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Does Medicare Cover Nursing Homes?

Does Medicare Cover Nursing Homes? 

As we grow older, considerations towards our long-term care grow larger.  It’s likely that you will need some sort of long-term care in the future, and it’s natural to wonder if Medicare will cover the costs. 

While Medicare does cover some long-term health care needs, it does not cover most of the costs associated with nursing homes. If you intend to live in a nursing home during your final years, you will need to prepare financially. 

Does Medicare Cover Nursing Homes – What You Need to Know

Medicare Part A provides coverage for stays in skilled nursing facilities, but there is a caveat. The coverage is for people who will improve eventually. For instance, if you have a serious wound that requires attention, you might be sent to a skilled nursing facility. In this case, Original Medicare will cover up to 100 days of your stay. 

What if you require custodial care? This is the term used to define basic daily care, such as bathing and eating. If you need this type of care to function, you will likely need to go to a nursing home. Unfortunately, Medicare will not cover your stay in a nursing home since it does not pay for custodial care. 

Long-term Care Insurance

Because Medicare does not pay for custodial care, many people choose to get long-term care insurance. This insurance covers some of the costs associated with nursing home care. 

Long-term care insurance becomes increasingly expensive as you age, and the coverage differs from one policy to the next. Some policies just cover room and board, so you would have to pay out of pocket for other services, such as personal care. Other policies are quite comprehensive. Also, some policies do not cover pre-existing conditions. 

Long-term care policies are available from several sources: you can get an individual plan, employer-sponsored plan, a plan offered by an organization, or you might be eligible for a state partnership program or a joint policy. 

What About Medigap?

Medicare Supplement (Medigap) plans are used to offset some of the out-of-pocket costs associated with Original Medicare. However, Medigap plans also do not cover custodial care. These plans do cover an assortment of health care expenses, but you will need to look elsewhere for nursing home coverage.

Get Help Choosing Coverage

If you are unsure of how to pay for a nursing home, talk to a licensed insurance agent. Medicare does not cover custodial care, but you can consider long-term care insurance.