Does Medicare Cover Long-Term Care?

Unfortunately, Original Medicare does not provide coverage for long-term care, including nursing home care or assisted living.

While Medicare Part A and Part B don’t cover long-term care, they do provide coverage for home healthcare services. Medicare may pay for an aide if you need professional home care, like skilled nursing or therapy services.

The services offered by a home health aide include help with tasks like bathing, toileting, and dressing. But, if you only need personal care and not skilled care, Medicare won’t cover the cost of an aide.

How Can I Pay For Long-Term Care?

For those who do not qualify for Medicare coverage and have a low income, there are other options for long-term care coverage, such as Medicaid, long-term care insurance policies, or paying out of pocket.

Using Medicaid For Long-Term Care

Medicaid covers long-term care for those who qualify. Eligibility typically depends on a person’s income and resources.

If you meet the requirements, you can use Medicaid services to cover some or all of the costs associated with nursing home care, assisted living facilities, adult day care programs, home health care services, and other types of long-term care.

Speaking with your local Medicaid office for more information about eligibility and coverage options is essential.

Long-Term Care Insurance Policy

Long-term care insurance covers a wide range of services related to long-term care, such as nursing home care, assisted living facilities, adult day care programs, and home health care services. Long-term care benefits vary depending on your chosen policy and may include some or all of these services.

Plans of this type can help reduce the financial burden of receiving care services. It’s important to carefully review your policy and speak with your insurance provider for more information about premiums and the coverage you will receive.

Alternative Solutions

If Medicaid coverage or long-term care insurance is not an option, other ways exist to pay for care needs. Depending on your circumstances, you may be eligible for one or more of the following:

• Veterans benefits
• Social Security income
• Savings from a reverse mortgage
• Supplemental health insurance plans
• State programs for long-term care cost coverage

Bottom Line

Medicare does not cover long-term care, but several other options exist to help pay for it. Each option has its eligibility requirements and coverage levels, so it is essential to speak with your local Medicaid office or insurance provider before making any decisions.

Understanding the different options available can help you make an informed decision about which solution is best for your situation.

Sources: Medicare.gov – AARP – Forbes

FAQs

• What if I have a Medicare Advantage plan or other medicare health plan?

  Most Medicare Advantage Plans (like an HMO or PPO) and other Medicare health plans don’t provide long-term care coverage. Check your plan for more information.

• How many days will Medicare pay 100% of care in a skilled nursing care facility?

  Medicare covers up to 100 days of care in a Skilled Nursing Care Facility in a single benefit period as long as you stay eligible.

• Can you run out of Medicare benefits?

  There is no maximum number of benefit periods. You must first pay a certain amount for the services and items covered each year before Medicare begins to cover them. Under Original Medicare, these are extra days that Medicare will cover if you are hospitalized for more than 90 days.