Will Medicare Pay For Long Term-Care In A Nursing Home?
Most long-term care delivered in nursing homes is provided to people with chronic, long-term illnesses or disabilities. The care they receive is personal care, sometimes still referred to as custodial care. Medicare does not pay for this kind of care. It pays less than 10% of all nursing home costs. Medicare only pays when you are receiving medical and rehabilitative care, and then only for a set period of time. To qualify for the limited Medicare nursing home benefit, you must have first spent three full days in a hospital within 30 days of your admission to a nursing home. You must also need skilled care that only a licensed professional can provide, every day of your stay. If you meet these requirements Medicare will only pay the full cost of nursing home care up to the first 20 days of a covered stay. After the first 20 days, if you still require daily skilled care, Medicare will only pay part of the nursing home bill. You will have to pay a co-payment for each day for the next 80 days that Medicare continues to pay for your stay. Medicare will not continue to pay after it has paid for your nursing home care for 100 days within a benefit period.
Will Medicare pay For long Term-Care In My Home?
Yes, but only if you meet certain stringent requirements of the Medicare program and only for a set period of time. These requirements apply whether you are in a Medicare managed care program like an HMO or receiving traditional Medicare fee-for-service benefits. You must be homebound and require skilled nursing or rehabilitation services at least several times weekly that only a licensed professional can provide. The services you receive must be from a home health care agency that participates in Medicare.
You may also receive some personal care services along with any skilled care you require. However, Medicare does not pay when personal care is all you need, and it doesn't pay for general household services such as laundry, shopping, or other services you receive in your home. Remember that Medicare also may not pay for all of the services that a home health agency provides, and you may need to pay those costs yourself.
Does Disability Income Insurance Cover Long-Term Care?
No. Disability Income insurance doesn't pay for medical care, personal care, or long-term care, regardless of whether it is "short term" or "long term" disability income protection. The purpose of this type of insurance is to replace earned income. Disability Income insurance generally pays a percentage of an employed person's earned income if they are disabled while covered by the plan. Because it's called disability insurance, some people may mistakenly assume they are also covered for the costs of long-term care services.
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