Medicare Does not CoverLonger Term Care

Medicare does not cover long term care. I recently shared this information with relatives who are struggling to arrange care for their elderly parents. It is not unusual for people to misunderstand what Medicare covers and what it does not cover.

Here is what I wrote to my relatives:

Medicare is health insurance for people over 65.  Assets play no role in whether or not a person gets Medicare.  The Medicare premium is taken out of your parent’s Social Security checks each month. Medicare is only health insurance.  It does not cover long-term care.

Medicare covers skilled nursing facilities, and your mother’s two different stays at the skilled nursing facility were covered by her Medicare Advantage plan.  Your parents were put into a Medicare Advantage plan through your father’s company retirement plan.

Medicare does not cover long-term care, whether in a facility or at home.

Home Health care is covered by Medicare when a person is released from the hospital or from a skilled nursing facility (SNF). But your mother has been out of the SNF long enough that Medicare would not now cover any new home health care. If she goes back into the hospital or SNF, she could get home health care after her discharge – if her doctor requests it. Medicare covers home health care through contracted nurses and physical therapists who provide skilled services.

If your parents need help around the house, Medicare does not cover this. If your mother needs to go into convalescent care at some point, your parents have assets that would be used to pay the expensive monthly charge. They would not qualify for Medicaid because Medicaid only covers people with very limited income and very limited assets.

Some people spend their life savings on a nursing home. When they run out of money, they apply for the state Medicaid program to pay their nursing home bill. Then the state makes them move to a nursing home that is contracted with Medicaid.

It  is too late to protect your parents’ assets, so they would pay for their long-term care costs. Some people create a trust to protect their assets from long-term care costs, but that must be done five years before a person needs long-term care.  When a person applies for Medicaid, the state “looks back” five years into a person’s finances to see if they tried to hide assets or give them away to their children in order to qualify for Medicaid-funded long-term care.

Most people don’t realize that Medicare does not cover long-term care.  I started out in insurance selling long-term care policies.  It was a tough sell because nobody wants to spend money on a long-term care policy they might never use. The only easy sales were with people whose parents had spent years in a nursing home and went through all their savings. But most people think this will never happen to them.

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