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  • Writer's pictureDylan Edwards

Why Medicare should never be considered a payment source for extended care

Medicare and health insurance do not pay for extended care. They may pay for short-term care, but only if it is skilled or rehabilitative in nature.

This is a drastic difference to what most people require when they need assistance.

Medicare is an entitlement program that provides health insurance for people age 65 and older, for people of any age who have had Social Security Disability Insurance (SSDI) for two years or who have End Stage Renal Disease (ESRD), which is permanent kidney failure requiring dialysis or a kidney transplant. It is administered by the Centers for Medicare and Medicaid Services (CMS).

Medicare’s definition of skilled care requires both a skilled service as just noted, and the

care must be rehabilitative—recuperative, restorative—in nature. The goal of rehabilitative services is to put the patient back, as much as possible, in the position she was in prior to the medical event which lead to the need for rehabilitation.

The bottom line is Medicare has very limited coverage for long term care - and does not cover what most people end up requiring when the need for care arises. Medicare provides valuable coverage but ideally works hand in hand with a private long term care policy.

Contact us today and learn how we can help plan for the major gaps in coverage that Medicare does not include.

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