One of the more common questions we are asked by our estate planning clients (usually on behalf of an aging parent or loved one) involves long term care expenses and to what degree they are paid for by “Medicare”?
The short answer is: Medicare does not pay for “long term care”.
But the “short answer” requires some elaboration.
First, Medicare will pay for a patient in a nursing facility when that person is receiving rehabilitative therapy. In that case, Medicare will pay fully for the first 20 days. Second, if that person is still receiving therapy treatments, Medicare will pay a portion of the cost for UP TO the next 80 days. Third, after a total of 100 days receiving therapy has elapsed, and assuming the person did not have a valid long term care insurance policy in place, the person must either go on private pay if they wish to remain in the facility or they must qualify for Medicaid.
There are many issues to be considered to determine whether a person is qualified for or can be qualified for Medicaid benefits. Therefore, it is advisable that the family seek the advice of an estate planning attorney who is experienced not only in trusts and estates but in the area of Medicaid planning.
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