The $100,000 “Skilled Nursing” Bill: The 5 Things You Must Know About Medicare’s Limited Coverage
The Bill That Blindsided My Neighbor
My neighbor was so relieved that Medicare covered her husband’s hospital stay. She was blindsided when the “skilled nursing” facility he went to for rehab sent them a $100,000 bill. I wish she had known these five things. 1) Medicare only covers skilled nursing for a very short time. 2) You must have a “qualifying” 3-day hospital stay first. 3) You only get up to 100 days, and the co-pays after day 20 are huge. 4) The care must be “skilled,” not just custodial. 5) It is not, and never has been, a long-term care solution.
My Guide to the “3-Day Hospital Stay” Rule That Must Be Met Before Medicare Pays for Rehab
The Most Important 72 Hours of Your Life
My mother fell and broke her hip. She spent two days in the hospital and was then transferred to a rehab facility. A week later, we got a huge bill. Medicare denied the rehab stay. The reason? The dreaded “3-day rule.” To qualify for Medicare-covered skilled nursing care, you must first be formally “admitted” as an inpatient to a hospital for three consecutive days. My mom’s two-day stay meant she was out of luck. Those 72 hours are the golden ticket to getting your rehab covered. Without them, you pay for everything.
How Medicare’s “100-Day” Skilled Nursing Benefit Really Works (And Why Almost No One Gets All 100 Days)
The Myth of the 100 Days
The “100-day” skilled nursing benefit is one of the most misunderstood parts of Medicare. It is not a guarantee. Here’s how it really works. The first 20 days are covered 100%. From day 21 to day 100, you are responsible for a huge daily co-pay (over $200 a day). But almost no one gets all 100 days. The moment the facility determines that you no longer need daily “skilled” care (like physical therapy) and only need “custodial” care (like help with bathing), Medicare coverage ends, whether it’s day 25 or day 65.
The “Improvement Standard” Myth: How I Kept My Mom’s Therapy Covered Even When She Wasn’t “Improving”
The Plateau That Almost Ended Her Care
My mom was in a skilled nursing facility after her stroke, receiving physical therapy. The facility told us they were stopping her therapy because she had “plateaued” and was no longer improving. I knew this was wrong. I had read about the “Jimmo v. Sebelius” court settlement. It says that Medicare cannot deny therapy services based on a patient’s lack of improvement. As long as the therapy is necessary to maintain her current condition or prevent it from getting worse, it should be covered. Citing this settlement got her therapy reinstated.
My Story: We Thought Medicare Would Pay for Dad’s Nursing Home. We Were Catastrophically Wrong.
The Misunderstanding That Cost Us Our Life Savings
My father had Alzheimer’s, and we knew he needed long-term nursing home care. We had always assumed that his Medicare would pay for it. It was the single biggest, and most catastrophic, misunderstanding our family ever had. We put him in a nice facility. The bills started coming—$10,000 a month. Medicare paid nothing. We learned the hard way that Medicare does not pay for long-term “custodial” care. We had to spend down my parents’ entire life savings before he could finally qualify for Medicaid. Our ignorance cost us everything.
“Custodial Care” vs. “Skilled Care”: The Two Words That Define What Medicare Will Pay For
The Million-Dollar Distinction
My mother needed help with bathing, dressing, and remembering to take her pills. This is “custodial care.” My father needed his surgical wound checked daily by a nurse and intensive physical therapy. This is “skilled care.” The difference between these two words is worth a million dollars. Medicare will only pay for short-term, daily skilled care. It will not, under any circumstances, pay for long-term custodial care. Understanding this distinction is the absolute key to understanding what Medicare will and will not cover for long-term care.
