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Will Medicare or Medicaid Pay for Long-Term Care Services

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Feb 26, 2015

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Idaho - Boise and the Treasure Valley

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Will Medicare or Medicaid Pay for Long-Term Care Services? Many people need some sort of long-term care services and support later in life as their ability to care for themselves declines. These services, such as assistance with bathing or showering, dressing, eating, transferring, toileting or continence can be provided in a persons home or long-term care community. May people who need long-term care services are confused about how much these services cost and who will pay for them. Some people think Medicare pays the costs. Others think they merely have to apply for Medicaid to have the government pick up the costs. Neither is necessarily correct. Medicare and Medicaid are two completely different programs which cover different services. Medicare Medicare is a health insurance program run by an agency of the federal government. It is available to all United States citizens above the age of 65 regardless of their income, providing that he or she paid taxes into the Social Security fund. It is basically run the same everywhere in the United States. Patients pay part of the cost through deductibles for hospital and other medical services. Medicare only covers medically necessary care and focuses on medical acute care such as doctor visits, drugs and hospital stays. Medicare coverage also focuses on short-term services for conditions that are expected to improve such as a short stay in a rehabilitation facility, or physical/occupational therapy to help a patient regain function after a fall or stroke. Medicare does not cover long-term care services. Medicaid Medicaid is a joint federal and state government program that helps folks who have low income and minimum assets pay for non-medical long-term care services provided at home or long-term care community. Each individual state runs its own Medicaid program. Unlike Medicare, Medicaid pays for personal care assistance on a long-term basis even if there is no expectation that a persons condition will improve. Under the Federal Spousal Impoverishment Act, the government provides protection for married couples whereby a certain amount of the couple's combined assets and income are protected for the well spouse while the other spouse is qualified for Medicaid. For persons who do not meet the low income and asset criteria for Medicaid coverage, private paying from income and savings is the most common source to cover long-term care costs. Long term care insurance helps cover costs for those who purchased a policy earlier in life. Family members also play a large part by providing informal primary caregiving services to loved ones who need help. This article was written by Donna A. Schuyler, Attorney, who practices in the areas of estate planning, elder law, guardianship, and probate. Donna Schuyler Law, PLLC; elderlawboise.com. Phone 208-344-1947

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