(888) 335-8996

Speak with a Licensed Insurance Agent

Search
Close this search box.

Long Term Care Planning for Seniors

Summary: Long term care includes services that help to meet a person’s everyday care needs. Medicare (specifically Medicare Part A) will cover long term care costs if certain criteria is met. However, Medicare Part A does not cover 100% of the costs. There will still be costs you must cover as the patient. Estimated Read Time: 7 min

Find Medicare Plans in 3 Easy Steps

Let us help you navigate your Medicare journey

Table of Contents:

  1. What is Long Term Care?
  2. Guidelines for Long Term Care Coverage Eligibility Under Medicare
  3. How Much Does Long Term Care Cost?
  4. What is the Long Term Care Partnership Program?
  5. What’s the Difference Between Medicare vs. Long Term Care Insurance?
  6. Estate Planning With Long Term Care in Mind

As we age, we become more susceptible to illnesses and hospitalizations. Unfortunately, the older we get, the more likely we are to require the need for long term care to help with everyday tasks.

Long term care planning is extremely important in the estate planning process. When you are planning for long term care, it is important to budget costs and ensure the care you receive is adequate.

What is Long Term Care?

Long term care includes a variety of services that are designed to meet a person’s everyday care needs. At some point in life, it is not uncommon to require the help of a long term care professional. So being able to plan ahead is an important step that should not be overlooked when you are planning for your estate.

In some cases, the need for long term care can happen suddenly, without the proper time to prepare for the event. Thus, having a pre-determined action plan is helpful if this situation ever arises.

Most long term care costs are the patient’s responsibility. But, in some cases – limited coverage is available. Most individuals seeking long term care are Medicare-eligible. However, to qualify for long term care benefits under Medicare, you must obtain treatment at an approved facility.

After meeting requirements, Medicare may pay for a short-term stay in a skilled nursing facility.

Guidelines for Long Term Care Coverage Eligibility Under Medicare

Medicare Part A will cover long term care costs if certain criteria is met. However, Medicare Part A does not cover 100% of the costs. There will still be costs you must cover as the patient.

Medicare may pay for long term care under the following conditions:

  • You are admitted as an inpatient at an approved hospital for at least three days
  • You are admitted to a Medicare-approved nursing facility within 30 days of your inpatient hospital visit
  • You require additional therapy such as physical or occupational
  • Your condition medically demands skilled nursing services

Medicare long term eligibility starts after meeting these requirements and pays for a maximum of 100 days during each benefit period.

Find Medicare Plans in 3 Easy Steps

Let us help you navigate your Medicare journey

How Much Does Long Term Care Cost?

Aside from the inpatient costs that Medicare Part A covers, Medicare does not cover the full cost of long term care. Medicare only pays for long term care for a short time under specific requirements.

Medicare Part A covers hospital inpatient care, but you may have a deductible and coinsurance expense for each benefit. Medicare stops covering the costs once you exhaust your lifetime reserve days. Meaning, you’re responsible for ALL costs of long term care.

However, outside of Medicare, other programs are available to help with long term care costs. For example, Medicaid aids low-income individuals or families to help with healthcare costs.

The Medicaid program is the largest payer in the country for long term and nursing home care. If you do not qualify for Medicaid services, other alternatives include buying private long term care insurance.

Private insurance companies sell insurance for long term care; costs and benefits often vary among plans. A private nursing home room costs on average $9,733 each month. You can imagine how financially exhausting this may become – and fast if you’re unprepared.

What is the Long Term Care Partnership Program?

The Long Term Care Partnership program helps protect your assets from being seized to pay for long term care coverage. The program is protection for your lifestyle, income, and assets.

Although conventional long term care insurance is required to qualify for Partnership asset protection, without long term care insurance, family or personal assets and income likely pay the hefty medical bills. The Partnership Program helps keep some of your finances in order when receiving care. However, requirements or Long Term Care Partnership Program eligibility varies among states.

What’s the Difference Between Medicare vs. Long Term Care Insurance?

Comparing healthcare coverage, Medicare doesn’t pay for most long term care services. Leaving the costs up to the patient; that’s where Long Term Care insurance is beneficial. Long term care insurance helps pay for nursing home care, assisted living facilities custodial or personal care, and extended home assistance.

Find Medicare Plans in 3 Easy Steps

Let us help you navigate your Medicare journey

Even if you have Medicare coverage, you can also enroll in a long term care plan to help cover these costs. Having the additional coverage acts as a safety net to ensure you do not lose all your assets to pay for the care you receive.

Estate Planning With Long Term Care in Mind

If you are in the process of estate planning, long term care may not be a topic that crosses your mind. However, ensuring you have the proper finances and protections in place to cover your long term care is crucial.

Continue reading our estate planning guide for more information on keeping your estate planning documents safe.

Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare guru serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

Comment

Your email address will not be published. Required fields are marked *

X