Today, people are living longer than ever before. In fact, it has been said that many who are already alive right now will live long past age 100. While this is great news, it also means that many people will require assistance either on a physical level, for cognitive reasons, or both – and this long-term care can come at a substantial price. Last year, the average cost of a private room in a skilled nursing home facility was approximately $90,000. With savings rates so low and a recent roller coaster stock market, where will retirees get the needed funds to pay this tab? Little can be done to lower the expense of long term care, however you can offset some of the costs.
While many are under the misconception that Medicare pays for most – or all – long-term care services, this is unfortunately not the case. It’s vital that you understand exactly what Medicare Part A will cover when dealing with long-term care. Any confusion or misunderstandings could lead to you having to pay thousands of dollars of your hard earned money for the care and services. It can quickly drain your savings account and put financial strain on you and your loved ones.
Part A of Medicare does, however, cover some qualifying long-term care costs. These include certain expenses for semi-private rooms, meals, skilled nursing and rehabilitative services, and certain other medically necessary services.
But these expenses are only covered when the Medicare enrollee has entered into the skilled nursing home facility immediately following a 3-day inpatient hospital stay (not including the day of discharge) for a related injury or illness. (A qualifying inpatient stay, according to Medicare, will begin on the day that the enrollee is formally admitted with a doctor’s order).
In addition, in order to qualify for Medicare approved long-term care coverage in a skilled nursing home facility, the enrollee’s doctor must also certify that the individual needs skilled care. This may include care such as physical therapy or IV injections.
It is important to note that Medicare does not cover custodial care, such as basic assistance with activities of daily living – especially when assistance with these activities is not needed in conjunction with another more serious, and recuperative, illness or injury.
If a person does qualify for Medicare covered care in a skilled nursing facility, he or she will have all of their costs paid in full for the first 20 days of each benefit period. Following that, should they need to stay longer in the nursing facility, they will be required to pay the following amounts (in 2018):
- $167.50 per day for day 21 through 100
- Covers everything after 100 days each year
Because the Medicare enrollee will be required to pay a great deal of money out of pocket – even after just 20 days in a skilled nursing home facility – it may be a good idea to consider one of the Medicare Supplement insurance policies that cover the Medicare skilled nursing home coinsurance. Having a Medicare Supplement Insurance Plan that covers this, can potentially save an individual or couple thousands, even after just a very short period of time, should they require a long-term care need.
Given today’s longer life spans, the likelihood of living longer is great – meaning that the probability of long-term care is also heightened. Having this financial need protected with Medicare and Medicare Supplement can help to protect retirement assets.
Medicare Supplemental insurance policies are handled through insurance companies, and operate similar to just about any other kind of insurance plan. With ten different plans available, you can find something to fit your goal. A is the most basic supplemental plan and only covers a few of the expenses that are left behind by original Medicare, while Medigap Plan F is the most extensive but covers everything.
If you’re worried about having to pay for the expenses bills that come along with long-term care, or any of the other expenses that Medicare doesn’t reimburse, then these supplemental policies are a great way to offset those costs. When deciding on the best plan for you, acknowledge the different circumstances that could affect your decision, your health, finances, healthy history, and more. If you’re in great health, with few problems in your past, you could consider applying for a policy that isn’t’ extensive, but is more affordable and saves you money every month.
You also have to take some time to look at your finances and budget. If you’re living on a fixed income, additional health coverage comes at a price that may not be able to fit comfortably in your budget. Having a Plan F that gives the most additional coverage would be perfect for everyone, but that doesn’t mean that every enrollee is going to be able to afford a Plan F.
If you have any questions about Medicare coverage and long-term care, we would be happy to answer those questions. Long-term care can cause havoc on your savings account if you don’t plan for it. That’s why it’s vital that you get the coverage you deserve. Additionally, if you have any questions about any of the Medicare supplemental insurance policies, we can get you a quote and get you connected with the Medigap policy that fits your needs perfectly.