The Hard Limit to Medicare

Most of our seniors who see us for help with their parents are shocked to have just learned that Medicare does not pay for long term care in a nursing home.  This is often the result of having been poorly informed when their parent was moved from a hospital to a Nursing Home – Rehabilitation facility once they were medically stable enough to do so.  Many are told that they should not worry about the move to a Nursing Home because Medicare will pay, at least in the short term.

Medicare only pays for rehabilitation care for up to the first 100 days in a care facility.  But, most of the time, Medicare actually pays for far fewer days because Medicare rehabilitation is keyed to the patient going home.  So, if the patient does not, or cannot get well enough to go home, and that determination is made within a shorter period than 100 days, the patient’s family will get a nice (48 hour) notice from the Nursing facility that Medicare is about to stop paying and the family must either come up with money for private nursing home care or they must take the parent out of care and deal with the problem some other way.

Moreover, if the patient has been admitted successive times for the same underlying cause, the 100 day clock runs on each successive admission without a reset.  In this case, a patient can exhaust their care days in short order on the last admission.  Understanding your rights under Medicare, and realistically assessing he likelihood of a long term care admission, are keys to having the right estate planning and final care planning documents in place to prevent unnecessary spend down and loss of family equity.

This article is written by an attorney at Wyatt & Mirabella, PC. Always consult an attorney before making any legal decisions. To make an appointment today for a free consultation, please click here to contact us.