The Greatest Medicare MythConception

The Greatest Medicare MythConception

A recent inquiry we received via the “Submit Your Question” tool on our website highlighted what I believe is the greatest misconception around Medicare coverage. It reads:

My mom is retirement age and will be eligible for Medicare in just a few months. Is it necessary for her to get separate/private long-term care coverage?

This individual thinks that Medicare will help pay for long-term healthcare costs. In fact, according to the American Association of Homes and Services for the Aging, 54 percent of Americans think the same thing.

However, that’s not the case at all. Medicare was never intended to cover – and never has covered – extended nursing home care or chronic conditions. It will pay for up to a maximum of 100 days of care for qualifying conditions. But beginning Day 21, you’ll be required to pay a significant co-pay. Now here’s the caveat and key point:

Medicare covers only skilled care – not chronic – conditions.

The moment that your condition is diagnosed as chronic (i.e., defined as cognitive impairment or the inability to perform any two of the six activities of daily living, which include bathing, continence, dressing, eating, toileting, and transferring), Medicare will stop – even if it’s been fewer than 100 days. So what most of us consider long-term care is not covered by Medicare.

Medicaid, a welfare program that reimburses for chronic care, may be an option, but only after you’ve proven that you’re seriously impoverished with nearly nothing in countable assets (around $2,000, depending on the laws of your state).

Be sure you have appropriate coverage for yourself – and your parents or loved ones.
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