Article 108-Estate Planning Series: Will Medicare Pay for My Long Term Care?

Written by Wright Law on . Posted in Long Term Care

Last column I explained the options to pay for long term care are limited.  Adding to the problem is a significant amount of incorrect information about what those options are.  For example, many seniors erroneously believe Medicare will pay long term care costs.  This is not correct.

On the other hand, upon meeting certain conditions, Medicaid will pay for long term care.   I understand why people confuse the two.  Not only do the terms sounds similar but, in some cases, Medicare provides assistance for some of the same types of health issues as Medicaid. 

For example, Medicare Part A  covers care in a skilled nursing facility.  However, the coverage is only for treatment of certain conditions and only for a limited time.  In other words, the focus of Medicare is to treat short duration conditions which are expected to improve.  

For those who need skilled care, Medicare can help pay for those costs, but only up to 100 days for each benefit period.  Medicare covers other services for a longer period so long as the doctor continually certifies that those services are necessary to treat an illness or injury expected to improve.   Finally, Medicare can provide services for patients certified by a doctor as terminally ill (i.e. will probably live no longer than 6 months) even if the patient does in fact continue to live longer than 6 months.

By definition, the conditions for which Medicare provides benefits are not “long term.”  If the condition is not going to improve, or is not terminal, Medicare is not a long term option.  Unfortunately, there are many seniors whose ailment is not terminal, but will also not improve.  They need help with the most basic activities of daily living such as personal hygiene, dressing and eating. 

If certain conditions are met, Medicaid is an option.  Next column, I will explain the role of Medicaid for seniors in need of long term care, as well as its advantages and disadvantages.

© 2017 Steven J Wright  

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