What do seniors often misunderstand about Medicare's coverage for long-term care?

Question

Joseph Bachmeier · Accepted Answer

Some seniors think that Original Medicare covers all aspects of post hospital care. That is not the case. Original Medicare only covers "Skilled Nursing Care" and only for a certain period of time. Occupational and speech therapy is post-hospital care most people need but is only covered under Long-Term and Short-Term care plans.

Answered by Joseph Bachmeier on March 25, 2025

Agent Licensed in PA, AZ, DE & 5 other states

Answered by Joseph Bachmeier Medicare Insurance Agent

Tony Capraro III · Answer

They believe that Medicare covers LONG term Care and it does not ! That is why it's so imprtant to work with someone who knows ALL the specifics about Medicare and all  the other options!

Tasha Riggs · Answer

They believe Medicare Covers Long term care. It does not. After 90 Days in a Skilled Nursing or Hospital and you are not getting better you will need extra assistance above what your health plan will cover.

Answered by Tasha Riggs on March 27, 2025

Broker Licensed in CO, AZ, HI & 10 other states

Answered by Tasha Riggs Medicare Insurance Agent

Mark Maliwauki · Answer

This is a very good explanation from the source of truth ie; Medicare.gov on what Medicare's role is in covering long term care.

https://www.medicare.gov/coverage/long-term-care

Steven Graves · Answer

That’s an important topic! Many seniors have misconceptions about what Medicare covers when it comes to long-term care. Here are some common misunderstandings:

What Seniors Often Misunderstand About Medicare and Long-Term Care:
Medicare Does NOT Cover Custodial Care
Many believe Medicare pays for long-term custodial care—help with daily activities like bathing, dressing, or supervision—but it generally does not.

Skilled Nursing Coverage Is Limited
Medicare covers skilled nursing facility care only after a qualifying hospital stay and only for a limited time (up to 100 days), and it must be for specific medical or rehabilitation needs.

Home Health Care Is Also Limited
Medicare may cover some home health services, but only if they’re medically necessary and part-time or intermittent—not 24/7 care or supervision.

Medicare Doesn’t Cover Assisted Living or Nursing Home Costs
These costs are typically paid out-of-pocket, through Medicaid (if eligible), or long-term care insurance.

Bottom Line:
If long-term custodial care is a concern, it’s important to explore other options like Medicaid, long-term care insurance, or community resources.

Would you like help understanding your options for long-term care planning?

Call us for free help,   Medicare4USA.com      214-989-7900

Paul Potter · Answer

The purpose of Medicare is to health insurance coverage.  That does include hospitalizations, which usually do not last long, and skilled nursing, which we usually think of as rehabilitation services.  These visits, also do not usually last long.

The purpose of Long Term Care is to help people maintain their quality of life and well-being, typically when they are unable to independently perform daily activities.

Long Term Care Insurance is the tool that is used to help manage costs for Long Term Care.  This insurance is private insurance and requires an application and approval for coverage.

Luke Rhoads · Answer

Medicare generally does cover skilled nursing and home care while it does not provide coverage for assisted living and extended stays in nursing homes.

Don Hudson · Answer

Medicare focuses on Short term care in a hospital or rehabilitation services. Medicare is focused on healthcare. If you plan on going into a LTC facility or are concerned that some years down the road you may need to go into a LTC facility, it's best to look into other options that can assist you with LTC benefits. Many Life Insurance and Annuity products have LTC riders that can provide you with benefits.

Answered by Don Hudson on April 1, 2025

Broker Licensed in FL

Answered by Don Hudson Medicare Insurance Agent

Eli Roque · Answer

Medicare benefits only cover Part A Hospital and Part B Medical which means no coverage for long term care . Included in no coverage is prescriptions drugs.

Justin Sonon · Answer

Seniors often don't realize that long-term care coverage is not typically covered by Medicare plans.

Brady Kidwell · Answer

Seniors often misunderstand Medicare's coverage for long-term care, believing it covers extensive services like assistance with daily living activities (dressing, bathing, etc.) or long-term nursing home care. In reality, Medicare primarily covers medically necessary care and doesn't typically cover long-term care needs that are primarily custodial or non-medical.

Answered by Brady Kidwell on June 4, 2025

Broker Licensed in TN, FL, GA & KY, NC, SC & VA

Answered by Brady Kidwell Medicare Insurance Agent

Eddie Tune · Answer

medicare does not cover skilled nursing longer than 100 days a year , so It is not a long term care plan

Steven Bleicher · Answer

Please bear in mind that Medicare rules dictate that only the first 100 days are covered by Medicare when you are placed in a nursing home or an assisted living facility! Then, a previously-bought private LTC policy will kick in! Here is the dilemma: THE most frustrating aspect of LTC, other than its high cost, is when a couple apply for LTC and one is denied coverage while the other is approved. In these cases, the healthy spouse is so upset over this news that he/she decides NOT to pick it up at all! The ramifications of this is for example, the caregiver of the unhealthy partner who may have turned down this LTC policy opportunity now may find that he/she has also been diagnosed with a major condition of their own! Thus, unfortunately now they are BOTH in trouble! Buy LTC insurance as young as you can. The ages of the candidates have everything to do with the pricing per month quotation.

