What You Need to Know About Medicare & Long-Term Care

By Michelle Cemental

Long-term care is likely the furthest thought from your mind right now. You could have years comfortably living in your home, caring for yourself, before you need to worry about it. Being prepared, however, is a crucial part of the retirement process. Turning 65 means that you need to know about Medicare—and that includes your options for long-term care. But don't worry! Here is an easy guide to help you understand how Medicare works when it comes to long-term care.

Does Medicare Cover Long-Term Care?

Generally, Medicare does not cover long-term care. Long-term care has specific and conditions that deem it ineligible for Medicare to provide payment. However, there are some types of services and long-term care aspects that it will provide payment for for up to 100 days. 

Different parts of Medicare will pay for different areas of long-term care: 

  • Part A: nursing facilities, hospital stays and home health care

  • Part B: doctor visits, medical supplies and outpatient procedures

  • Part D: prescription drugs

Medicare Part C, also known as Medicare Advantage Plans, gives you Part A and B coverage through private insurance companies instead of through the government-run program. Medicare Advantage Plans may include private prescription drug coverage like Part D. While Part A is free for those who qualify, the other parts cost money each month. 

For more information on each part of Medicare, check out our blog post: Understanding Each Part of Medicare.

According to an article published by McKnight's Long Term Care News, over one-third of all Americans believe that Medicare will cover their long-term care needs. That's why it is crucial to learn about Medicare now so that you can plan for the future. 

Medicare will sometimes cover in-home care.  

If you're in need of more care than your family is able to provide, but don't think that you need to move into a nursing home yet, you have the option for in-home care that will help you with daily care tasks, meal delivery or preparation, and even transportation to and from medical appointments.  

Medicare will help pay for the cost of your nursing home.

Many states are going to a new model that pays out a certain amount for all of the services that you need while you're being cared for in a nursing home. This helps to ensure that you aren't going to receive unnecessary procedures and services simply because the nursing home wants to be paid for them.  

Medicare won't pay for retirement community living.

For many aging seniors, a retirement community seems like the perfect way to pass the years between being able to comfortably remain at home and needing nursing home quality care. At a retirement community, you're surrounded by others in the same stage of life you're currently in.  You have access to help if you need it. Unfortunately, Medicare won't pay for this option until you need continuous care in a nursing home setting, and in many cases, you won't be able to get into a retirement community unless you start with the lower-level services.  

Looking into your options about Caring Senior Service and how we can help with long-term care. It's best to start planning now because you only have a 6-month window around your 65th birthday to sign up for Medicare without any penalties.

Also if you are discovering that you have more questions than answers, feel free to contact your local Caring office for more information.

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Tags: Long-Term Care, Medicare