Comprehensive Elder Law Services Addressing a Full Range of Legal Issues

  1. Home
  2.  » 
  3. Articles
  4.  » Medicare And Long-Term Care: Plan Ahead To Protect Assets

Medicare and Long Term Care ~ Plan Ahead To Protect Your Life Assets

Carol Sikov Gross
Retirement planning involves many steps, including a careful review of potential health insurance needs. This includes examining Medicare availability and taking steps to help protect your finances.

In order to make the most of retirement years, it is wise to carefully plan out medical insurance needs. What will or will not be covered by Medicare? What other insurance may help, like a Medicare Supplemental policy? Without planning, when a family is faced with a crisis, which may involve placing a loved one in a long term care facility, the family may have no idea how to pay for that care. A certified elder law attorney should be able to discuss the various options with the family, including Medicare coverage and its limitations, Medical Assistance and eligibility, Hospice care for those who are terminally ill and Home Health Care and availability of Waiver Programs.

Medicare: The basics.

Medicare is essentially a form of healthcare subsidized in part by taxes. The system contains four different parts:

  • Part A: Hospital insurance – covers most medically necessary hospital, a certain amount of skilled nursing facility, home health and hospice expenses. Generally, those over 65 can qualify for premium-free Part A if they or their spouse has paid into Medicare. For those that do not meet these qualifications, Part A can be purchased.
  • Part B: Medical insurance – covers medically necessary physician services and preventative care. This can include lab tests and ambulance services. Generally a monthly premium is paid for this coverage. Most people pay $164.90 per month for this coverage along with a deductible of $226.00.
  • Part C: Medicare Advantage (MA) plans – not a separate benefit but is usually an HMO or PPO plan, which combines Parts A and B as well as Medigap insurance (a Medicare Supplemental policy). The amount paid will vary depending on the plan.
  • Part D: Coverage for prescription drugs – generally covered by private insurance companies and the cost varies depending on the plan and higher income consumers generally pay more.

Medicare Parts A and B are considered Original Medicare. Since original Medicare has deductibles and co-pays, most people also purchase a Medicare Supplemental policy a/k/a Medigap coverage. There are 10 different Medigap plans.

With regard to long term care coverage, Medicare Part A will pay after a 3 day hospital stay, when one goes to a Medicare approved nursing home within 30 days of the hospital stay for skilled care that is restorative in nature. If one meets these initial requirements, Medicare pays for 100% of the cost for the first 20 days. From Day 21 – 100, Medicare pays all except for a co-pay of $200/day in 2023 (which may be covered by the Medigap plan). Starting on Day 101, Medicare pays nothing. Planning needs to be done to help cover the on-going cost of long term care if one needs to remain in the nursing home.

Legal counsel: Protect your wealth.

It is important to note that the laws guiding asset protection planning are extremely complex and often change. As a result, those who are looking to protect their assets, while making sure they are able to have access to long term care, are wise to seek the counsel of an experienced long term care and asset protection attorney, like a certified elder law attorney.

Keywords: estate planning