Plan Your Future: The Big Things That Medicare Does NOT Pay For

Our last article discussed what Medicare will cost you. It also said that Medicare could be the best health insurance you’ve ever owned, at the lowest overall cost. That’s great news.

What’s Missing from Medicare?

No health insurance plan is perfect, of course, and Medicare does not cover some things that you will very likely need. Some of those things are big. They can cost you a lot out of pocket and completely ruin your finances. What are they?

The Huge Expenses that Medicare Will NOT Cover

If you set up your Medicare right, it will do a great job paying for your doctor, hospital and prescription bills. So that worry is over.

Expenses that Medicare will not Cover
Source: cnbc

But many people are aware of another worry. And it’s an expensive one too. It can:

  • Ruin your finances and leave you poor
  • Leave your spouse poor after you die
  • Destroy your family’s wellbeing, happiness and peace of mind

It is short-term care and long-term care. Rather than avoid the subject and hoping that it doesn’t happen to you (the chances are 50% that it will happen) let’s face the problem head on.

Why You Need Short-Term or Long-Term Care Insurance

Here are two examples of common Medicare exclusions:

Home Care After Accidents

Charlie was a senior in great physical condition. One day he was up on a ladder cleaning his gutters, fell off, and broke his hip. Multiple hospital stays, complications, and infections after surgery left him laid up at home for six months.

His spouse, Jennifer, could not pick Charlie up to bathe him, clothe him and move him to and from his wheelchair. So, she hired someone to come in and bathe, dress and move Charlie around, and to cook, clean and shop for them. For the six months that lasted, Charlie and Jennifer paid for that care out of their own pocket.

home health care insurance
Source – senior connection

Medicare does not cover ‘custodial’ home health care. The most Medicare will do is send a nurse out, perhaps once per week, to monitor medications, give injections and the like. The nurse will not do housework, shopping or things like that.

Cognitive Impairments

Two years after Charlie recovered, Jennifer was diagnosed with dementia, and then later with Alzheimer’s disease. Physically very healthy, Jennifer still could not be left alone.

Charlie drained his investment accounts to pay for many months of home health care. Then he used more money from savings to move them into an assisted living facility. Eventually Jennifer had to be put into a nursing home, and that expense completely wrecked the rest of Charlie’s life savings and investments. Now there is no inheritance to leave their children and grandchildren.

Medicare does not pay for assisted living or for nursing home stays.

The Solution is Easy to Discuss

Let’s talk over an insurance plan that makes sense for you. A short-term care policy, or perhaps a long-term care policy, will protect your life savings; and your family’s well-being. Don’t become a burden to those you love.

 long term care insurance

On a Budget?

Adding a long-term care option to a life insurance policy could only cost you pennies a day. Let’s find out now, before it’s too late.

Short Term and Long Term Care Insurance for Baby Boomers

Every now and then, we all need medical attention. Of course, it is not something we’re over the moon about, but hey, one can’t avoid the inevitable. Based on the severity of your ailment or disease, your Doctor will make recommendations and suggestions. He will decide whether your medical condition requires short term or long term care. What does this mean, you ask? Well, today, we will go over the difference between short term and long term care insurance and practices.

nursing home insurance
Source: very well health

Short Term Care: As the name suggests, short term care is temporary and brief. It provides medical and custodial services. This kind of medical care usually includes post-surgery care, physiotherapy, trauma care management, recovery from an accident, postpartum recovery, rehabilitation facilities, and other ailments that are goal oriented and demands that the patient receiving this type of care stays at the medical facility for a specific period.

This can vary from weeks to months or even longer based on the severity of your condition and on factors such as your body’s mechanism to cope with the treatment and its responsiveness to the medical care you are receiving. For instance, a person recovering from an accident may be given home care as opposed to a person who underwent surgery who is required to live at a medical facility for a specific period of time so his or her caregiver can monitor the patient’s condition and recovery.

Read more about the FAQs on Short Term and Respite Care

Short term medical care includes services such as wound dressing and sanitation, administration of prescription drugs and injections, saline treatment, patient education, post surgery consultation and care, monitoring and rehabilitative therapy.

short term care insurance
Source: knowledge stuff

Short term care insurance policies typically pay for services that include the intervention of a medical professional. Services that involve home care and assisted living. Short term insurance policies do not pay for years at a stretch, instead it pays for benefits for twelve months or less. Many policies have a 0 day deductible and a full year of benefits. Most people find this very affordable and convenient.

Long Term Care: Long term care includes a stay at a nursing home for long periods of time, personal assistance at home, adult day care centers, assisted living facilities and skilled nursing facilities, collectively known as long-term care facilities or LTCFs. This is a care type designed especially for our senior citizens who need help with simple everyday activities such as bathing, using the toilet, getting dressed, eating, grooming and other everyday activities that we take for granted. It caters to patients with serious medical conditions like Parkinson’s disease, Alzheimer’s disease, renal failure, cancer care, strokes and other critical illnesses.

Learn more about short term and long term care insurance

long term care insurance
Source: national care planning council

Many Long-term care insurance policies cover a variety of medical services such as home care, assisted living, adult daycare, respite care, hospice care, nursing home, Alzheimer’s facilities, etc. The coverage usually kicks in from day one and continues based on the terms and conditions of the policy you enroll under

There are two types of long term policies: Traditional policies and combination or hybrid policies.

The average cost of long term care is approximately $225 a day or $6,844 per month for a semi-private room in a nursing home, and $253 a day or $7,698 per month for a private room in a nursing home.

long term care planning
Source: insight law

Typically long-term care facilities offer a high level of medical care and support, while short term care facilities provide support with recovery and rehabilitation. Long term care involves the treatment of chronic and critical illnesses such as heart attacks, strokes, ALS, renal failure and the likes. Short term care offers services like speech therapy, counselling, occupational therapy, post trauma care, physiotherapy etc.

You will find more information on the benefits, eligibility and deductibles of long term care insurance

Are you  looking for professional advice on this topic. How about booking a consultation with our experts here at Flagship Financial