As you age, are you concerned about how you will care for yourself if you become incapacitated or disabled or just unable to care for yourself? Do you have any long-term care plans in place? Will you rely on Medicare to pay for the high cost of your long-term care? Figuring out healthcare costs in senior years is no small task. And, in fact, as the population ages, there are an increasing number of individuals requiring long-term care services. Whether due to chronic illness, disability, or the natural progression of aging, long-term care needs can quickly become complicated and complex.

As you look into long-term care you will find that it can be expensive, and that many  seniors wonder if Medicare will help bear the brunt of these costs. We know you need answers to how to pay for the care you may need. We want to share important information on what Medicare covers and what it does not, as well as why early planning with an experienced Florida elder law attorney is vital.

We need to start with understanding Medicare basics. Medicare is a federal health insurance program primarily for individuals 65 and older and covers a broad range of healthcare services.  Medicare is divided into parts:

  • Part A (Hospital Insurance). This covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Part B (Medical Insurance). Covers specific doctors’ services, outpatient care, medical supplies, and preventive services. Often you will hear of Part A and Part B referred to as Traditional Medicare. 
  • Part C (Medicare Advantage). A type of Medicare health plan offered by private companies that contract with Medicare. It provides all of Part A and Part B benefits.
  • Part D (Prescription Drug Coverage). This covers the cost of prescription drugs.

However, be very aware, Medicare’s coverage for long-term care is limited. While Medicare Part A does provide coverage for care in a skilled nursing facility, it is important to note the limitations that apply to most situations:

  • Coverage is only for short-term stays (up to 100 days) in a skilled nursing facility, and only after a qualifying 3-day hospital stay.
  • It does not cover long-term stays or custodial care, which includes assistance with daily tasks like bathing, dressing, and eating.

Medicare can also cover part-time or intermittent skilled nursing care and physical therapy if deemed medically necessary. But again, it does not cover 24-hour care or purely custodial care as you would need in an assisted living facility or nursing home. Given the limitations of Medicare when it comes to long-term care, it is essential for seniors to have a Florida elder law financial strategy in place. We have a few concepts for you to consider:

1. There are alternative options to explore. Look into long-term care insurance, which is designed specifically to cover these costs. These policies can be tailored to your needs, but they are more affordable if purchased when you are younger and in good health.

2. There may be Medicaid. Unlike Medicare, Medicaid does cover long-term care services, but it’s for individuals with limited income and assets. Proper planning can help seniors protect their assets while still qualifying for Medicaid.

3. Investigate asset protection. Through trusts and other financial strategies, seniors can shield their assets from being completely depleted by long-term care costs.

4. We highly recommend engaging as soon as possible with a Florida elder law attorney. Your Florida elder law attorney specializes in helping seniors and their families navigate the complexities of long-term care, estate planning, and related financial matters. They can offer invaluable advice on protecting assets, qualifying for Medicaid, and ensuring that seniors receive the care they need.

Remember, while Medicare offers invaluable health coverage for seniors, its provisions for long-term care are limited. Given the high costs of such care, seniors should plan ahead as soon as possible and utilize the guidance of a Florida elder law attorney who can help ensure that you have access to the best care without the looming stress of exorbitant costs.

We know this article raises more questions than it answers. We do telephone, computer, and face-to-face appointments. Our face-to-face appointments are held outside in the open air (frequently selected by clients for document signing) and inside our office conference room. We follow all CDC guidelines. Our office procedures adhere to COVID-19 safety protocols and are designed and enhanced by medical review and air quality engineering. We encourage you to contact us to schedule a meeting.