What if I need long-term care and Medicare does not cover it?
The short answer
Medicare does not cover most long-term care, like ongoing help with bathing, dressing, or living in a nursing home. Planning ahead with other financial tools is important, because the costs can be significant.
The full explanation
This is one of the biggest gaps in Medicare, and it surprises a lot of people. Medicare will pay for short-term skilled nursing care after a qualifying hospital stay, and it covers some home health services when specific medical criteria are met. But it does not pay for custodial care, which is the ongoing help most people picture when they think of a nursing home or assisted living. That includes help with daily activities like bathing, dressing, eating, and getting around.The costs for that kind of care are substantial. In Utah, nursing home and memory care costs vary by location and facility, but they are rarely affordable without a plan in place.Medicaid (not Medicare) does cover long-term care for people who qualify financially, but it requires spending down most of your assets first. That is a path many families end up on, but it is not always the outcome people wanted.Long-term care insurance is one tool that can help, though it is most affordable and available when purchased before health issues develop. Some life insurance policies also have long-term care riders. A financial planner who specializes in retirement planning can help you think through the options that make sense for your situation.Medicare alone is not a long-term care plan, and waiting to think about this until you need care usually means fewer options.
Related Medicare Resources
In
Utah
specifically
Utah's ADRC can connect you with local resources, including information about Medicaid eligibility and community-based care programs that may help reduce costs for older adults who want to stay at home longer.
What this means for you
For you, this means long-term care planning is separate from Medicare planning, and the earlier you think about it, the more choices you are likely to have.
Related Questions
Does Medicare cover long-term nursing home or assisted living care?
What does Medicare cover for skilled nursing facility care?
What does Medicare not cover?
What am I not thinking about with Medicare?
