Fact: Medicare is NOT DESIGNED to cover long term care. It was designed primarily to help with 'short term' rehabilitation.
"How much WILL the government actually pay?"
Medicare does not pay for long term care expenses. Medicare does cover some limited convalescent skilled nursing care and some limited home health care under restrictive, short-term conditions, but not for long term care. This short-term care is usually limited to 100 days, and to get it the following conditions must be met:
For Medicare you must have been in a hospital for at least three days immediately prior to entering the nursing facility. This eliminates most Alzheimer's and Parkinson's cases.
For Medicare you must go into the facility for the same condition for which you were previously hospitalized, and it must be within thirty days of discharge.
For Medicare you must be getting better each day. Once you level off, Medicare stops paying.
In any case, Medicare covers only Skilled Nursing care and does not cover Intermediate or Custodial care at all!
Susan L. McGloghlon, president of the American HealthCare Institute National Medicare Recovery Services, Inc. states, "There are no limits to the number of benefit periods (100 days) that a Part A Beneficiary is entitled to in a Skilled nursing Facility, provided you meet the criteria as set forth by HCFA."
But the catch is in "the criteria as set forth by HCFA". If you study the fine print, you may find that the cold hard fact is:
If you ever need prolonged, "long term" care, say for Alzheimer's or Parkinson's... It will not be covered by Medicare.
Medicare, HMO's, Major Medical and Medigap insurance do not pay for long term nursing home care stays.
A one year stay in a nursing home can cost anywhere from $42,000 - $191,000 per year, depending upon the nursing home's locale. Insurance can be purchased to help pay for these costs. Without it, your family nest egg can be wiped out. The well spouse can be left without financial resources for their living expenses.
Long term care issues are bound to become more contentious as budget balancers seek to slow the growth of federal Medicare and Medicaid... Many proposed cuts have already passed. If we accept the fact that the cost of long term care is going to continually rise and that programs such as Medicare are realizing marked reductions in funding, we also must accept that the responsibility for long term care expenses will rest squarely on us." In fact, with the Deficit Reduction Act of 2005, that is exactly the message from Washington.
The message: Take care of your self, and look out for your own. Don't count on Uncle Sam.