A lot of people mistakenly think that Medicare covers long-term nursing home care but it only provides very limited benefits. It is confusing. One of the major differences is that Medi-Cal is a needs-based program or income based healthcare assistance program. Federal, state and local tax funds fund it.
Medicare, on the other hand, is a health-care benefit that you are entitled to when you reach age 65 inasmuch as you paid into it during your working lifetime.
Here's what Medicare does cover with respect to skilled nursing care (nursing home care): (i) covers the first 100 days of skilled nursing care provided it was preceded by an inpatient hospitalization of at least 3 days. For example, a person suffering a stroke typically ends up in the emergency room, with a subsequent hospitalization, followed by rehabilitation in a skilled nursing facility; (ii) Medicare covers the first 20 days in full; and (iii) days 21-100 are partially covered and in 2019, you will be required to pay a daily $167.50 co-payment. After 100 days, the patient is fully responsible. Given that the average monthly cost of nursing home care in California exceeds $8,500 -- that will rapidly deplete an estate. Most families are simply not prepared for that kind of financial burden!
Next, "What Can We Do to Plan for Medi-Cal for Our Parents or Loved One?"
