Many seniors believe that some or all of their long term care costs will be covered by Medicare. This is not true for most long term care stays. Medicare will only cover long term care for rehabilitation purposes for up to 100 days and only if the Medicare recipient is discharged from a qualifying hospital stay. Even if Medicare covers the rehab stay, there is a significant daily deductible for days 21-100 of the nursing home stay. Medicaid provides coverage for longer nursing home stays, but requires additional qualification requirements. The requirements for Medicaid qualification are covered in several other blog posts. Medicaid planning involves legal techniques to qualify someone for Medicaid who has assets over the asset limit.
Planning that protects assets from a long term care stay is important to pay for things that Medicaid does not cover. Medicaid does not cover a private room only a semiprivate room. The Medicaid recipient can use the money that is saved to cover the difference between the private room rate. There are also experimental treatments that are not covered by Medicaid.
Those desiring nursing home Medicaid are encouraged to complete Medicaid planning to conserve assets. Most nursing homes will encourage the applicant to simply spend down their assets on nursing home care before applying for Medicaid, as the rate paid by a private individual to a nursing home is higher than the rate Medicaid pays. As the planning to conserve assets involves balancing several different rules, it is recommended that applicants seek the assistance of an experienced elder law attorney.