Does Medicare Cover Long-Term Nursing Home Care?

Posted by Jeimy Ramirez-Figueroa
Estimated Reading Time 1 minute 27 seconds

If you’re 65 years old today, you face a 70 percent chance of needing some type of long-term nursing care at some point in your life. And about 20 percent of you will reside in a nursing home for longer than five years. But with nursing home facilities costing several thousand dollars per month, how do most residents cover the expense?

You might assume that Medicare covers the cost of a nursing home, but that’s a common error. In fact, Medicare only covers temporary stays in rehabilitative facilities for specific reasons. Otherwise, the bill for nursing home care falls on you. You can plan for this expense in a number of ways, such as…

Long-term care insurance. If you thought ahead, you might have purchased long-term care insurance at some point during your fifties or early sixties. This important retirement planning step can help you to manage the cost of long-term care in the future. Depending upon your policy, you might be able to choose from a range of facilities or even in-home care.

Medicaid. While Medicare does not cover the cost of a nursing home, Medicaid (known by various other names depending on your state) does. This healthcare program, run jointly by the federal government and individual states, helps those with lower income and fewer resources to afford medical care and even the cost of a nursing home. However, not everyone will qualify.

Even if you don’t initially qualify for Medicaid, keep in mind that over time your financial status can change. Reapply if you think you might have become eligible, or work with an estate planning attorney who can help you learn about the asset rules.

Self pay. And of course, many nursing home residents have simply chosen to self pay for the facility. This route might be feasible for those who have saved significant resources for their retirement years, and/or draw a generous Social Security benefit.

For more information on covering the cost of a nursing home, contact a licensed agent. We can help you learn what to expect from your current Medicare policy.