Medicare covers a number of the healthcare services needed later in life, but not all of them. Many people are confused about what its limitations are. One of the essential questions that should be asked is: does Medicare cover long-term care for my parents?
No Long-Term Coverage for Daily Care
The short answer is: no. “Traditional” Medicare does not cover long-term care at home or in a skilled nursing facility. If someone needs to move into a nursing facility for ongoing medical support because of disability or age, Medicare will not pay for care over a long period of time. Adult day care, assisted living, custodial care, and in-home assistance with Activities of Daily Living (ADLs) are not covered either. Unlike “traditional” Medicare, some Medicare Part C plans (also known as Medicare Advantage plans) may provide some coverage for these services, but you need to check your policy for specifics.
You never know when long-term care might be required, so it is important to consider how you and your parents will pay for this type of care should you need it. For example, long-term care insurance policies can be used to pay for things not available through standard Medicare coverage, such as nursing home care, assisted living, in-home support, and more. Some people may qualify for Medi-Cal, a public insurance program financed by the State of California and the federal government, to pay for long-term care in a facility setting.
What is covered by Medicare?
Certain medical care services are available through Medicare, such as:
- Skilled Nursing Facility: After a long hospital stay (3 days or more), Medicare offers coverage for a stay in a skilled nursing facility. The first 20 days are paid in full, then the patient’s Medigap (or supplemental) policy typically pays a portion of the daily cost. Medicare coverage stops after 100 days in the facility. The patient must qualify for skilled nursing care under Medicare guidelines, so 100 days of coverage are not “guaranteed.”
- Hospice: In the final stages of a terminal illness, hospice care is provided to ensure comfort. These hospice services are available if you are not receiving curative treatment for the illness, and the doctor has determined that life expectancy is less than six months. Palliative care services are also available to treat pain and other symptoms of chronic illness.
- Home Health: When an injury or illness results in a homebound situation, short-term skilled care can be accessed through Medicare. Therapists and nurses can provide services in the home up to 28 hours per week, depending on the doctor’s recommendation.
Best Solutions: Long-Term Care for My Parents
If your parent needs long-term care, then it can be helpful to work with a team that knows how to find the best services in San Diego. At Windward Life Care, we offer the personalized support you deserve to evaluate your parents’ needs and access the right providers. Call today for a complimentary phone consultation.