Doesn’t Medicare cover the cost of nursing home care?

No, this is a common misconception, but Medicare does not cover the cost of long term nursing home care.  Medicare is an insurance program that provides health care benefits to persons who are over the age of 65, or are blind or disabled.  For recipients, it is basically their primary form of health insurance.  But what many seniors fail to understand is that Medicare does NOT pay for long-term care expenses!

Part of the reason for the confusion is that Medicare does pay for rehabilitation.  If a senior on Medicare has a hospital stay of at least three days and then is admitted to a Skilled Nursing Facility for rehabilitation, Medicare will pay for the care—for a while anyway.  Medicare will only pay for the rehabilitation for a maximum of 100 consecutive days.  Plus, once those days are used up, they’re gone for good. 

Did you notice that I said a “maximum” of 100 days?  That’s because it’s actually based upon how well the patient responds to the rehabilitation.  The patient must experience some improvement.  If the patient’s health is not improving, Medicare may decide that the condition is long-term and benefits will be cut off—even if you haven’t reached 100 days yet. 

Another thing that most people don’t realize is that Medicare only fully covers the first 20 days, after that there is a daily deductible of about $140 per day!  So a 100 day stay could still end up costing you over $11,000!  [If you have a Medicare Supplemental Insurance policy, it might help cover some or all of the difference though.]