your Long Term Care?

As mentioned earlier in this article, Medicare does not pay for LTC. It only pays for medically necessary care that is provided in nursing homes. After receiving 100 days of care in a nursing facility you shall be discharged.

Notice that professional LTC specialists never bring up Medicare in conversations that deal with LTC planning because it is not an option people should take. Medicaid is often mentioned because the uninsured will inevitably turn to it in the future once he runs short of funds and is no longer capable of paying his LTC costs out-of-pocket.

Besides, Medicaid is not that bad especially if it is treated as supplemental LTCI via the Partnership Program which is a collaborative effort between private insurance companies and state Medicaid programs.

If you’ve been keeping abreast of LTC news notice that the only time people are discouraged from Medicaid is when they start acting as though this federal health insurance program is solely responsible for their LTC. Otherwise, Medicaid is a good add-on for one’s LTC plan.

It’s different with Medicare because it won’t fork out a single penny for you if all you need is someone to assist you with your ADLs, cook your meals, do your laundry, and accompany you to the doctor.

Now that you know Medicare has nothing to offer in the LTC arena, you can cross it out from your options and if anyone asks you will Medicare pay for your long term care, simply quip that you’re better off with a practical LTC plan.