Many times, people ask, “Won’t I be covered for nursing home care if I got Medicare? Does Medicare pay for that cost of care?” And the answer is that they are two different programs.
Medicare is basically health insurance for retirees. You pay a premium, you get a benefit. Medicare covers medical care. You can think of it this way, Medicare will help to pay for your cost of care if you’re going to get better. If you’re in a hospital or if you’re in a nursing home, and you’re going to get better and come home, that’s when Medicare cares.
But it’s when you’re not going to be coming home, or when you’re not going to get better, instead of needing medical care, that you need custodial care or long term care in the nursing home, that’s when Medicare stops caring. And we have to look for a different way to pay for that cost of care.
One of the ways of doing that is through the Medicaid program. Medicaid is very different than Medicare. Now, Medicare does pay for nursing home care in one limited circumstance, and that is where a person goes to a hospital, receives care there for at least three days and then goes into a skilled nursing facility for rehabilitation. Medicare in that situation can pay up to a hundred days of care, at least a portion of that cost of care, but none of those days are guaranteed. Medicare will only benefit those who are going to be in for rehabilitation.
Beyond that, we have to look for different ways to pay off that care in a nursing home. And generally that’s going to be their private pay, VA benefits, Medicaid, or perhaps long term care insurance.