Will the Government Pay for My Long Term Care?

April 16, 2012 § 2 Comments

A study by the U.S. Department of Health and Human Services says that “people who reach age 65 will likely have a 40 percent chance of entering a nursing home.  About 10 percent of the people who enter a nursing home will stay there five years or more.  This year, about nine million men and women over the age of 65 will need eldercare.  By 2020, 12 million older Americans will need eldercare.   Most will be cared for at home; with family and friends as the sole caregivers for 70 percent of the elderly”. Medicare.gov

A new population of seniors and those nearing the senior status are looking for some type of financial means to pay for long term care (eldercare) in case of failing health.   Many have taken care of family members who had no means to pay for their care or have seen their parents entire retirement savings wiped out because of medical and nursing home costs.

Does the government Medicare program pay for eldercare costs?

A statement on the Medicare.gov website clarifies what Medicare will pay for.

“Generally, Medicare doesn’t pay for long-term care.  Medicare pays only for medically necessary skilled nursing facility or home health care.  However, you must meet certain conditions for Medicare to pay for these types of care.  Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom.  Medicare doesn’t pay for this type of care called “custodial care”. Custodial care (non-skilled care) is care that helps you with activities of daily living.  It may also include care that most people do for themselves, for example, diabetes monitoring.  Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility and home care (skilled care) coverage if the care is medically necessary.”

How does Medicaid cover long term care costs?

Fortunately, there is a government program that will help pay for long term care costs – Medicaid.

Unfortunately, this program is unfairly discriminatory and will only pay for care for individuals who have less than $1,500 to $2,000 in assets (and in about 22 states, the program will only cover individuals who fall below a certain income threshold).  All other individuals wanting help from Medicaid must impoverish themselves paying for their own eldercare services first, before Medicaid will help them.

Planning for the final years of life and dovetailing government programs, care provider systems and funding sources can be invaluable yet complicated.  This area of planning can be one of the most challenging endeavors undertaken by anyone attempting to help seniors in this final phase of life.

With the help of a trained professionals who understands all of the issues pertaining to eldercare, a plan can be prepared to protect assets, locate appropriate funding and provide the necessary support to ease the burden for the final years of life.  The Law Office of Dawn M. Weekly, PC provides such services with their Life Care Plans for client.  Contact our office for an initial appointment and we will help you put together a plan for possible long term care costs.

The Law Office of Dawn M. Weekly, PC. is located in Sandwich, Illinois and focuses on elder law and Life Care Planning for clients.  Their office may be reached by calling 815-570-2334.

  Every day of every week, Weekly Law is there for you.


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§ 2 Responses to Will the Government Pay for My Long Term Care?

  • Dawn-Great post and a good eye opener for those who think the Government will “take care of them.”

    • Yes….many of my clients believe that Medicare will pay for their long-term care and that’s only true for rehabilitative care, not custodial care. Once your condition is chronic rather than acute, you are on private pay unless you have long term care insurance. And the monthly cost of that can range from $3000 to over $10,000 per month!

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