The Unofficial Guide to “Home Health Care” on Medicare (And Its Severe Limitations)
The “Homebound” Hoop You Have to Jump Through
I thought getting Medicare to cover “home health care” for my dad would be a great way to keep him out of a nursing home. I was surprised by the severe limitations. First, he had to be certified as “homebound” by his doctor, meaning it’s a major effort for him to leave the house. Second, the care had to be “skilled” and part-time, like a nurse visiting a few times a week. It did not cover a full-time, 24/7 caregiver to help with daily living. It’s a helpful, but very limited, short-term benefit.
How to Maximize Your “Physical Therapy” and “Occupational Therapy” Benefits
Getting Every Drop of Therapy We Could
After my husband’s knee replacement, he needed a lot of physical and occupational therapy. The skilled nursing facility seemed eager to discharge him early. We knew we had to be his advocates. At every care plan meeting, we came prepared. We documented his progress, but we also highlighted his remaining deficits. We asked the therapist for specific, measurable goals for the next week. By being actively involved and constantly advocating for his need for continued skilled therapy, we were able to maximize his covered rehab stay.
My Guide to Getting a “Hospice” Diagnosis to Cover End-of-Life Comfort Care
The Shift from “Cure” to “Comfort”
My mother’s battle with cancer was long and difficult. Finally, her doctor told us that further treatment would be futile. He recommended we switch our focus from “cure” to “comfort.” He certified her as being terminally ill with a life expectancy of six months or less. This certification was the key to unlocking the Medicare hospice benefit. She had to agree to stop curative treatment. In exchange, Medicare covered 100% of the cost of her pain management, nursing visits, and support care, allowing her to live her final months in peace.
The Unspoken Truth About “Memory Care” and Why Medicare Doesn’t Cover It
The Safe Place That Medicare Wouldn’t Pay For
My dad’s dementia progressed to the point where he was wandering and unsafe at home. He needed a secure “memory care” unit. We were shocked to learn that Medicare does not consider this a medical necessity and does not pay for it. The care he needed was considered “custodial”—supervision and help with daily living. The secure doors and specialized activities were not a “skilled” service. We had to pay for his memory care entirely out of pocket until his assets were spent down and he could qualify for long-term care Medicaid.
How to Use a “Medicare Advantage” Plan’s Short-Term Care Benefits Strategically
The Three-Week Stay My Advantage Plan Paid For
My mother, who had a Medicare Advantage plan, had a bad fall. She didn’t have a qualifying 3-day hospital stay, so Original Medicare would have paid nothing for her rehab. But her Advantage plan had different rules. Many Advantage plans waive the 3-day rule. They authorized her to go to a skilled nursing facility for three weeks of intensive rehab, even after just a one-day hospital stay. The short-term rehab benefits in a Medicare Advantage plan can often be more flexible and generous than those in Original Medicare.
My Guide to the “Benefit Period” for Skilled Nursing (And How It Can Restart)
The 60-Day Clock That Reset My Benefits
My father used 30 days of his Medicare skilled nursing benefit after a surgery in January. He went home, and for 60 consecutive days, he did not require any inpatient care. In April, he had another fall and needed to go back to the rehab facility. Because he had been “out” for more than 60 days, his “benefit period” clock had reset to zero. He was now entitled to a full, fresh 100 days of skilled nursing coverage. Understanding this 60-day reset rule is crucial for managing your benefits.
The Unspoken Power of Appealing a “Discharge” from a Rehab Facility
The “No” We Didn’t Take for an Answer
My mom was in a skilled nursing facility, and she was still very weak. On a Friday afternoon, the facility handed us a letter saying her Medicare coverage was ending and she was being discharged on Monday. It felt like they were just trying to clear a bed for the weekend. We knew we had a right to an immediate appeal. We contacted our state’s “Quality Improvement Organization.” The appeal forced the facility to let my mom stay while an independent reviewer looked at her case. We won the appeal, and she got another week of covered therapy.
