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Medi-Cal Planning | Paying For Long-Term Care

Paying For Long-Term Care

Some people are able to pay for long-term care out of their own funds. Others are able to get long-term care insurance before they became ill. Unfortunately, the majority of people needing long-term care have already become ill and cannot obtain long-term care insurance. They also cannot afford to pay for the cost of long-term care themselves without depleting all of their life savings and other assets. A person under these circumstances is forced to look to public benefits programs, such as Medicare and Medicaid, for help.

What Is Medicare?

Medicare is a federal health insurance program primarily for Social Security recipients who are 65 years of age or older. Many people assume that Medicare will cover the cost of long-term care. But the reality is that it will only cover the cost of some nursing home care. For example, the program will pay for skilled nursing care, but will not pay for custodial care – the kind of help that someone in need of long-term care usually requires. Also, Medicare will pay the full cost of the first 20 days you spend in a nursing home as long the only services you receive are Medicare “covered” services. Thereafter, the Medicare recipient will need to make a co-payment of $105 a day. Altogether, Medicare will not pay for more than 100 days of skilled care in a nursing facility.

What is Medi-Cal (a.k.a Medicaid)?

Medi-Cal is a “need-based” health care payment program funded by the state and federal governments. The program is designed to pay for the medical care of those California residents who have very limited income or resources. Medi-Cal pays for the bills of most nursing home residents in California. If you have very limited resources and are over the age of 65, blind, or disabled, you may qualify for this program. However, with the help of an elder law attorney, a middle-income person may also qualify for Medi-Cal.

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