Long Term Care
Are you looking for Long Term Care Insurance in California?
The experts at Nelson Insurance have over 12 years experience helping families find suitable coverage that meet your needs. We shop multiple companies to find the right solution for you and your family.
What is Long Term Care?
Long-term care is a range of services and supports you may need to meet your personal care needs. Most long-term care is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called Activities of Daily Living (ADLs), such as:
- Using the toilet
- Transferring (to or from bed or chair)
- Caring for incontinence
Other common long-term care services and supports are assistance with everyday tasks, sometimes called Instrumental Activities of Daily Living (IADLs) including:
- Managing money
- Taking medication
- Preparing and cleaning up after meals
- Shopping for groceries or clothes
- Using the telephone or other communication devices
- Caring for pets
- Responding to emergency alerts such as fire alarms
Does Medicare cover Long Term Care?
According to Medicare.Gov -Original Medicare (Part A and Part B) covers some hospital and medical costs. Medicare Part D covers some prescription drugs. Medicare generally doesn’t cover long-term care except in certain circumstances. Medicare draws a line between medical care (which is generally covered) and what it calls “custodial care” which is generally not covered. Custodial care includes help bathing, eating, going to the bathroom, and moving around. However, Medicare may cover long-term care that you receive in:
- A long-term care hospital (generally you won’t pay more than you would pay for care in an acute care hospital)
- Skilled nursing facility (Medicare covered services include a semi-private room, meals, skilled nursing care and medications)
- Eligible home health services such as physical therapy and speech-language pathology
- Hospice care including nursing care, prescription drugs, hospice aid and homemaker services
Although Medicare covers long-term hospital care, you could face significant charges if you receive long-term care beyond three months. In 2021 under Medicare Part A, you generally pay $0 coinsurance for the first 60 days of each benefit period, once you have paid your Part A deductible. For days 61-90, you pay $371 per day of each benefit period. For days 91 and beyond you pay $742 coinsurance per each “lifetime reserve day” after day 90 for each benefit period and you only have up to 60 days over your lifetime. Beyond the lifetime reserve days you pay all costs until a new benefit period begins.