Long Term Care And Medicare

When budgeting the projected costs of long-term care and choosing a long-term care insurance policy, many Americans erroneously assume that Medicaid or Medicare will completely cover their care as they age. However, these programs only cover long-term care only under very specific conditions. In general, if you don’t suffer from a chronic, debilitating disease, Medicare or Medicaid won’t cover your long-term care as you age. This means you’ll likely have to make an arrangement to pay for your long-term care out of pocket or with a long-term care insurance plan.

Long-Term Care and Medicare

Medicare only pays for long-term care that’s deemed medically necessary. In general, this doesn’t apply to the inability to care for one’s basic needs due to age—the type of care that’s needed in this situation is known as “custodial care,” and it’s not covered.

Medicare Advantage Plans may cover debilitating illness—either mental (such as dementia) or physical—if long-term care or skilled nursing care becomes necessary. However, each patient is evaluated on a case-by-case basis and coverage will depend on your individual Medicare plan.

Medicaid, Long Term Care and You

Medicaid only pays for long-term care for seniors if care is deemed medically necessary due to a severe disability. Medicaid is also an income and assets based program, so not all seniors qualify for this type of assistance. Like Medicare, Medicaid also doesn’t cover custodial care.

Long-Term Care Insurance

If you’ve been planning on relying on Medicare or Medicaid to cover your long-term care, you may still have time for a course correction. Long-term care insurance policies are available for private purchase, and may help you to cover the expenses associate with assisted living facilities and long-term care.

The premiums for these policies can be covered by the insured or by a family member, and a variety of options are available. If you feel that this may be an option to help you afford long-term care, speak to your financial adviser or insurance agent today. It’s never too late to plan for your future.


Medicare. (2009) Paying for long-term care. Retrieved October 29, 2010, from http://www.medicare.gov/longtermcare/static/PayingOverview.asp

Virginia Cooperative Extension. (2009). Long-term care insurance.Retrieved October 29, 2010, from http://pubs.ext.vt.edu/354/354-172/354-172.html