Is Medicare Reliable for Long Term Care?
Designed for individuals that require short term care or those that need constant monitoring as they recuperate from an illness or injury, Medicare is definitely not a consideration for someone who is planning his or her future healthcare. So this really comes as a puzzling question – will Medicare pay for long term care?
Perhaps that can be answered with a yes if the individual who is seeking for Medicare coverage has stayed for three consecutive days in a hospital prior to his entry to a nursing home to receive skilled nursing care. After all, one of the goals of this federal health program is to help a person recover from an injury or illness so that he can go back to his normal life.
Providing custodial care or simply assistance in the activities of daily living (ADL) such as eating, bathing, toileting, dressing, transferring, and continence has never been part of the Medicare program. It is Medicaid that extends this type of service to low income individuals and families; and even to those who have assets provided that they spend down their assets up to the required asset limit in their state of residence.
Medicare will only provide full long term care coverage to an individual who enters a nursing home after having been confined for three days in a hospital to receive medical care. This full nursing home coverage, however, is only limited for 20 days.
After shouldering a patient’s nursing home expenses for 20 days, Medicare will continue to pay just a smaller portion of the person’s daily nursing home expenses so the latter has to be financially equipped to pay out-of-pocket the amount which Medicare will no longer cover.
It’s distressing to hear 60-year-olds ask will Medicare pay for long term care because it’s obvious that they have not planned their long term care. Five years from now they will retire from their jobs and perhaps start to shop for a long term care insurance (LTCI) policy. Unfortunately, not everybody at 60 can still boast a health in tiptop condition.
If a 60-year-old person is found healthy by an insurance firm marketing LTCI policies then well and good as he won’t be subjected to an extremely high annual premium. Unfortunately, this is a rare case because most people who waited till they’re past the age of 50 before securing an LTCI policy winded up paying twice the annual premium of a 50-year-old.
Still, many of them don’t neglect purchasing a policy even later in their lives rather than be forced to pay out-of-pocket for their LTC expenses. At present, the average annual rate of a private nursing home is $77,745. Those living in the south, however, are faced with higher rates.
For an assisted living facility, expect to fork over $39,552 annually or an average monthly rate of $3,296. Now before thinking that home care is the cheapest option, think again. It’s only a fraction lower than the price of an assisted living facility at $36,480 per year.
Knowing the cost of care is going to help you plan your LTC needs efficiently. It will also prevent you from asking will Medicare pay for long term care, a nonsensical question which obviously came from an unprepared citizen.
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