How to Use a “Medigap” Policy to Cover the Steep Skilled Nursing Co-Pays (Days 21-100)
The Co-pay That My Medigap Paid
My dad was in a skilled nursing facility for rehab. Medicare covered the first 20 days completely. But on day 21, a huge daily co-pay of over $200 started. This would have drained his savings in a matter of weeks. Thankfully, he had a Medigap plan. His Medigap policy covered that daily co-pay 100%, from day 21 all the way through day 100. His Medigap plan was the crucial bridge that allowed him to get the full, extended course of rehabilitation he needed without facing a catastrophic bill.
My Story: The Day We Got the “Notice of Medicare Non-Coverage” Letter
The Letter That Said the Money Was Stopping
My mom was recovering in a rehab facility. She was making slow progress. Then, the facility’s case manager handed me a letter. It was the “Notice of Medicare Non-Coverage.” It said that as of two days from now, Medicare would no longer be paying for her stay because her care was no longer considered “skilled.” The letter was a terrifying, official notice that the financial clock was ticking. It also explained my right to an immediate appeal. We had to make a very difficult decision, very quickly.
The Guide to “PACE” Programs: The All-Inclusive Model for People Who Would Otherwise Need a Nursing Home
The Program That Keeps My Mother Home
My mother needs a nursing home level of care, but she is desperate to stay in her own house. We found a “PACE” program near us. It’s an all-inclusive care model covered by both Medicare and Medicaid. She goes to a PACE day center a few times a week where she sees her doctors, gets her physical therapy, and socializes. They provide all her transportation. They manage all her medications. PACE is her health plan and her senior center, all rolled into one. It’s the program that is allowing her to age in place safely.
How to Find a “Geriatric Care Manager” to Help You Navigate This Maze
The Expert I Hired to Be My Guide
My father was discharged from the hospital, and I was suddenly in charge of arranging his home care, finding a rehab facility, and dealing with his bills. I was completely lost in a maze of options. I hired a “geriatric care manager.” She was a licensed social worker who was an expert in local senior resources. She knew which facilities had the best reputations. She understood the Medicare rules. She was the professional guide who helped our family navigate the most complex and emotional journey of our lives. Her fee was worth every penny.
The Unspoken Role of “Speech Therapy” After a Stroke
The Words We Fought to Get Back
After my husband’s stroke, he couldn’t speak. It was a condition called aphasia. The skilled nursing facility focused on his physical therapy, but his speech therapy was just as important. We had to advocate for him to get the intensive speech therapy he was entitled to under his Medicare benefit. The speech therapist worked with him every day, helping him find his words again. It was a long, slow process, but that skilled therapy, covered by Medicare, was the key to him reconnecting with his family and his world.
My Guide to the “Appeals” Process When a Facility Cuts Off Care
The Fight We Were Prepared For
The rehab facility told us they were discharging my dad because Medicare would no longer pay. We believed he still needed care. We knew we had to appeal, fast. The discharge notice they gave us had the phone number for our state’s “Quality Improvement Organization” (QIO). We called immediately to file an expedited appeal. This automatically kept my dad in the facility with his Medicare coverage active while the QIO did an independent review of his case. Knowing how to launch that appeal gave us the power to fight back.
How “Observation Status” in the Hospital Can Invalidate Your Skilled Nursing Benefit
The Two Nights That Didn’t Count
My dad spent two nights in the hospital after a fall. The doctor then recommended he go to a rehab facility for skilled nursing. We were shocked when Medicare denied the claim. The reason? The hospital had never formally “admitted” him as an inpatient. He was there for two nights “under observation.” Because he didn’t have the required, prior 3-day inpatient stay, his skilled nursing benefit was invalid. It’s a cruel, bureaucratic trap that costs families a fortune.
The Unspoken Financial Devastation of Long-Term Care Costs
The Legacy That Vanished in Two Years
My parents did everything right. They worked hard, saved their money, and had a comfortable nest egg of about $250,000. Then, my mother was diagnosed with Alzheimer’s. The cost of her memory care facility was $10,000 a month. In just over two years, their entire life savings were gone. Completely wiped out. They had to spend down to their last $2,000 to qualify for Medicaid. The cost of long-term care in this country is a financial tidal wave that can destroy the legacies of even the most responsible families.
