Will Medicaid Or Medicare Pay For LTC?What is the difference between Medicare and Medicaid... and will either of them pay for long term care expenses?
MedicareMedicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease.Most people get their Medicare health care coverage in one of two ways. Costs vary depending on the plan, coverage and the services used. Most long term care is furnished in nursing homes to people with chronic, long term illnesses or disabilities. The care they receive is referred to as custodial care. Medicare does not pay for custodial care! To qualify for the Medicare nursing home benefit you must spend 3 full days in an acute care hospital within 30 days of your admission to a nursing home. In addition, you must need skilled nursing care 7 days a week and/or rehabilitation services at least 5 days a week. Medicare will not pay for your stay if you need skilled nursing or rehabilitation therapy only once or twice a week. The longest stay in a nursing home that Medicare will pay for completely is 20 days. After that, it will only pay a portion of your bill. Once you have received 100 days of payment, the benefit expires. Do not rely on Medicare to pay for long term care expenses if you wind up in a nursing home. There is a provision that permits some payment if you receive skilled treatment in your home. The rules are very strict and, in all likelihood, would not provide you with anything significant in the way of reimbursement.
MedicaidMedicaid is for the poor and destitute. It’s a social welfare program with lots of rules and paperwork. Plus, it's struggling itself to keep up with increasing costs.Funding comes from both federal and state governments. Getting approved for benefits is very difficult for the average individual. Even if you could qualify (so-called Medicaid planning) --- the result would likely be humiliating for you and your loved ones. First, you would be considered a ward of the welfare court. You would have no say in how or where you would be treated. Second, the care you might qualify for will not be the type of long term care you would want to have. Recent changes in the law have tightened up even more one's ability to qualify for Medicaid assistance... unless they are genuinely destitute. Be extremely cautious if you are led to believe that rearranging your assets will permit your eligibility. This is a very dangerous planning strategy.
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