Does Medicare Pay For Long Term Care?
What is Long Term Care?
- Long Term Care consists of Medical and Custodial Care received at home or at a hospital or facility such as a Skilled Nursing Home or Assisted Living Facility.
- This Custodial care includes Activities of Daily Living (ADLs) such as bathing, dressing, eating, etc.
- The costs for this level of care can be significant.
- Unfortunately, Original Medicare does not cover the majority of custodial care.
- As a result, Medicare Advantage Plans do not cover Long Term Care.
- Medicare does cover Medical related care such as: Hospital Care, Physician Services, some Home Health Care, Hospice Care and Preventative Services.
- Medicare Part A does cover care up to 100 days in a Skilled Nursing Facility.
- However, there are certain requirements that must be met before they will cover the 100 days.
- This stay must occur after a Hospital Stay. Unfortunately, Medicare will not pay for any extra days the person may need in the Skilled Nursing Facility, or Long Term Care in a facility such as in an Assisted Living Facility.
The other options to pay for Long Term Care in Boynton Beach
- Most insurance policies provide limited coverage for Long Term Care.
- As a result, many people have to use personal funds.
- Some people purchase Long Term Care insurance policies. However, they are expensive and the coverage depends on the type of policy purchased.
Other Options: Extensive Government Programs:
- Program-Of-All Inclusive-Care for the Elderly (PACE). These are combined Medicare and Medicaid programs offered by some States. Usually people who qualify can continue to live at home. The program consists of a team of health care professionals including, medical, social services and long term care. A variety of services are offered. More information on how the programs work and where to find Local PACE programs can be found using the above website.
- Medicaid may provide financial assistance for Long Term Care. However, depends recipient have to qualify based on low income and assets.
- State Health Insurance Program (SHIP) have extensive information and education on local programs, how to apply and help with appeals. In Florida, the program is called SHINE, Serving the Health Insurance Needs of the Elderly.
- Department of Veteran’s Affairs. Covers long-term care for some Veterans at a facilitiy of home.
- National Council on Aging has a useful tool which connects older Americans and disabled people to programs they may qualify for and apply on their website.
- Social Security Disability pays monthly income to disabled and older adults with little or no income and assets.