My Guide to Finding a Good “Rehab” Facility That’s Not a Depressing Nursing Home
The Place That Felt Like a Health Resort, Not a Hospital
My dad needed post-surgery rehab, and I was dreading the thought of him being in a depressing, old nursing home. I did my research. I used the “Medicare Care Compare” website to look for facilities that had a 5-star rating specifically for “short-term rehabilitation.” I found a newer facility that felt more like a health resort. They had a bright, modern physical therapy gym and private rooms. It was still a skilled nursing facility, but it was designed for short-term rehab, not just long-term custodial care.
How to Transition from “Medicare-Paid” Rehab to “Private Pay” or “Medicaid-Pending”
The Day the Medicare Money Ran Out
My mom was in a rehab facility, and we knew her 100 days of Medicare coverage were coming to an end. She still wasn’t ready to come home. We had a meeting with the facility’s business office. We had to transition her payment status. Because she still had some savings, she became “private pay,” meaning we had to start writing a check for the daily rate. We were also simultaneously applying for Medicaid for her. The facility allowed her to stay with a “Medicaid-pending” status while we waited for the application to be approved.
The Unspoken Importance of the “Care Plan” Meeting at the Facility
The Meeting Where We Made Our Voices Heard
Two days after my mom was admitted to the rehab facility, they held a “care plan” meeting. It was us, the nurse, the physical therapist, and the social worker. This meeting was our chance to be heard. We talked about my mom’s goals. We asked about the therapy schedule. We discussed the discharge plan. We made it clear we were an involved, observant family who would be advocating for her every step of the way. Being an active participant in that first care plan meeting set the tone for her entire stay.
My Story: How We Pieced Together Care Using Medicare, Savings, and Family Help
Our Family’s Patchwork Quilt of Care
My dad needed 24/7 care at home. We couldn’t afford a full-time agency. We created a patchwork quilt of care. His Medicare covered a visiting nurse a few times a week. We used his savings to hire a private caregiver for four hours every morning. My sister took the afternoon shift. I took the evening shift. We were all exhausted, but this combination of formal and informal care, of Medicare and our own time and money, was the only way we could honor his wish to stay in his own home.
The Guide to “Durable Medical Equipment” (Like Hospital Beds) for Home Care
The Hospital That Came to Our House
To bring my mom home safely, we needed a hospital bed and an oxygen concentrator. Her doctor wrote a prescription for this “durable medical equipment” (DME). Medicare Part B covered 80% of the cost of renting the equipment. Our Medigap plan covered the other 20%. We used a Medicare-certified DME supply company. They delivered the bed, set it up in her living room, and taught us how to use the oxygen machine. This benefit was crucial for creating a safe, at-home care environment for her.
How to Use Medicare for “Wound Care” and “IV Therapy” at Home
The Skilled Nurse Who Came to Us
My dad was discharged from the hospital with a complex surgical wound that needed daily care and a course of IV antibiotics. We thought he would have to go to a nursing home. But his doctor certified that he was “homebound.” Because he met this criteria, Medicare’s home health benefit kicked in. A skilled nurse came to our house every single day to change his dressing and administer his IV medication. This skilled care, provided in the comfort of our own home, was completely covered by Medicare Part A.
The Unspoken Emotional Toll of Navigating Long-Term Care for a Loved One
The Hardest Job I Never Applied For
Becoming the caregiver for my father and the navigator of his long-term care journey was the hardest job I’ve ever had. I wasn’t trained for it. The emotional toll was immense. I felt a constant mix of grief, frustration with the bureaucracy, and guilt that I wasn’t doing enough. I was drowning. The best thing I did for myself was join a local caregiver support group. Just being in a room with other people who truly understood the weight I was carrying was a lifeline that kept me from going under.
