Will Medicare Pay for a Nursing Home in Kentucky?

Have you looked into the future as you get older wondering how you would pay for long-term care if you were to need it? In Kentucky, will Medicare pay for a nursing home? Not necessarily. In fact, many individuals mistakenly believe that Medicare will cover their nursing home expenses. Be aware that Medicare is primarily designed as an acute care payor system so it is focused on short-term medical needs rather than long-term care. By not knowing there may be gaps in Medicare coverage, families are unprepared for the financial burden of extended nursing home stays.
Because of the increase in the population of older adults in Kentucky, it is important to know that there are limitations to Medicare. If there is no planning ahead, then nursing home care can rapidly become a burden and family members may find themselves in a difficult financial situation. Now is the time to research Medicaid and other public benefit programs with a Kentucky estate planning and elder law attorney. Why? Because without proper planning, nursing home care can quickly become a significant expense and individuals and families may find themselves in a difficult financial situation. By exploring other options, such as Medicaid and other public benefits programs, with an experienced Kentucky estate planning and elder law attorney you can have peace of mind that your long-term care needs are adequately met. Below we have specifics of Medicare’s coverage limitations and the alternatives available to help our clients work through the complexities of long-term care planning in Kentucky we want to share.
To begin, Medicare is a federal health insurance program primarily for people aged 65 and older, as well as for certain younger individuals with disabilities. It is true that Medicare is an invaluable resource for many, but its coverage is limited to acute care. What does that mean? It means it is designed to pay for short-term medical treatment rather than ongoing, long-term care.
For example, Medicare may cover up to 100 days of skilled nursing care under certain conditions, such as after a hospital stay, but only if the individual requires daily skilled care provided by, or under the supervision of, skilled nursing or therapy staff. Even then, full coverage is only provided for the first 20 days, after which a significant co-payment is required. After 100 days, Medicare coverage ends entirely, leaving individuals responsible for the full cost of their care.
Everyone needs to know that the cost of long-term care in a nursing home can be staggering. In fact, according to the Genworth Cost of Care Survey, the median annual cost for a private room in a nursing home in Kentucky is over $100,000. So with Medicare only covering short-term stays, how will families manage these expenses over the long term? With that said, this is where understanding your options and planning ahead becomes crucial.
There is a joint federal and state program that plays a critical role in providing long-term care coverage for those who meet its eligibility requirements. It is called Medicaid. Unlike Medicare, Medicaid works to cover long-term care services, including nursing home care, for eligible individuals. We highly recommend that you work with an experienced Kentucky estate planning and elder law attorney because qualifying for Medicaid can be complex, involving strict income and asset limits.
Knowing the limitations of Medicare and the complexities of Medicaid, it is important to begin planning as soon as possible. Planning ahead for long-term care can help individuals and their families avoid the financial strain of paying out-of-pocket for nursing home care. By working with a Kentucky estate planning and elder law attorney, individuals can explore various options to protect their assets and know that their long-term care needs are met.
When preparing for the future knowing that Medicare has limited coverage for nursing homes in Kentucky is a crucial step in preparing for the future. By planning now and working with an experienced Kentucky estate planning and elder law attorney, individuals and their families can explore all available options and develop a strategy that ensures long-term care needs are met without depleting any assets. Of course actions can be taken in a crisis, but individuals and their families taking action now to protect their future can give everyone peace of mind.
We know this article raises more questions than it answers. Our firm offers a number of legal services designed to help you and your family. We understand that not everyone can come into our office. Unlike other firms we can make arrangements to come to you. Let us know when you call us at (502) 348–4873 to set an appointment or fill out our contact form and we will contact you to coordinate a meeting based on your individual needs.