Many believe that Medicare will pay for most of their long-term care expenses. While Medicare will pay for some LTC related services, it does not provide payment for the comprehensive LTC services that are usually needed. Most long-term care isn’t medical care and Medicare will only pay for medical care. Instead, most long-term care is help with basic personal tasks of everyday life, sometimes called activities of daily living.
Not Covered by Medicare:
Custodial care is one of the primary aspects of long-term care and is not covered by Medicare (except in limited circumstances). This is personal care given to someone to help them with activities of daily living (ADL- eating, bathing, dressing, toileting, transferring (walking) and continence). These make up the majority of LTC services and are the primary source of long-term care.
Nursing homes, assisted living facilities, home healthcare and adult day care are not covered unless it is skilled nursing care, prescribed by a doctor and on a part time basis and the individual must be “confined” (unable to leave their home without assistance).
Ongoing care is not covered by Medicare. Skilled nursing care beyond 100 days is not covered.
Covered by Medicare:
Medicare will cover some LTC services but in general they are very limited in both scope and time. In addition, you must need medical care and not just Long-Term Care. For a complete list of what Medicare covers please see: https://www.medicare.gov/coverage/long-term-care.html
What does this mean for me?
Do not count on Medicare when creating your Long-Term Care plan. Medicare only helps with Long-Term Care needs on a very limited basis. Call us today and we will help you create a Long-Term Care plan that fits your needs!