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DO YOU UNDERSTAND MEDICARE?

The Elder and Disability Law Firm, APC Feb. 16, 2016

Long-term care is becoming increasingly common for individuals. With the rising numbers of Alzheimer's cases in the United States, it is imperative that family members protect themselves from the burdening costs associated with long-term care. All too often families are blindsided by the costs and often Medicare doesn't cover the long-term needs of an individual.

THE MISCONCEPTION

Too many individuals assume that Medicare pays for long-term care, but it doesn't. It is imperative that a person make preparations to preserve their assets to cover the costs associated with long-term care and especially to absorb the remainder of what Medicare doesn't pay - which is a significant chunk.

Part of the reason people misunderstand how Medicare works is they misunderstand the term "nursing care." There are two types of nursing care:

  1. Skilled Care - Medicare will pay for skilled care, but only so much. This is the care required to help restore an individual to how they once were. Medicare will cover up to 20 days if you were previously admitted to the hospital for a minimum of three days. Days 21 to 99 you can still receive coverage, but you'll have to pay a premium (which can start as low as $125 per day and go up). After you've reached 100 days, Medicare will no longer cover your skilled nursing care, even if you require it.

  2. Long-Term Care - Long-term care is not covered by Medicare whatsoever. To Medicare, long-term care is more like custodial care. It doesn't improve your lifestyle or functioning, so you won't receive assistance from Medicare. Long-term care may include assistance eating, toileting, bathing, etc.

If you suspect you'll need long-term care, it is in your best interest to start planning ahead of time and not assume Medicare has you covered.

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