Many people falsely think Medicare, or their health insurance, is going to pay for home care, or assisted living, or nursing home care when they become seniors and must have some assistance to live independently.
The fact is that neither private health insurance nor Medicare covers the cost of long-term in-home services you or your aging parent may need. But many private long-term care insurance policies and certain Veterans’ Administration benefits do. This post is meant to help you begin to understand your options.
Understanding Medicare
Medicare is a national United States health insurance program for people 65 and older. It is also for people with certain disabilities or end-stage kidney failure. Although millions of Americans have it, Medicare coverage is still widely misunderstood.
Though it may come as a shock to some readers, Medicare does not pay for any long-term care, including nursing homes, assisted living, and home care services.
However, Medicare does pay for certain short-term care options if ordered by the person’s physician, such as:
- Short-term skilled care in a nursing home or rehabilitation facility after an illness or injury. Coverage usually extends for the first 20 days, after which the individual must pay daily coinsurance, up to 100 days, at which point Medicare stops.
- Short-term home health care provided by physical, occupational, or speech therapists whose services are prescribed by a medical doctor.
- Short-term skilled nursing or therapy in the home, provided by advanced practice registered nurses (APRNs), registered nurses (RNs), or certified nursing assistants (CNAs) or physical, speech or occupational therapists. Care services may include injections, wound care, medication management, hospice care, and other medical treatments and procedures.
Financing Long-Term Care
Industry experts estimate that by 2030, 1 in 5 Americans will at the age where long-term care solutions are needed. Today, millions of Americans require extensive care, often in the home, but also through nursing home care and assisted living.
Private long-term care insurance is the most common solution used, but it can be expensive. A long-term care policy essentially provides reimbursement (up to a predetermined daily limit) for services relating to daily care, which may include hiring a home care aide to assist with bathing, toileting, dressing, meal preparation, and other activities of daily living.