What Medicare Doesn’t Cover
Medicaid planning is vitally important to ensure that you have the money to pay for your healthcare needs as you get older or you become sick. Many people believe that Medicare will cover them fully when they qualify for benefits, but unfortunately this is simply not the case. If you are counting on Medicare to pay for everything you need as a senior, your assets could be at serious risk.
Zimmer Law Firm can help you to understand what Medicare will and won’t cover and to make a determination regarding whether you need a Medicaid plan. We can also provide assistance taking steps to ensure that you are able to get Medicaid to provide you with coverage when you need it so you are able to get the care you need without having to spend all of your assets and losing your chance to leave a legacy.
Medicare Doesn’t Cover Many Important Types of Care
There are a huge number of different kinds of care services that Medicare will not pay for when you are a senior. Some of the many things Medicare will not pay for include dental care, hearing aides, and eye exams and glasses.
Unfortunately, even when Medicare does provide some coverage for medical services and medical devices, seniors may still incur significant expenses. For example, there are 20 percent coinsurance costs that seniors have to pay for many of the services they receive through Medicare.
Medicare prescription drug coverage is also more limited than many seniors expect it to be. Studies from Employee Benefits Research Institute have indicated a senior couple should expect to save around $370,000 just to cover healthcare costs alone if that senior couple has high prescription drug needs — which is a lot of money to pay out of pocket when covered by Medicare.
While these are all important types of care Medicare won’t pay for, there is also one other category of care that is excluded from coverage and that is extremely expensive: custodial care. Custodial care refers to care that can be provided by unskilled professionals, such as health aides, rather than care which must be provided only by someone with specialized medical training. Custodial care could be provided in a nursing home or by home healthcare workers who come to a patient’s house. It includes things like helping with showering, dressing, using the facilities, or eating and drinking.
Medicare provides no coverage for custodial care at all, which means Medicare pays nothing for seniors to get care in a nursing home or to get care provided at home. Medicare would only pay for nursing home care if it was received in a skilled nursing facility and was classified as skilled nursing care. Most of the time, this is not the kind of care seniors end up requiring.
Since Medicare won’t pay for custodial care provided at home or in a nursing home, seniors end up in a difficult situation. They may be forced to pay for this care out of their own pocket, which could be prohibitively expensive and which could cause them to run out of money and even have to sell assets. Seniors who need to rely on their own money to pay for nursing care may be unable to leave a legacy by passing assets down to loved ones since their funds will have to be spent on care costs at home or in an institutional setting.
How Can Seniors Protect their Assets?
Once you become aware of all that Medicare does not cover, it becomes clear that you need a way to protect yourself from having to spend all of your money on medical treatment and long-term care costs. You should work with a Medicaid planning attorney at Zimmer Law Firm who can help you to take steps to get covered by Medicaid.
Medicaid can provide coverage in many situations where Medicare does not, including paying for custodial care for eligible Medicaid recipients. Medicaid is a means-tested benefit, which means if you have too many assets, you won’t be able to get covered. Making a Medicaid plan allows you to protect the assets you hope to pass on to loved ones while making sure you are able to get Medicaid to pay for care when you need it.
To find out more about the Medicaid planning process, join us for a free seminar. You can also give us a call at 513.721.1513 at any time for personalized help and advice.