Who Pays for Long-Term Care?

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Confused About Medicare?

You are not alone, many Americans are confused about what medicare covers. To put it simply Medicare is an insurance that is delivered in several parts.

Part A

Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care.

Part B

Part B helps cover medically-necessary services like doctors' services, outpatient care, durable medical equipment, home health services, and other medical services. Part B also covers some preventive services.

Part C

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.

Part D

Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, or you don’t get Extra Help, you’ll likely pay a late enrollment penalty.

(quoted directly from Medicare.gov)

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Does medicare cover Long-Term Care?

UNCLE SAM DOES NOT WANT TO PAY FOR YOUR LONG-TERM CARE


The simple answer is no. Medicare does not cover Long-Term care, but it does cover some services and inpatient stays in nursing facilities. Payment for these services is driven by doctor's orders.

Part A

  • Medicare Part A covers inpatient stays in Skilled Nursing Facilities and will not pay for custodial care or long-term care.
  • Medicare Part A covers Hospice care for terminally ill patients.
  • Medicare Part A covers Home Health Care services. Medicare pays for these services for a limited time as ordered by a doctor based on a rehabilitation care plan.
  • Medicare Part A covers care in a Religious Non Medical Care Institution.

Part B

  • Part B pays for Home Health Care services only on a part-time basis for a limited period of time,under certain conditions and no more than 21 days per calendar year.
  • Part B also pays for durable medical equipment such as wheel chairs, walkers, canes and more.

Who Pays for Long-Term Care?

Long-Term care can be very expensive and is typically paid privately by the individual or family receiving care. There are several public programs that offer help paying for long-term care, but each on has specific guidelines that must be met to qualify. Most of the public programs are means-test programs, meaning services are delivered based on income.

Public Programs

  • Medicaid
  • Older American Act Programs offered through Area Agency on Ageing
  • Veterans Affairs LTC Benefits

Private Programs and Financing Options

  • Long-term Care Insurance
  • Life Insurance
  • Reverse Mortgages
  • Savings from Annuities or Trusts


Elder Care Consultant

Providing Long-term care for yourself or a family member can be complex, expensive and physically demanding. Eldercare Consultants, Patient Advocates or Geriatric Care Managers can help you find resources and develop plans to provide care at a reasonable cost.

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