Many people assume that Medicare will cover their long-term care. In reality, Medicare doesn’t offer coverage for those who need to stay in nursing homes indeterminately because they can no longer care for themselves or are disabled. Medicare also doesn’t cover adult daycare or assisted living. So, if you are planning for yourself or caring for a loved one, here is what you need to know about Medicare coverage for long-term care.
What is Long-Term Care?
Before we discuss Medicare long-term coverage, it is vital to know what long-term care means. Long-term care, often called custodial care, consists of a range of services considered necessary to take care of your health needs over a prolonged period of time. For people with disabilities or chronic conditions, long-term care provides both medical and non-medical support.
It can include help with daily tasks such as dressing, eating, or bathing. Other services may include meal preparation, housekeeping, help with basic communication, and transportation to doctor’s appointments. You can get long-term care in a nursing home, assisted living facility, or your home.
Medicare Long Term Care Coverage
While Medicare doesn’t cover most of the long-term care costs required by a Medicare beneficiary, Medicare pays for some form of long-term care expenses.
Skilled nursing care: Medicare can cover short-term skilled nursing care and pay for your recovery after staying in the hospital for three days. Medicare will pay for the entire cost of skilled nursing care for the first twenty days, after which you will be responsible for paying a $185.50 coinsurance daily. Medicare will stop paying for your skilled nursing care after 100 days.
Home health care: Those that are homebound by injury or illness and have their physician recommend short-term skilled care may be covered by Medicare for the costs of services therapists and nurses provided in their house. However, this is not 24/7 care; it is for no more than a total of 28 hours a week, though you can qualify for more with your doctor’s recommendation.
Hospice: Hospice is the care of those with a terminal illness to help make them more comfortable during the last stage of their life. Medicare pays for this, but you are only eligible if you are no longer being treated for the terminal illness, and your physician confirms that you have no longer than six months to live. However, you can still get longer care as long as your physician says that it is necessary.
Contact Cornerstone Senior Advisors for more information about how Medicare can help cover some parts of long-term care.