Answered by Steven Bleicher on June 15, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

Medicare primarily covers skilled medical care, but not the daily living activities such as bathing, dressing, or using the bathroom, which are usually where help is needed in long-term care settings. 

This often leads to financial strain and unexpected expenses when needing long-term care services.

Hannah Skinner · Answer

There is a common misconception that Medicare covers long term care or nursing home care. Unfortunately, Medicare does not cover long term care or a stay at a nursing home. I would recommend a long or short term care policy to cover this expense.

Answered by Hannah Skinner on July 14, 2025

Agent Licensed in SC, AL, AR & 44 other states

Answered by Hannah Skinner Medicare Insurance Agent

Fred Manas · Answer

Seniors often misunderstand that Medicare covers most, if not all, of their long-term care needs. In reality, Medicare's coverage for long-term care is limited and primarily focused on skilled nursing facility care following a qualifying hospital stay. It doesn't cover the type of ongoing personal care (like bathing, dressing, and eating assistance) that many seniors need. 
Here's a more detailed breakdown of the misunderstandings:
"Medicare will cover all my long-term care needs."
.
This is a common misconception. Medicare primarily covers medically necessary skilled nursing care for a limited period (up to 100 days) following a qualifying hospital stay. It doesn't cover custodial care, assisted living, or adult day programs. 
"Medicare will pay for my nursing home stay indefinitely." Medicare's coverage for skilled nursing facilities is limited to 100 days, even after a qualifying hospital stay. After that, individuals are responsible for the costs, and Medicaid may be an option depending on their financial situation. 
"Medicare will cover home health services for my ongoing care." While Medicare can cover home health services for a limited period under specific circumstances, it does not cover ongoing, non-medical assistance with daily living activities. 
"Medicare will cover assisted living or adult day care." Medicare generally does not cover these types of long-term care settings. 
"Medicare will cover all my medical expenses for long-term care." .
While Medicare covers medical services, it doesn't cover the costs associated with the ongoing non-medical care and assistance that many seniors need.

Gary Henderson · Answer

There is no long-term care provision 

Long-Term care policies are purchased separately. The older you are the more expensive they are

Vachik Chakhbazian · Answer

While Medicare does cover some short-term skilled nursing care after a hospital stay, it doesn't pay for ongoing care for chronic conditions or disabilities.

Michael Kim · Answer

They think it's a senior living center. No it's a long term care meaning after you had surgery you are going into a long term care to get healed and get better. You will come out eventually, you will not live there indefinitely.

Answered by Michael Kim on March 25, 2025

Agent Licensed in NV, AR, AZ & 18 other states

Answered by Michael Kim Medicare Insurance Agent

Eizel Mere · Answer

Seniors tend to believe Long Term Care is covered by Medicare, but it is not. They will cover for up to 150 days in the hospital and up to 100 days of skilled nursing care.

Wild Bill Anderson · Answer

This confuses many before we explain it.
Medicare does not cover long term care.  But it can help with rehab at skilled nursing (SNC) as long as they think you could get better. Max benefit under any plan is 100 days. Some would be less.

There are prerequisites under Medicare alone or Supplements in order to get help with rehab at SNC. To get help you need to have atleast 3 days as an inpatient before going to an approved SNC facility.  Observation does not count toward the 3 days. 

Under Advantage plans you usually have no 3 day requirement in the hospital to get help at SNC.

Robert Rowe · Answer

They typically think Medicare covers long term care which in fact it does But for only 21 days fully and 22-90 with very large copays. Long term care is the single largest gap in a Medicare plan.

Melanie Blackston · Answer

Seniors often think that Medicare covers all long-term care costs, mainly nursing home care and assisted living. However, Medicare mainly focuses on acute care and short-term skilled nursing care after their hospital stay. It generally does not cover the long-term, custodial care needed for activities of daily living, such as bathing, dressing, and eating.

Answered by Melanie Blackston on June 24, 2025

Broker Licensed in SC, GA & NC

Answered by Melanie Blackston Medicare Insurance Agent

Jason Kirschner · Answer

They believe that Medicare covers LONG term Care and it does not ! That is why it's so imprtant to work with someone who knows ALL the specifics about Medicare and all the other options!

Jennifer Dixon · Answer

Most insurance carriers including Medicare do not cover Long Term care.   There are separate policies that can be purchased.

Roseann Vandevender · Answer

A number of Medicare recipients believe that Long Term Care is a covered by Medicare and/or their Supplement plans. Custodial Care is not covered by Medicare. Private insurance or Medicaid can be used to cover this expense depending on your financial situation .

Answered by Roseann Vandevender on May 8, 2025

Agent Licensed in OH, AZ, CO & TX

Answered by Roseann Vandevender Medicare Insurance Agent

Eric Stokley · Answer

A common misconception is that Medicare covers all senior living cost. 

It does not pay for room, board, or personal care in senior living communities such as assisted living or independent living.

What do seniors often misunderstand about Medicare's coverage for long-term care?

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What do seniors often misunderstand about Medicare's coverage for long-term care?

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