If I need long-term care in the future, how does Medicare fit into that plan, and what should I be doing now to prepare?

Question

Samantha Jellison · Accepted Answer

This is a great question and I am pleased to hear that you are thinking about this proactively.

Unfortunately, Medicare does not cover long-term care, such as your stay in a nursing/retirement home or having someone come to your own home daily for custodial care (bathing, dressing, feeding, ect.). 
You should consider discussing a Long-Term Care policy with your agent/broker. 
One thing to note is that as you age, these policies become more expensive. In many cases, people faced with the situation to enter Long-Term care may have to apply for Medicaid in order to receive any financial assistance or cover their costs. In some cases, extended family members may be able to contribute, however it can end up being a hefty financial burden.

Bill Green · Answer

This is such an important question, and one that doesn’t get asked enough. Medicare clearly states in the Medicare and You handbook that it does not cover long-term care—things like help with bathing, dressing, or full-time nursing home care. Many people assume it’s included, only to find out later that it’s not, and by then it's almost always too late to get it because they can no longer qualify based on their health. The good news is there are several ways to prepare for long-term care costs, and we can help you explore options that don’t follow the old use-it-or-lose-it model. Today’s plans often provide a benefit whether you use the care yourself or pass it on to a beneficiary. Planning early not only protects your retirement savings—it also gives you more choices and peace of mind for the future.

Answered by Bill Green on March 26, 2025

Broker Licensed in FL, AL, AZ & 19 other states

Answered by Bill Green Medicare Insurance Agent

Ray McCauley · Answer

medicare does not provide long term care however i would suggest purchasing long term care now while your young to keep the premiums lower because they raise the older you are when you sign up for a plan

Answered by Ray McCauley on March 27, 2025

Broker Licensed in CA, AZ, FL & ID, NV, SC & TN

Answered by Ray McCauley Medicare Insurance Agent

Pamela Camey · Answer

Medicare does not provide long-term care coverage or custodial care unless medical care is needed.  
Medicare does cover 90 standard days for long-term acute care at a hospital. 

 Currently, Medicare will pay for Home Healthcare for as long as you qualify.  However, you plan of care must be recertified every 60 days by your doctor.  If a person has a three -day inpatient stay at a hospital or has a Medicare-covered skilled nursing facility ( SNF) stay, Part A will cover up to 100 days. 

If you are considering the purchase of Long term care Insurance, these  guidelines vary from State to State.  In retirement planning, you may want to consider purchasing a Long Term care Insurance policy  to protect your assets.  There are also  short term care insurance policy available as well.  When planning for Long term care needs, there is no need to settle for just one solution.  You may want to consider looking at Traditional Long term care insurance, Asset- based LTC policies or even consider stacking them together.  National Association of Insurance Commissioners wrote a Shopper's Guide to help you understand long-term care and the insurance options you may choose. 

https://content.naic.org/sites/default/files/publication-ltc-lp-shoppers-guide-long-term.pdf

Jane Ahrens · Answer

Medicare does not provide long term care. The only care provided by Medicare in a Skilled Nursing Facility is for rehab ordered by a doctor after a surgery. That coverage ends at 100 days and often ends sooner if the patient stops progressing. For traditional nursing home custodial coverage, a long-term-care policy would need to be purchased.

Answered by Jane Ahrens on March 31, 2025

Broker Licensed in NY, AL, AZ & 16 other states

Answered by Jane Ahrens Medicare Insurance Agent

Gregg Matheny · Answer

Medicare unfortunately does not cover long term care. However skilled nursing facilities, some home health care, and hospice are covered. If you’re looking for long term care coverage your best bet would to be looking into life insurance policies with a “long term care rider”, your premium would change depending upon the length of the benefit I.e. a 3. yr benefit period would be less than a 10 yr or lifetime period. I would strongly encourage doing this now. If you try to wait till you need it you will probably get denied.

Answered by Gregg Matheny on March 26, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

Rebecca Bilbrey · Answer

When you need long-term care, the only way Medicare pays any part of it is if you need medical attention to recover from something; and even then the coverage is very limited (no more than 100 days in a skilled nursing facililty, and you have daily copays). The best way to prepare for needing long-term care services (help with eating, bathing, toileting, transferring, dressing, or continence), is to get a long-term care insurance policy or a life insurance policy with a long-term care rider or an annuity with a long-term care rider BEFORE you are excluded due to your health. Most people wait until it is too late and then cannot get through underwriting OR cannot afford the premiums which are determined based on your age. Even if you want your family to take care of you, a long-term care plan is a good idea because your family will need help or you'll break them. Being a full-time caregiver with no assistance is incredibly hard on someone's health.

Answered by Rebecca Bilbrey on April 17, 2025

Broker Licensed in TX, AL, CO & 6 other states

Answered by Rebecca Bilbrey Medicare Insurance Agent

Brian Krantz · Answer

Medicare doesn’t cover most long-term care, like assisted living or help with daily activities. It only covers short-term rehab after a hospital stay. If you're thinking ahead, it's smart to look into long-term care insurance or talk with a financial planner.

Answered by Brian Krantz on March 25, 2025

Broker Licensed in NY, AK, AL & 48 other states

Answered by Brian Krantz Medicare Insurance Agent

Suzanne Lamperti · Answer

Medicare does NOT cover long term care. The best defense is to purchase Long Ter Care Insurance.  The ONLY way Medicaid will cover is if the individual has $2000 or less in assets.

Louanne Allison · Answer

Medicare and a Medicare Supplement or Advantage plan will provide up to 100 days of nursing home care, and is generally not enough if a person needs long term care (LTC). The average stay in a nursing home is 3 years. LTC is expensive and I usually recommend it only if a person has assets between $500,000 and $1,000,000. If they have over $1 million, they can just pay for it. If a person has under $500,000, they can spend it down to get into the Medicaid range where the state will pay. If person has assets between $500k and $1 million, a LTC plan may be a option to explore. I can provide a quote.

Answered by Louanne Allison on April 14, 2025

Agent Licensed in MI, FL, IL & OH, TN, TX & UT

Answered by Louanne Allison Medicare Insurance Agent

Aaron Young · Answer

If you think you might need long term care in the future and don't have a long term care policy in force now, you will have to pay for that care out of your own pocket. Medicare pays for some short term care such as skilled nursing and rehabilitation, but will not pay for long term nursing home care.

Answered by Aaron Young on April 14, 2025

Agent Licensed in OK, AR, GA & 6 other states

Answered by Aaron Young Medicare Insurance Agent

If I need long-term care in the future, how does Medicare fit into that plan, and what should I be doing now to prepare?

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