Medicare is our national healthcare program essentially for individuals who have attained 65 years of age. When a patient’s recovery from a medical event plateaus, Medicare only provides up a maximum of 100 days until coverage under this plan ceases. At this point one must pay for rehabilitation and long-term care needs. Long-term care needs are for those with cognitive issues or in need of assistance with activities of daily living such as ambulatory, toileting, etc. needs. Unless the family assumes the role of such care, there are three options to pay for such care: (1) long-term care insurance; (2) self-pay; or (3) Medicaid coverage.
If one has long-term care insurance coverage the insurance company pays for long-term care covered under the policy until the policy limit is exhausted. If one has no long-term care insurance, or when such insurance is exhausted, one must pay for such care from savings and investments. However, with a careful spend-down plan one may qualify for Medicaid coverage and protect assets for a spouse/family. Proper planning is essential, or coverage will be denied. Since there is a five-year look-back period in which all financial aspects are reviewable by the State, advance planning provides greater options for the preparation for such an event.