Most seniors that I have spoken to believe that Medicare pays for long-term care. What do you think? On one hand, Medicare is so complete, it seems to pay for almost everything the elderly require, health-care-wise. Most of us know someone who has had a nursing home stay or in home care paid for by Medicare, so it must pay for long-term care, right? On the other hand, maybe you’ve overheard a friend talking about their parents being cleaned out by a nursing home. Which is true?
Medicare is part of the U.S. Social Security system. It provides major medical benefits to the vast majority of our nation’s seniors. The coverage is so extensive, it’s unusual for a senior to find themselves in a medical situation where at least some of the bill, if not most, isn’t paid by Medicare.
Having such complete coverage does create something of a problem, though. It might be easy to assume that you have no medical worries and that everything’s okay. Keep reading…
Medicare is primarily a major medical plan, and it is helpful to remember that fact. Medicare does pay for a nursing home stay, but here’s the fine print. First, you must be admitted to a hospital three or more days for a medical condition. Second, you must be transferred to a nursing home for rehabilitation. So, if you fell and broke your hip, the bill for the hospital, your doctors, and so on would be paid by Medicare. You need rehab, so you are moved to a nursing facility – still Medicare.
So what can go wrong? First, rehabilitation assumes that are continuing to get better. When you stop improving, the benefits end. Or, if you get grumpy and throw out your therapist, same result. In any case, there is a limit of only 100 days or the actual length of your rehab, whichever is shorter. You are personally responsible for all costs thereafter.
And don’t expect your health insurance will pick up the bill. A Medicare supplement is designed to pay for the “gaps” in coverage – not provide coverages outside the system. Check your policy, but it is unlikely you have any long-term protection.
In short, Medicare pays for short term rehabilitation, not long-term care. If you are relying on Medicare to help you pay for a nursing home, I suggest you reconsider. A shocking majority of Americans have no plan whatsoever for long-term care. The good news is that the Federal Medicaid system does provide long-term care benefits – but that’s a different article! For information, please visit the website below.