Who Pays for Long-Term Care?

Who Pays for Long-Term Care?

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You may be surprised. Consumer surveys reveal common misunderstandings about which public programs pay for long-term care services. It's important to clearly understand what is and isn’t covered.

Medicare:

  • Only pays for long-term care if you require skilled services or rehabilitative care:
    • In a nursing home for a maximum of 100 days, however, the average Medicare covered stay is much shorter (22 days).
    • At home if you're also receiving skilled home health or other skilled in-home services. Generally, long-term care services are provided only for a short period of time.
  • Does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term care services.
  • You'll have to pay for long-term care services that are not covered by a public or private insurance program.

Medicaid:

  • Does pay for the largest share of long-term care services, but to qualify, your income must be below a certain level and you must meet minimum state eligibility requirements.
  • Such requirements are based on the amount of assistance you need with ADL.
  • Other federal programs such as the Older Americans Act and the Department of Veterans Affairs pay for long-term care services, but only for specific populations and in certain circumstances.
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*Information on this site's long-term care webpages is from www.longtermcare.acl.gov.