[This is part one of our guest blog series on elder care written by Carolyn L. Rosenblatt, RN, Elder law attorney, AgingParents.com]
Have you ever thought that when your parents age and receive Medicare, that the government will take care of whatever health care needs they have? That's a myth lots of people believe. But beware. There's much to consider in this belief that isn't true, such as how the government will and won't take care of our aging parents.
The Myth: Medicare will cover you for all costs of care when you are over 65 and start receiving it.
The Truth: Medicare is a federally paid insurance program with limited coverage for the very things that most people need as they age.
Let's look at a few of the things that Medicare does cover. First, it will pay for a hospitalization once the elder is admitted. It will pay for doctor's office visits, certain medications and a limited amount of rehabilitation in a nursing home. It will not pay for a long term stay in a nursing home once the need for skilled care (nursing, physical therapy and other therapy) is over. The patient does not get to decide when he or she no longer needs therapy. The staff at the nursing home decides this. Typically, a few weeks of therapy is all you get. Then they send you home or you have to pay for nursing home care out of pocket.
Now let's consider what Medicare does not pay for. First, any care in a nursing home after the staff decides the person is not making much progress. Once they decide you are no longer eligible and your care is custodial, nothing is covered. Medicare calls everything that is not skilled care from licensed providers "custodial care". Since its inception, Medicare has never paid for custodial care.
Medicare does not pay for help at home to keep your aging parent out of a nursing home. It does not pay for hearing aids, dental care, and many medications doctors prescribe. It only covers 80% of the cost of services it does pay for, and that's after a deductible. Most people have to pay out of pocket for supplemental insurance for the other 20% of costs for treatment. Supplemental insurance does not cover the things that Medicare will not pay for. It is only a supplement that picks up the other 20% of things Medicare will pay for in the first place.
What if your aging parent needs help at home with something basic, like bathing, walking and cooking? Or just to maintain independence and not have to go to a nursing home? Wouldn't it be cheaper to give them help at home rather than spend taxpayer dollars after they go broke paying for help at home out of pocket? Of course. And that is not how our government works.
If your aging parent runs out of retirement savings for any reason, and they need help at home, you, the adult child may have to pay for it. With longevity being what it is, this is a serious risk for many of our elders. All the kinds of help called "custodial" are quite expensive. The median price of a home care worker, for example, is $20 an hour.
Medicaid is the government sponsored program of insurance for those who are low income and have limited assets. You have to be really out of money to qualify for it, with no more than $2000 in the bank, investments or a retirement plan. And what Medicaid will pay for can look pretty dismal. The lowest end nursing homes are among those that accept Medicaid. You would not want to send your loved one there if there were any way to avoid it.
The takeaway is this: Look ahead. No magical government program is going to take care of your aging parents. Conservative spending in one's later years may leave enough to cover the cost of the kind of home help most of us are eventually going to need.
Learn more about aging parents and how to best manage their needs at AgingParents.com and The Family Guide to Aging Parents.
Carolyn Rosenblatt has over 45 years of experience in her combined professions of nursing and legal practice. She has expertise in aging issues and serves as a consultant and conflict resolution specialist. She has worked extensively with geriatrics and legal issues of aging. Together with her husband, psychologist Dr. Mikol Davis, she founded AgingParents.com, a resource for families, located in San Rafael, CA. AgingInvestor.com, an education resource for the financial services industry about aging clients, diminished capacity and financial decisions.