Why does Medicare’s long term care benefit pay such a small portion of the cost of long term care?
Medicare provides coverage for up to 100 days of long term care for its beneficiaries (generally speaking, those who are over age 65 or disabled and who are eligible to receive Social Security retirement or disability benefits). While that benefit may sound generous, it is sharply limited by two factors. First, while the first 20 days of care are fully covered, the next 80 days require a substantial ($137.50 in 2010) daily payment by the beneficiary. Second, Medicare limits its long term care benefit by defining “skilled nursing” care to include only those services which will result in rehabilitation of the patient. Between those two limitations few nursing home residents (but more home care patients) are covered by Medicare for their long term care.
