From Your Leaders in Aging Services  •  Presbyterian SeniorCare Network  •  Lutheran SeniorLife
Select Page

Living Independently Blog

Fact Vs. Myth: Will Medicare Cover My Long-Term Needs?

ENV_Blog_image_2a

One of the biggest senior care misconceptions that the industry just can’t seem to shake is the idea that Medicare covers long-term care. According to a Bankers Life study, 56% of middle-income Baby Boomers believe that Medicare will pay for their ongoing long-term care. Often called custodial care, long-term care is a range of services and support to meet health or personal care needs over an extended period of time. This is non-medical care that non-licensed caregivers provide.

The need for long-term care comes into play when the aging process begins to take effect and one loses the ability to perform activities of daily living, otherwise known as ADLs. The six essential ADLs include the ability to dress, eat independently, bathe, use the toilet, walk or transfer from one position to another, and maintain bowel and bladder continence.

The reality is that every one of us may someday need this type of care. A person turning 65 today has a nearly 70% chance of needing some type of long-term care services and support in their remaining years, and 20% will need care for longer than five years, according to the U.S. Department of Health & Human Services.

So, what’s behind the enduring myth that Medicare pays for long-term care?

The confusion likely stems from the services that Medicare Part A (hospital insurance) will cover. Two of those are inpatient care in a skilled nursing facility (SNF) and home health care -- common settings for long-term care. But Medicare only pays for care that is skilled, meaning that it requires the skills of a speech-language pathologist, occupational therapist, registered nurse or physical therapist. If the average non-medical person can provide the care without additional training, Medicare will not pay for it because the care is not skilled.

To be clear, Medicare does not pay for long-term care, and this care can be very costly. Because there are gaps in both Medicare and long-term care insurance, you need a care coverage plan. Envisage can help supplement long-term care insurance or be a replacement for it.