Did You Know: Does Medicare cover long-term care

Does Medicare cover long-term care? No.

A beneficiary could end up in a skilled nursing home after a fall, surgery, or other incidents that require temporary rehabilitation that IS covered by Medicare. However, once you are discharged and no longer covered by Medicare you move to self-pay.

If you are transferred to a skilled nursing home due to the reasons listed above and it’s determined that your level of care requires custodial care (24 hours) you can apply for Medicaid or Medicaid spend down to qualify for assistance. For example, if your income is above the Medicaid annual limit, but your level of care costs can spend down your assets/income to below Medicaid level, you could be approved. The level of care would be assessed by the facility and Medicaid.

Medicaid programs vary from state to state. Most often, eligibility is based on your income and personal resources. Many states have higher Medicaid income limits for nursing home residents. You may be eligible for Medicaid coverage in a nursing home even if you haven’t qualified for other Medicaid services in the past. Learn more: https://www.medicare.gov/what-medicare-covers/what-part-a-covers/how-can-i-pay-for-nursing-home-care

Many people are advised to cancel their Medicare Health plans when they have Medicaid and move into a long-term care facility. This is because Nursing Home Medicaid will cover all of your health care costs – skilled care (physicians and nurses), non-skilled care, medications, supplies and durable goods, etc. – once you are in the program and living in a nursing home.

Long-term care costs are expensive and require a financial analysis that you can self-pay for two or more years to be accepted to a facility. Most people who enter nursing homes start by paying for their care out-of-pocket. Individuals do have the ability to purchase a long-term care insurance policy when they are healthy, or add long-term care riders to their life insurance or annuity policies to help in these circumstances.