The Most Common Misconception About Medicare and Who Pays For Long Term Care

HNWElder Care Law, Elder Law

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold, NJ Medicaid Attorney

In my Elder Law practice, I work with many people of various ages at various stages of life.

I counsel them in the subject of Medicare, how it works and what is covered. It’s in this discussion that common misconceptions become known. These misconceptions make people vulnerable and at great disadvantage in terms of their asset protection, if not addressed correctly. To that end, I hope the following discussion is helpful in this very important area.

The most common misconception I encounter concerns Medicare and Long Term Care. Most people believe that Medicare and/or other health insurance plans will cover the cost of long term care, either at home or in a nursing home.

Nothing could be further from the truth.

As people retire and get older long-term care considerations become very alarming. Many thoughts about retirement contemplate long-term care but the foundation steps must be taken.

Most people are not aware that the most that Medicare will pay for in a nursing home is 20 days in full and up to 80 days in part for a total of 100 days. But that is provided only if the nursing home stay is immediately preceded by at least a three-day hospital stay. Furthermore, the nursing home must be a skilled nursing home and not just custodial.

If you think you’ll be eligible for custodial care on a daily basis for yourself or your loved one then don’t depend on Medicare to cover it.

Long-term care insurance is the only source of payment for custodial care services, outside of Medicaid.

Then as to Medicaid, a person must have little or no resources and/income for Medicaid coverage. If you have any assets, those will be the source of payment if you do not have long-term care coverage.

It is impossible to predict the need for long-term care. However it should be a part of every retirement and asset protection plan.

The sooner you begin discussing these plans with a qualified financial planner or Asset Protection Attorney, the more confident you will feel in the face of any aging related health issue.

To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at  Please ask us about our video conferencing consultations if you are unable to come to our office.

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