Phone: 727-397-5571

Medicare and Long Term Care Insurance

In helping your elderly loved one, you are frequently dealing with Medicare and long-term care insurance issues. These concerns may arise in a time of crisis or it may be something that is expected. Regardless, we can help make sure you correctly access your necessary Medicare benefits. Similarly, we can help you decide if long-term care insurance is something you need. We do not sell long-term care insurance but we know how the long-term care industry works; an educated consumer usually makes the best decision.

Medicare and Rehab

If your loved one has had a recend medical event, such as a fall or a stroke, Medicare will help pay for their rehabilitation stay in a skilled nursing facility to receive rehabilitation. Medicare (or an HMO replacement) is a Federally funded program with two parts – A & B.

Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facilities, hospice, and home health care. Most people don’t pay a Part A premium because they paid Medicare taxes while working. This is called "premium-free Part A."

Part B helps cover medically-necessary services like doctors' services, outpatient care, durable medical equipment, home health services, and other medical services. Part B also covers some preventive services. If you have Part B, you pay a Part B premium each month which is taken directly from your Social Security check. Most people will pay the standard premium amount of $104.90/month (2016).

When dealing with Medicare in the long-term care planning context, we are frequently dealing with rehabilitation benefits. Here, Medicare covers skilled nursing and rehabilitative services that are medically necessary after a 3-day minimum hospital stay for a related illness or injury. To qualify for care in a skilled nursing facility, your doctor must certify that you need daily skilled care like intravenous injections or physical therapy. Medicare doesn’t cover long-term care or custodial care; the benefits are as follows:

  • You pay:

    • Days 1–20: $0 for each day you are receiving rehab.
    • Days 21–100: $161 for each day you are receiving rehab.
    • Days 101 and beyond: all costs.

The reality is that most of our clients never use their full 100 days as most do not need that much rehabilitative therapy. This is where we can help find appropriate discharge plans with our Life Care Planning.

Long-Term Care Insurance

While most of our clients do not have Long-Term Care Insurance for various reasons, we highly recommend coverage for many of our clients. The reality is that this insurance is really an asset protection device – if you have money, Long-Term Care Insurance can help offset the very, very high cost of long term care. Our Life Care Planning Team will be able to discuss this insurance with you and provide our learned knowledge to your situation to help you decide if Long-Term Care Insurance would be worthwhile to you. 

Whether you are planning for incapacity or you are in a time of crisis, it is important to work with an attorney who has the experience and resources to cover all the bases so there are no surprises. DeLoach, Hofstra & Cavonis, P.A. is a full service Elder Law firm that can protect your assets, fight to get the best health care, and help you make sound financial decisions to maximize your assets and government benefits like Medicaid. In order to maximize your assets, your Medicare coverage, health insurance, long-term care and other policy or benefit at your disposal must be carefully managed. A Florida Bar Association Board Certified Elder Law attorney like D. R. "Rep" DeLoach, III is especially trained to do just that.

Helping Every Step of the Way

Quick Facts: How An Elder Law Guide Protects You

  • You will receive guidance on how to best utilize Medicaid and Medicare.
  • Should you stay on your Medicare plan?
  • Medicaid and asset protection planning, even with your loved one already in the nursing home.
  • Ways around the 5 year lookback period.
  • We will help you properly apply for Medicaid and other benefits.
  • We will guide you and your loved one to make the most of your rehabilitation and placement afterwards.

Experienced Attorneys Offering Personal Service

DeLoach, Hofstra & Cavonis, P.A. is a full-service law firm that is dedicated to elderly citizens of St. Petersburg, Seminole, and Pinellas County. We are large enough to have the skills, experience and resources to handle all of your elder law issues. However, we provide the level of customer service enjoyed at smaller law firms. If you have any questions or concerns that you'd like to discuss with us, give us a call or contact us online any time.

Live Chat