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DOES MEDICARE COVER LONG TERM CARE?
Medicare is mainly designed to cover medically necessary care and focuses only on medically acute care (doctor visits and hospital stays) or short term services when the condition is expected to improve. Generally it doesn't pay for most Long Term Care and/or custodial care for assistance with ADLs.
Medicare will help pay limited skilled nursing care facility, hospice or home health care if you meet certain conditions described below:
- You have to have stayed in a hospital for at least three days
- You have to have admitted to a Medicare-certified nursing facility within 30 days prior to your hospital stay
- You need skilled care and/or physical or other types of therapy
If these conditions are met, Medicare will pay:
- Portion of your cost for up to 100 days
- For the first 20 days, Medicare will pay 100 percent of your skilled nursing facility cost
- For days 21 - 100, you have to pay for your own expenses up to $128.00 per a day and Medicare will pay for the balance
- For days over 100, you pay 100 percent for as long as you stay in a skilled nursing facility.
