Will Medicare Cover Long-Term Care?

You rely on Medicare for your healthcare coverage. But does it cover what you need, i.e., long-term care? The short answer is, no, Medicare does not cover long-term care. However, there is more to the story you need to know to get the coverage you need.

What is Long-Term Care

According to Medicare, long-term care is a range of services and support for your personal care needs. Most long-term care isn’t medical care. Instead, it is to help with basic personal tasks of everyday life like bathing or dressing.

What do you need to know from this definition? Long-term care may not be what you think it is. Medical long-term care has different limits and requirements than long-term custodial care, which includes daily living activities.

What Medicare Doesn’t Cover

So, what exactly does Medicare cover? What might be considered long-term care will likely be included under Part A, but maybe under Part B as well?

Part A covers emergency hospital and skilled nursing facility care, or home care if necessary. However, it is only covered up to certain limits. You can stay at a hospital for up to 60 days without having to pay. After that, you will have to pay a daily coinsurance.

When you think of long-term care, you probably think of care in a skilled nursing facility. In a nursing facility, you can receive care for ailments such as recovering heart conditions, therapy following surgery, and more. Most of these services will be covered under Part A or B.

However, coverage in these facilities is limited and will not live up to your expectations for long-term care. Part A only fully covers up to 20 days each year. After that, you will pay progressively more out-of-pocket.

You may also be covered for certain in-home treatments. This can include various in-home therapies, part-time nursing care, and more. However, it must be considered “medically necessary” and cannot include custodial care. Part A and B coverage overlap in many areas. Getting care in a nursing facility or at home is covered by Part A, but the treatments you receive must be deemed “medically necessary” for coverage from Part B.

What Medicare Does Cover

As you can see, there are a number of things Medicare doesn’t cover in terms of long-term care. There are, however, plenty of necessary things that Medicare will cover. You may not be able to receive custodial care, but you can receive the treatments you need no matter how long you need them as long as it’s considered medically necessary. And, if you have a supplement or Advantage plan, you can receive additional benefits to get even more coverage you may need.

Medicare Info You Can Trust—Call Jersey Medicare Solutions

Your Medicare coverage is important, and it’s important to us. We’re here to give you the advice you can rely on to plan for the future. Call Jersey Medicare Solutions at 1-800-549-6804 or email Info@JerseyMedicareSolutions.com.