Medicare Lacks Long Term Coverage

Medicare Lacks Long Term Coverage

Medicare is touted as the best option for medical care in old age. Unfortunately, it does nothing in terms of long term care. Medicare long term coverage is not realized as this is a very costly affair for the federal government. The maximum number of days that Medicare can take care of medical care is 100 days’ stay in hospitals or nursing homes as inpatients under the Medicare Part A plan. Even in this case, only the first twenty days are fully covered by Medicare; the remaining eighty days’ payments are made on a co-payment basis. All expenses beyond this limit are borne by the individual. Long term care insurance becomes a necessity for majority of people aged 65 or over. It is estimated that the average visit in a long term care facility is about 2 ½ years or 900 days. And, Medicare cannot pay for such a long term with the limited premiums. Individuals are encouraged to find alternative insurance plans that cover long term care in medical facilities or at home.

The eligibility criteria for long term care insurance state that the person must be unable to complete any two of the six “activities of daily living”: eating, bathing, continence, dressing, toileting, and transferring (such as from a bed). Other categories of people eligible for long term care insurance include those with Alzheimer’s disease or cognitive impairment. People with a doctor’s approval that they need additional care for at least ninety days are also eligible for this insurance. Long term care insurance provides you the flexibility to choose the type of medical care you prefer to receive: whether in a hospital or at your home. This is again an advantage over the Original Medicare plan which restricts the treatment to hospitals and nursing homes. Eligibility also is very restricted for Medicare. It is only a short-term recuperative care that stipulates a hospital stay of at more then three days and that the patient gets skilled care on a daily basis. Long term care usually includes custodial care and skilled-nursing care. While custodial care can be given by any family member, skilled-nursing care is administered by licensed nurses in hospitals or at home. Medicare covers only skilled-nursing care and no assistance is given to long term custodial care. Even though Medicaid may help the impoverished by covering the nursing home costs, the number of Medicaid facilities is limited. Most aged people require long term custodial care to carry out their daily activities and take medications as their age advances or when they are made weak by diseases. It would be wise to consider other health insurance options rather than depend on Medicare if you need long term care.

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