My Guide to Understanding the “Five-Star Rating” System for Nursing Homes
The Report Card I Studied Before I Chose
I would never send my child to a 1-star school, so I wasn’t going to send my mother to a 1-star nursing home. Before I toured any facilities, I went to the “Medicare Care Compare” website. It has a five-star rating system for every nursing home in the country. It rates them on things like staffing levels, health inspections, and quality measures. I made a rule for myself: I would only consider facilities that had an overall rating of four or five stars. This simple tool helped me weed out the bad places immediately.
How a “Chronic Care SNP” (Special Needs Plan) Can Help Manage Long-Term Conditions
The Plan That Was Built for My Dad’s Disease
My father has end-stage renal disease (ESRD) and needs dialysis three times a week. It’s a complex, chronic condition. We enrolled him in a “Chronic Condition Special Needs Plan” (C-SNP). It’s a type of Medicare Advantage plan specifically for people with certain diseases. His C-SNP has a network of top nephrologists. It provides free transportation to his dialysis appointments. And he has a dedicated care coordinator who helps him manage his medications. This specialized plan provides a level of coordinated care that a generic plan could never match.
The Unspoken Question: “At What Point Do We Consider Medicaid?”
The Conversation We Had to Have
My mom was in an assisted living facility, and we were paying for it from her savings. Every month, I would watch her bank account get smaller and smaller. We had to have a hard conversation as a family. We had to ask, “At what point do we start the Medicaid application process?” We decided that when her savings dropped to about a six-month supply, we would hire an elder law attorney and begin the application. It was a painful conversation, but it was a necessary one. We had to have a plan for when the money ran out.
My Guide to Finding a “Respite Care” Provider to Get a Short Break
The Week Off That Saved My Sanity
I was my husband’s full-time caregiver, and I was at my breaking point. I hadn’t had a real day off in over a year. I was exhausted. I learned that some Medicare Advantage plans, and especially hospice benefits, offer “respite care.” I found a local nursing home that had a respite program. My husband was able to stay there for one week while I took a much-needed vacation. That short break allowed me to recharge my batteries and come back as a better, more patient caregiver.
How to Use Medicare for “Short-Term” In-Home Help After a Surgery
The Angels Who Helped Me Get Back on My Feet
I live alone, and I was being discharged from the hospital after a hip replacement. I was worried about how I would manage. The hospital’s discharge planner arranged for Medicare-covered home health care for me. For three weeks, a physical therapist came to my house to help me with my exercises. A home health aide came to help me shower and get dressed. This short-term, skilled help was completely covered by Medicare Part A, and it was the crucial support I needed to recover safely and independently in my own home.
The Unspoken Reality of What “Assisted Living” Costs (And Why Medicare Won’t Pay)
The Beautiful Apartment That Medicare Didn’t Recognize
We found a beautiful assisted living facility for my mom. It had a lovely apartment, a dining room, and social activities. The cost was $6,000 a month. We were stunned to learn that Medicare would pay for exactly zero of it. The reason is that Medicare does not pay for “room and board” or “custodial care.” Assisted living is considered custodial care. It’s a harsh reality that many families discover too late. The cost of this type of long-term care falls entirely on the individual until their assets are gone and they can qualify for Medicaid.
My Guide to Finding Palliative Care Services (Distinct from Hospice)
The Comfort Care I Got Alongside My Treatment
I was diagnosed with a serious, but not terminal, illness. I was still undergoing curative treatment, but the symptoms were making my life miserable. My doctor referred me to a “palliative care” team. They are specialists in managing the pain, nausea, and anxiety that come with a serious illness. They worked alongside my oncologist. My Medicare Part B covered the palliative care visits just like any other specialist. It’s a wonderful benefit that focuses on your quality of life while you are still fighting the disease. It’s not the same as end-of-life hospice.
