What You Need to Know About Medicare Coverage for Long Term Care

Many retirees expect that Medicare will cover most of their healthcare needs throughout retirement, and that’s why they’re often surprised at their out-of-pocket expenses. Unfortunately, long term care, or nursing home care, is no exception to this rule. We don’t want you to experience an unpleasant surprise in the event that you ever need to stay in a nursing home or move to one permanently, or if you need in-home nursing care. So here’s what you need to know about Medicare coverage for long term care, so that you can plan for this potential expense in the future.

Medicare offers only limited coverage for long term care. You can obtain coverage for a few weeks in a rehabilitation facility or a short-term stay in a nursing home. After that, you will be responsible for the entire bill. And that can feel overwhelming, because nursing home care costs several thousand dollars per month and can vary greatly by facility.

Self pay is the obvious option. Many retirees end up self paying for a nursing home stay, but this can become problematic if you need to withdraw larger sums from your retirement accounts than you had planned. You don’t want to risk running out of money at this stage of life.

Long term care insurance is a wise choice. If you planned for the future back in your forties or fifties, long before you retired, you might have obtained long term care insurance at an affordable monthly premium. There might still be time to plan for this option, depending upon your age. But because premiums get higher after age 60 or so, long term care insurance becomes unaffordable for some people.

Medicare (Medi-Cal in California) does pay for long term care. You might be eligible for Medicaid, depending upon your income and assets. But because Medicaid is generally only available to those of lower incomes, not everyone can qualify. If you find yourself just above the income or asset limits, talk to an experienced estate planning attorney about how you can qualify while protecting those assets. And remember, not all facilities accept Medicaid payment, so carefully research the ones available in your area.

If you have questions about your Medicare plan, give us a call. We can help you understand your plan’s limits, and come up with alternate ideas in the event you need an uncovered service.

Posted by PGIA
8 months ago / June 21, 2023

Filed Under: Medicare Info