Does Medicare Cover Long-Term Care?

Many people mistakenly think that Medicare will pay for their future long-term care needs. That's probably because prior to 1998 it did. But the rules changed with the passage of new legislation. Today, Medicare coverage for long-term care services is very limited and it should not be considered a funding source for long-term care needs.


Medicare is the federal health insurance program for people 65 years of age or older or the totally disabled. It was created in 1965 under the Social Security Act. Medicare services focus on acute medical conditions and are curative and rehabilatative in nature. Long-term care addresses chronic conditions and is custodial in nature.

There are four different parts to Medicare:

Medicare Part A is considered hospital insurance. It helps cover the cost of a skilled nursing facility following three nights in a hospital when discharged to a Medicare-approved skilled nursing facility, hospice or approved for home health care. 

Medicare Part B is considered medical insurance and covers medically-necessary services like doctors’ fees and outpatient care. Part B also helps cover some preventive services to help maintain health. This is a voluntary program with premium cost, deductibles and co-pays. The monthly premium is deducted from the insured’s social security check.

Medicare Part C, also known as Medicare Advantage Plans, combines Part A, Part B and sometimes Part D.. These plans must cover medically necessary services and can charge different co-payments, coinsurance or deductibles. Medicare Advantage Plans are offered through private health systems and generally offer more coverage including hearing, vision and dental plans.

Medicare Part D is prescription drug coverage. It helps lower prescription drug costs and helps protect against higher costs in the future. There are several plans offered through private insurance carriers.

Medicare Supplement Policies,  also known as Medigap plans, augment Medicare coverage. They are standardized by the Centers for Medicare and Medicaid Services, but sold and administered by private companies. 

Some Medigap policies sold after the introduction of Medicare Part D on January 1, 2006 may include coverage for prescription drugs. Medigap policies sold after January 1, 2006 are prohibited from covering drugs.

Source: Centers for Medicare and Medicaid Services www.medicare.gov.

Medicare and Medigap plans are not designed to pay for long-term care.
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