Q What exactly does Medicare cover? My father is in his late 70’s and in failing health.
He has told me when the time comes he would agree to go to a “home,” (my mother died many years ago).
He seems to think Medicare will cover the cost of a nursing home. I don’t think it does. Who is right? (From a son in Beloit).
A Great question! Medicare coverage can be very confusing.
Once you think you have it clear, it changes. Your father probably remembers the days when the Medicare benefit was greater than it is now.
The fact is, Medicare only covers the cost of a nursing home stay after a person has been in the hospital for at least three days for a medically necessary condition.
That means that your father would have to have something happen, then be hospitalized for at least three days, and then he could transfer to a nursing home.
The care at the nursing home would be covered as long as skilled care is being delivered. That means something like physical therapy or intravenous injections are needed on a daily basis. The number of days of coverage is limited.
Medicare does not cover long-term or custodial care. So, unfortunately, if he only needs help bathing, dressing, or with his meals, Medicare would not cover those costs.
It would be a good idea to ask him if he has any kind of long term care insurance or any VA benefits or something through his previous employer.
If he has long term care insurance, those costs might be covered under that policy. If he needs help with meals, bathing, dressing, or house cleaning, moving to a nursing home might not be necessary.
There are many options for in-home support.
The way to begin is to have a conversation with your father about what he would like and the areas where he could use some help. After you both have a clear understanding of the need, contact your local senior center to find out what is available. If there is not a senior center nearby, contact the eldercare locator at 800-677-1116.
Do you have a question? Questions for the “Ask Jean” column may be sent to Jean Mueller at [email protected]
Jean Mueller has been a registered nurse for over 30 years. Her experience includes working in home care settings, skilled nursing care, and training individuals to become certified nursing assistants. For the past 13 years she has worked in the Aging Services department of the Madison Diocese Catholic Charities.