How to Protect the “Community Spouse” from Financial Ruin
The Law That Protected My Mom’s Future
When my dad had to go into a nursing home on Medicaid, my mom was terrified she would lose everything. We learned about the “Community Spouse” protections. These federal laws allowed my mom, the community spouse, to keep the house, a car, and a significant portion of their savings (over $148,000 in some states). It’s a law designed specifically to prevent the healthy spouse from becoming impoverished when their partner needs long-term care. It was the legal shield that protected my mother’s financial future.
The Unspoken Power of “Discharge Planning” That Starts on Day 1 of a Hospital Stay
The Plan We Made from the Very Beginning
The moment my father was admitted to the hospital, I asked to speak with a “discharge planner” or a case manager. I knew that the decisions made in the first 24 hours would affect his entire journey. We started talking about his post-hospital needs from day one. This proactive planning gave us time to research rehab facilities. It gave us time to understand the Medicare rules. It prevented us from being rushed into a bad decision on the day he was actually ready to leave. The discharge plan should start at admission, not on the day of discharge.
My Guide to the “Jimmo v. Sebelius” Settlement and Why It Matters for Your Therapy
The Court Case That Kept My Therapy Going
My father was receiving physical therapy at a skilled nursing facility, but they told us they had to stop because his condition was not “improving.” I knew about the “Jimmo v. Sebelius” settlement. This is a crucial court case that affirmed that Medicare must pay for skilled therapy that is necessary to maintain a patient’s condition or slow their decline. It doesn’t have to show improvement. I cited this case to the facility’s director. They knew I was right, and they continued my father’s therapy.
The Unspoken “Family Caregiver” Burnout Crisis
The Job I Wouldn’t Trade, The Burnout That Almost Broke Me
I am the primary caregiver for my wife, who has MS. It is a role I do out of love, but the burnout is real. It is a 24/7 job with no pay, no vacation, and immense emotional stress. It has affected my own physical and mental health. This is the unspoken crisis in long-term care. Millions of family caregivers are being pushed to their absolute limit. Finding support, whether it’s through a local caregiver group or a respite care grant, isn’t a luxury; it’s an act of survival.
How to Have “The Conversation” About Long-Term Care with Your Parents
The Awkward Talk That Is an Act of Love
It was the conversation I was dreading. I had to sit down with my healthy, independent parents and ask, “What if…?” What if one of you gets sick? What are your wishes? Where are your legal documents? It was awkward for the first five minutes. Then, it became one of the most loving and productive conversations we’ve ever had. We talked about their fears and their desires. They showed me where their power of attorney forms were. Having “the conversation” before a crisis is the greatest gift you can give them, and yourself.
My Guide to Understanding “Activities of Daily Living” (ADLs) and “Instrumental Activities of Daily Living” (IADLs)
The Checklist of Independence
To qualify for long-term care benefits, my mom’s needs were assessed based on two checklists. The first was “Activities of Daily Living” (ADLs). These are the most basic self-care tasks: bathing, dressing, eating, toileting, and transferring from a bed to a chair. The second list was “Instrumental Activities of Daily Living” (IADLs). These are the tasks needed to live independently: managing money, shopping, cooking, and using the telephone. Her inability to perform a certain number of these ADLs was the key that unlocked her eligibility for a higher level of care.
The Unspoken “Waitlists” for Good Facilities and How to Get on Them Early
The List I’m Glad We Joined a Year Ago
We knew my mother would eventually need to move into a high-quality assisted living facility. We toured several, and our favorite one had a waiting list that was over a year long. We put her name on the list, even though she wasn’t ready to move yet. It was one of the smartest things we did. A year later, when she did need to move, her name was at the top of the list, and she was able to get a spot. For the best facilities, you have to plan ahead and get on the waitlist long before a crisis hits.
My Guide to Long-Term Care Insurance: Is It Ever Worth It?
