Day: January 1, 2023

Long-term Care Planning: Medicare, Medicaid, and Insurance

Long-term care is something that people generally aren’t eager to think about. However, roughly 7 out of 10 people will require long-term care at some point during their lifetime. When the national average cost of a private room in a nursing facility is $9,034, older adults and families need to address long-term care in their financial and legal planning.

Long-term care is a general term that describes various care services that regular health insurance does not cover. It might include things like:

  • In-home assistance with routine daily activities (activities of daily living or ADLs)
  • Living in a nursing home or assisted living facility
  • Nursing care
  • Physical, occupational, or speech therapy

Because long-term care is not covered by health insurance, you need to make other plans to pay for it.

Does Medicare Cover Long-Term Care?

Medicare is a government-provided health insurance program for adults who are over the age of 65. It also covers some individuals with disabilities as well. Unlike Medicaid, Medicare does not depend on your income, assets, or disability status.

Adults who qualify pay for Medicare just as they would a private health insurance company. The main difference is that Medicare provides more extensive services and lower fees compared to the average private insurance company. In many cases, those receiving Medicare do not pay any insurance premiums at all for Medicare Part A, which provides hospital services.

Medicare Part A covers things like:

  • Care in a skilled nursing facility
  • Hospital stays
  • Hospice care
  • Some home healthcare

It does not cover more basic things that medical insurance might cover, such as doctors’ services, medical supplies, and preventive services.

Medicare also does not cover long-term care, including living in an assisted living facility or nursing home.

As a result, individuals and families cannot rely on Medicare to pay for the full cost of a nursing home or assisted living care. Instead, they need to make other arrangements to pay for long-term care.

Does Medicaid Cover Long-Term Care?

Medicaid might be an option to pay for long-term care in some situations. However, using it appropriately might require some long-term planning. In most circumstances, you will need at least five years to appropriately plan to use Medicaid for long-term care. Learn more about Medicaid planning by downloading our free e-book.

Long-Term Care Insurance

Neither regular health insurance nor Medicare addresses long-term care. So, how can individuals and families pay for long-term care? Long-term care insurance might be a good option.

Long-term care insurance is available from many private insurance companies. It generally covers expenses that Medicare will not cover. If you buy a policy under the age of 55, it is often more affordable than waiting until you are older.

Get Help with Long-Term Care Planning

You might also be able to tap into other resources to pay for long-term care, such as using investments or Veterans’ benefits. However, you need to have a full understanding of your options to plan appropriately.

Get help with long-term planning from the experienced elder law attorneys at Beasley & Ferber. We can help you review your options and make recommendations for your unique situation. Contact us today for more information.


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