Last column I explained the options to pay for long term care are limited. Adding to the problem is a significant amount of incorrect information about what those options are. For example, many seniors erroneously believe Medicare will pay long-term care costs. This is not correct.
On the other hand, upon meeting certain conditions, Medicaid will pay for long term care. I understand why people confuse the two. Not only do the terms sounds similar but, in some cases, Medicare provides temporary assistance for some of the same health issues as Medicaid.
For example, Medicare Part A is sometimes called “Hospital Insurance.” You may be told it also covers skilled nursing facility care, hospice care, and home health care. While this is true, the coverage is only for treatment of certain conditions and only for a limited time. In other words, the focus of Medicare is to treat conditions which are expected to improve.
For those who need skilled care, Medicare can help pay for those costs, but only up to 100 days for each benefit period. Medicare may cover other services for a longer period so long as the doctor continually certifies that those services are necessary to treat an illness or injury which is expected to improve. Finally, Medicare can provide services for patients certified by a doctor as terminally ill (i.e., will probably live no longer than 6 months) even if the patient does in fact continue to live longer than 6 months.
By definition, the conditions for which Medicare provides benefits are not “long-term.” If the condition is not going to improve, or is not terminal, Medicare is not a long-term option. Unfortunately, there are many seniors whose ailment is not terminal, but their condition will not likely improve. They need help with the most basic activities of daily living such as personal hygiene, dressing, and eating.
If certain conditions are met, Medicaid is an option. Over the next few columns, I will explain the role of Medicaid for seniors in need of long-term care in Idaho, as well as its advantages and disadvantages.
*Steve Wright is an Idaho licensed attorney. This column is provided for informational purposes only and should not be construed as legal advice, which requires a specific discussion of specific circumstances.
© 2025 Steven J Wright