The Elrod Firm

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Why Won’t Medicare Pay Our Long-Term Care Costs?

Justin, my husband has been receiving rehabilitation in a nursing home for the past two months, but I just received word that Medicare isn’t going to pay for his care any longer. I was told we’d owe over $5,000 per month starting next week. What have we done wrong? Why won’t Medicare cover his expenses? – June

June, I’m sorry to hear that you’ve been blindsided, but you’re not alone. There is a ton of confusion on the question of where Medicare fits into long-term care services.

The short answer is that Medicare will only cover a short period of time in a nursing home, no more than 100 days but often less. Medicare will only pay for time in a nursing home designated for rehabilitation, and it will only do so for as long as the medical professionals deem rehabilitation services as medically beneficial. Even if a person in a nursing home has not received his 100 days of Medicare time, he may be taken off of Medicare if rehabilitation is no longer beneficial.

There are only four ways to pay for long-term care: private pay out of your own pocket, long-term care insurance, veteran’s benefits, and Medicaid. When your husband’s rehabilitation time ends, you can no longer look to Medicare to pay his nursing home bill, and I’m sure you don’t want to private pay any longer than you have to. If you have long-term care insurance, now is the time to make a claim. Otherwise, we need to meet to discuss the availability of veteran’s benefits or Medicaid in your situation. Even if you don’t believe you would qualify for assistance through these programs, you owe it to yourself to check them out.

Are you in a similar situation?

We can help you navigate your unique circumstance.

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