Does Medicare Cover Long-Term Care?

Long-term care is a popular insurance term nowadays. With the aging population, there is a lot of talk about how the younger generation is going to take care of aging relatives. With that consideration, many people are discussing, or relying on, long-term care. Long-term care is generally a variety of services that includes medical and non-medical care for someone who has a disability or chronic illness.

In general, Medicare does not cover most long-term care. Most long-term care falls under the definition of “custodial care” – this is care to help someone with the daily activities of living, such as dressing, bathing and using the bathroom. This kind of care is also called “non-skilled care”.

Medicare does pay for some versions of care that fall under the long-term care umbrella. For example, Medicare does pay for “skilled care” at a skilled nursing facility (SNF) that is deemed medically necessary. Also, Medicare does pay, in some instances, for home health care. However, in both of these situations, you must meet Medicare’s eligibility requirements in order to receive the care, the first of which is that the care must be considered medically necessary. If you do not know whether your care will be covered by Medicare, the most accurate way to find out is to speak with the care provider’s office to find out how it will be filed/treated by Medicare.

There are, of course, long-term care insurance policies, which are an option if you want to be secured with some sort of long-term care. These policies are best purchased between the ages of 45-60, in most cases. Once you are over that age, cost can be somewhat prohibitive, although they are still a viable and useful option if you want to be protected against the escalating cost of healthcare.

If you have any questions about Medicare or Medigap plans, you can contact us on our website or call us at 877.506.3378. Although Medicare Supplements do not help you pay for long-term care, in most cases, they do fill in the gaps in Medicare’s coverage of care at a skilled nursing facility. Also, they fill in many other gaps in Medicare – things that Medicare does not cover.

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