PAYING FOR LONGTERM CARE
by Clayton Davis, Attorney at Law
Because long-term care can be very expensive, finding
accurate information about all possible sources of help
is essential.
The first step should be to gather information about
all assets, sources of income, and health insurance
coverage for both you and your spouse. Locate the VA
service number if you or your spouse ever served in the
military. Reviewing your latest income tax return will
help prevent overlooking any assets or incomes.
Medicare Coverage
Many people are surprised Medicare has such limited
coverage for nursing home cost. At most, Medicare
covers 100 days in the nursing home. You must have
been admitted to the nursing home within 30 days of
discharge from a Medicare covered inpatient hospital
stay of at least three days. Furthermore, you must
receive skilled nursing or other medical professional
care. Medicare will not cover expenses if you require
only custodial services regardless of your condition.
Continued eligibility is dependent on your continued
need for skilled services that will at least slow the
decline in your condition, but many medical providers
are unaware that rehabilitation progress is no longer
76 Senior Resource Directory 2020-2021
required for eligibility. Medicare rules are extremely
complicated, so you may need to consult SARCOA’s
SHIP contractor at 334-671-3990 if you need assistance
in understanding how Medicare rules apply to your
situation.
Medicare Part A pays all the costs, including
prescriptions, for the first 20 days of covered skilled
care. If you continue to receive skilled care during the
next 80 days, Medicare will continue to pay, but a copayment
($176 per day in 2020) is required from you
or your other coverage.
Co-payment Coverage
All your Medicare co-payments will be covered if you
have Medicaid, QMB, TRICARE for Life, or Medicare
supplement standard plans C, D, F, G, M or N. Plan K
covers 50 percent of co-payments, and Plan L covers 75
percent. Standard Plan B’s (such as Blue Cross C+ Plan
B) do not cover any of these co-payments. Civil service
retirees usually have coverage for at least 10 days of copayments.
Skilled Care Beyond 100 Days
If you need skilled care beyond 100 days and have
TRICARE for Life, it will pay 75 percent of your nursing