The Policy I Bought in My 50s
When I was in my mid-50s, I made the decision to buy a long-term care insurance policy. The premiums weren’t cheap. But I saw what my parents went through, and I did not want my children to have that burden. My policy will provide a daily benefit amount that will cover a significant portion of the cost of a nursing home or an in-home caregiver. For me, paying the premiums now is worth the peace of mind of knowing that I will have more choices and my assets will be protected if I ever need long-term care.
The Unspoken Financial Link Between a “Fall” and a Nursing Home Admission
The Fall That Cost a Fortune
My grandfather was living independently at 88. Then, he had a bad fall and broke his hip. That one event was the trigger for everything that followed. The fall led to a hospital stay. The hospital stay led to a rehab facility. And the rehab facility revealed that he was no longer safe to live alone, which led to a permanent nursing home admission. That one, single fall was the starting point of a journey that ultimately cost him his independence and his entire life savings. Preventing falls is a health issue and a major financial issue.
The #1 Myth About What Medicare Covers for Long-Term Care
The Myth That Can Bankrupt You
The single biggest, most dangerous myth about Medicare is that it will pay for your long-term nursing home stay. It will not. Medicare’s skilled nursing benefit is a short-term, post-hospitalization benefit for rehabilitation. It is not designed for, and will not pay for, long-term “custodial” care for conditions like Alzheimer’s or general frailty. Believing this myth is the reason so many families are financially unprepared when a long-term care crisis strikes.
How to Create a “Care” Plan Before the Crisis Hits
The Plan We Made on a Quiet Sunday Afternoon
My wife and I sat down on a quiet Sunday afternoon and created our own “care plan.” We wrote down our wishes for future medical care. We designated a “power of attorney” for each other. We made a simple list of all our financial accounts and passwords. We put all of these documents into a single binder that our children know about. We created this plan while we were both healthy and clear-headed. It was a simple, loving act of preparation that will prevent our children from having to make impossible decisions in a moment of crisis.
My Story: The Hardest Financial Decision Our Family Ever Had to Make
The Choice Between Her Home and Her Care
My mother needed nursing home care, but her only real asset was her paid-for house. To get her on Medicaid, we had to sell the house she had lived in for 50 years. I had to pack up her memories, her photographs, her whole life. Using the proceeds from the sale of her beloved home to pay for her care until the money was gone was the single hardest, most heartbreaking financial decision our family ever had to make. It felt like we were losing her twice.
The Unspoken Hope of “Aging in Place” Technologies
The Tech That Keeps My Mom Safe at Home
My mom is 88 and lives alone. We use technology to help her “age in place” safely. She wears a medical alert pendant around her neck. If she falls, she can press a button and be instantly connected to an emergency operator. We have a smart pill dispenser that beeps when it’s time for her to take her medication and sends me a text if she misses a dose. And we use a simple video calling device so she can see her grandkids every day. This technology gives us peace of mind and keeps her independent.
The Ultimate “Long-Term Care” Reality Check
The Numbers Don’t Lie
Here is the ultimate long-term care reality check. At least 70% of people over 65 will need some form of long-term care services in their lifetime. The average cost of a semi-private room in a nursing home is now over $90,000 per year. Medicare will pay for almost none of it. Private health insurance won’t pay for it. This means that for the majority of Americans, the cost of long-term care will be paid for by either their own life savings, a long-term care insurance policy, or, ultimately, by Medicaid after their savings are gone.
Why Your “Retirement Plan” is Incomplete Without a “Long-Term Care” Plan
The Hole in Your Retirement Bucket
You can have a perfect retirement plan. You can have a million dollars saved up, a diversified portfolio, and a smart withdrawal strategy. But if you don’t have a specific plan for how you will pay for long-term care, your retirement plan has a giant hole in the bottom of the bucket. A single diagnosis of Alzheimer’s or Parkinson’s can unleash costs that will completely drain even a well-funded retirement nest egg in a matter of years. A true retirement plan isn’t complete without a long-term care plan.