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Q: Does Medicare Cover Nursing Home Care?

Asked by Anonymous on October 12, 2017

Is there Medicare coverage for nursing homes? If not, what kind of care does Medicare cover?

Howard Yeh
Howard Yeh October 12, 2017

Medicare coverage for nursing homes is essentially nonexistent; Medicare usually does not cover nursing home costs. Nursing homes are considered to be custodial care, not medical necessities. Medicare only covers hospital and medical bills – things that it considers medically necessary.

The exception for Medicare is the Part A skilled nursing benefit, which provides 24/7 in-patient care after a hospitalization for up to 100 days. Skilled nursing facilities help patients after an injury – they’re not nursing homes in the sense that nursing homes are often a designated place for the care of aging seniors.

Nursing home coverage is best provided by long-term care insurance, purchased well in advance of the recipient needing nursing home coverage. Otherwise, he/she might not meet underwriting and will be paying a substantial premium for meager coverage. If a senior needs to move to a nursing home and cannot afford care, Medicaid is also an option to look into.

Taking the Next Steps

Learn more about Medicare coverage at HealthCare.com. Some Medicare Advantage plans may also include a long-term care component.

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