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.

Lt Col Tim Brown · Answer

Medicare does not cover long term care.  If you want that coverage, you need to apply for that type of plan.  It goes through underwriting and they are not cheap.

Norman Smith · Answer

Medicare has no coverage for Long Term Care. What you would need is a separate policy, and there are very few companies that handle it, and do it properly. I handle these often as we are focused solely on the Retirement focused segment. Be aware that since women use this more often then men, and that they live longer on average, this is the sole insurance that is more expensive for women than men! If you reach out I can assist you with the preparation and coverage.

Answered by Norman Smith on June 11, 2025

Agent Licensed in FL & PA

Answered by Norman Smith Medicare Insurance Agent

Steven Graves · Answer

Great question—planning ahead for long-term care is really important, especially since Medicare has limited coverage in this area.

How Medicare Fits into Long-Term Care:
Medicare generally does NOT cover long-term custodial care, such as help with daily activities like bathing, dressing, or constant supervision.

It does cover limited skilled nursing care after a qualifying hospital stay, but only for a short period (up to 100 days).

Medicare covers some home health services, but these must be medically necessary and part-time—not ongoing 24/7 care.

What You Should Do Now to Prepare:
Understand Your Coverage Gaps
Know that Medicare alone won’t cover most long-term care expenses.

Explore Other Options
Look into Medicaid eligibility if your income and assets qualify—it can cover long-term care services.
Consider long-term care insurance policies designed specifically for this purpose.

Plan Financially
Start saving or consult a financial advisor about strategies to pay for potential long-term care.

Discuss Your Wishes
Talk with family and healthcare providers about your preferences for care and living arrangements.

Research Local Resources
Identify community support programs, adult day care, and respite care options available in your area.

Would you like help understanding long-term care options or connecting with resources to start your planning?

Medicare4USA.com
214-989-7900

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

Amy Putrino · Answer

Long term care in not covered by Medicare.  If you are looking for coverage for LTC, you will have to look at products outside of your traditional Medicare plan.

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

Robert Moore · Answer

The best way to prepare for long-term care is to purchase a long-term care policy outside of medicare.

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

Michael Ryan · Answer

Medicare does not generally cover long-term care, but it can cover some limited skilled nursing facility care and home health services under specific conditions. 
Most long-term care, including custodial care like help with daily living activities, is not covered by Medicare. 

Medicare's Limited Coverage: 
Skilled Nursing Facility Care: Medicare Part A may cover some short-term skilled nursing facility care (up to 100 days) following a qualifying hospital stay, but only for skilled care, not custodial care. 

Home Health Care: Medicare may cover some part-time or intermittent home health services if they are medically necessary for the treatment of an illness or injury. 

Hospice Care: Medicare Part A may cover hospice care for terminally ill patients. 

What Medicare Does NOT Cover: 
Custodial Care: Medicare generally doesn't cover assistance with activities of daily living (ADLs) like bathing, dressing, eating, or using the bathroom if that's the only care needed. 
Long-term care in nursing homes or assisted living facilities: Medicare does not cover long-term stays in these facilities if they are primarily for custodial care. 
Most non-medical home care services: Medicare typically doesn't pay for non-medical home care services. 

While Medicare can cover some skilled care in certain situations, it's crucial to understand that it does not cover the majority of long-term care needs, especially custodial care.

If custodial care or extended care in a facility is a concern  (which it should be) please reach out.. There's more options available today than in the past.. Waiting until it's needed limits the options available to you..

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

Shane Bullock · Answer

It's true that around 70% of Americans who are 65 today will need long-term care at some point. Medicare, unfortunately, will not cover true long-term care needs such as nursing homes or custodial care. Medicare will continue to help pay for inpatient and outpatient medical services, but it will not help pay for your stay at a nursing home. To prepare, I recommend working closely with your trusted insurance agent and your financial planner to come up with a plan. 

Even though it seems far off in the future, I recommend starting these conversations when you are in your 50s to early 60s. Too many people wait until they are facing a long-term care need to start planning, which leaves them very few options. Unfortunately, many people who leave it until then will likely be forced to see how quickly they can qualify for Medicaid to help them pay for long-term care. It's certainly worth it to plan early.

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

Steven Lovell · Answer

Medicare is very limited in what it covers for long-term care. It will cover you up to a 100 days for skilled nursing care. It will cover hospice and it will cover some home healthcare with specific conditions that have to be met. If you want to make sure you're covered for long-term care, you need to be contacting an agent like myself to discuss a long-term care insurance plan or a hybrid long-term care plan where you don't have to pay for a premium. 706-294-4270

Answered by Steven Lovell on June 7, 2025

Broker Licensed in GA, CA, FL & 7 other states

Answered by Steven Lovell Medicare Insurance Agent

Cathy Barnett · Answer

Medicare does not cover Long term Care.  However, I can help with short Term Care coverage.  many Life Insurance companies can help with Short Term Care.

Cody Brown · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/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#cody-brown

Rosalind Ryan · Answer

Medicare doesn’t cover most long-term care, such as help with bathing, dressing, or using the bathroom—services often needed with chronic illnesses or disabilities. To prepare, consider exploring Medicaid eligibility or purchasing private long-term care insurance. Planning now ensures you can access the care you may need later—whether at home, in the community, or in a facility—while maintaining independence and control over where and how you receive support.

Answered by Rosalind Ryan on June 4, 2025

Broker Licensed in GA, AL, FL & 8 other states

Answered by Rosalind Ryan 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

Mike Henry · Answer

Medicare covers the first 100 days of skilled care. It will cover you at home while recuperating from an injury

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.

Chuck Winslow · Answer

Medicare provides some help with long-term care, but it’s important to know its limits so you can plan ahead:

How Medicare fits in:

Medicare covers short-term skilled care (like rehab after a hospital stay), usually up to 100 days in a skilled nursing facility if certain conditions are met.

It does not cover long-term custodial care, like help with bathing, dressing, or eating if that's all you need.

Medicare Advantage Plans may offer limited extra benefits, but they still do not cover full-time long-term care.


What you should be doing now:

1. Explore long-term care insurance or hybrid life/long-term care policies—these can help pay for care in the future.


2. Consider short-term care plans that fill gaps in Medicare coverage.


3. Create a financial plan for care needs—including home modifications, in-home support, or assisted living.


4. Talk with a specialist about Medicaid planning if you think you may eventually need state assistance.


5. Document your wishes with a healthcare directive and involve family in your planning.



Preparing now gives you more options, better care, and less stress for your loved ones later. If you want help reviewing your coverage and planning ahead, I’m happy to walk through it with you.

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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