Doesn't Health Insurance Pay for Long-Term Care? What About Medicare and Supplements? Medicaid?

There is a common misconception that health insurance, including Medicare and Medicare Supplements (Medigap), pay for long-term health care services.

The answer is these traditional health insurance programs will not pay for most long-term care services and supports. Health insurance, including Medicare and supplements, will pay for a limited amount of skilled long-term care services. 

Most Long-Term Health Care is Custodial Care

However, most long-term health care is custodial in nature. Custodial care is help with your activities of daily living or supervision due to a cognitive decline. Health insurance, including Medicare and supplements, will not pay for custodial care. 

They will pay for a limited number of days of skilled care. An example of skilled care is the rehab you may require following a surgery or a stroke. For example, Medicare pays 100% of the first 20 days of skilled care. Most people have a Medicare supplement which will pay the remaining 80 days of skilled care. Fater that, you are 100% out-of-pocket.

Medicaid

Medicaid is the medical welfare program. It will pay for all types of long-term health care services if you have little or no income and assets. While some states are expanding Medicaid to include some in-home care, many people end up in a Medicaid nursing home for their care.

What this means to you is without some type of Long-Term Care Insurance, you will have to pay for most, if not all, of your future extended care. Your family may need to become caregivers, a role that is physically and emotionally demanding.

Unless you have lived through a long-term health care event with a family member, you may not be aware that your health insurance or Medicare will not pay for long-term care services and supports. Medicaid is the medical welfare program, and you must have little or no income and assets to qualify.

A qualified and experienced Long-Term Care Insurance specialist can explain exactly what is covered by your current insurance and show you how Long-Term Care Insurance can pay for your choice of quality care, including in-home care.