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Do you understand how your long-term care will be covered?

When considering plans for late life, many people put a lot of effort into retirement savings and some even take time to create strong estate plans to ensure their wishes are acted upon regardless of circumstances. But what if circumstances require long-term care because of medical conditions?

While many people dream of spending the rest of their days in their own home — or even in the home of a loved one — realism tells us this isn’t always possible. Sometimes a medical condition requires professional care that can only be had in a facility such as a skilled nursing home. Sometimes home care is possible, but untrained loved ones still need in-home help from nurses or others.

When these things happen, the bills can be steep, and you need to know who is going to pay for such care if it becomes necessary. You might be surprised to find out how little traditional payers will cover. Medicare, for example, only covers a stay in a nursing home under certain conditions and only if you qualify for a skilled nursing facility. It won’t cover care in other nursing homes or assisted living facilities, and Medicare only covers a maximum of 100 days.

Medicare will also cover some charges for in-home care, but again, those are limited by type and length. Medicare also won’t pay for services that are helping someone with activities of daily living, which compromise much of the service performed by professionals for individuals. These services have to be covered through another means.

Medicaid in most states does pay for more care, but you have to meet income qualifications. You might also qualify for coverage under federal programs such as Veterans Affairs programs, but it’s also a good idea to consider long-term care insurance early. Working with a lawyer who understands coverage helps you estimate future care costs and determine whether you need additional coverage.

Source: U.S. Department of Health and Human Services, “Who Pays for Long-Term Care?,” accessed March 11, 2016

DarrasLaw is Americas' most honored and decorated disability litigation firm in the country. Mr. Darras has seen more, evaluated more, litigated more, and resolved more individual and group long term disability and long-term care cases than any other lawyer in the United States.

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