Why You Can’t Rely on Medicare for Long Term Care

Like many of today’s aging adults, you may be starting to look at long term care options for yourself or a loved one. This is especially true if you are considering the possibility of nursing home care at some point in the future or you are looking for care for an elderly loved one.

Unfortunately, relying on Medicare is not an option.

Medicare is a wonderful program for aging and disabled adults. But it is limited in its scope when it comes to long term care and aging adults should understand its benefits and its limitations.

Although it’s true that Medicare will pay for some types of elder care, you can’t rely on it for things like nursing home care, assisted living, or even adult daycare facilities or services. This may be a surprise to some who have been counting on Medicare for future living options.

Medicare Does Some Things Very Well

• It provides recovery services in a skilled nursing care facility in the event that a patient needs additional care coming out of a hospital stay.
• It will pay for home health care when a patient is homebound subsequent to an injury or illness.
• It will pay for hospice services in the event of a terminal illness.

But long term care is not something that Medicare benefits cover.

Long term care is expensive. How expensive? Consider this data for median costs in 2020 in the New York metro area:

• $11,771 monthly for a nursing home semi-private room
• $12,927 monthly for a nursing home private room
• $5,991 monthly for an assisted living one-bedroom unit
• $4,957 monthly for a health aide or homemaker services

Of course, you may have substantial savings and assets that can offset these expenses. But many older adults are simply not prepared for them, especially since Medicare is off the table for them.

You do have options, however, and it’s important to begin to consider them as early as possible.

Qualifying for Medicaid is one option. However, because Medicaid is designed for low-income people, it is dependent on you showing you have very little in the way of assets and income. This can be done though and it is advisable to speak with an elder law attorney to help you put together a spend down plan.

Long term care insurance is another option. These policies are sold by insurance companies and will provide for many things that Medicare will not cover such as nursing home care and assisted living. When it comes to long term care insurance, it’s important to understand, however, that the older you are, the higher your premium.

Some companies will allow you to trade in a life insurance policy for a long term care policy. If you are or were employed by the government or served in the military, you may also qualify for insurance discounts.

Taking time to consider your options now is important for anyone who is aging in America today. Long term living is expensive and you want to position yourself early in the event that it becomes a reality for you or a family member. Talking to an elder law attorney can help you understand your options, assess your unique situation, and help you with money-saving strategies.

At AJC Law, we are an elder law firm dedicated to the concept of aging with dignity. We would be happy to discuss your options with you. Contact us at www.thechamberlainlawfirm or (201) 273-9763.