No matter how much you do to remain healthy, there is always the possibility that you will, at some point, need help performing some basic daily tasks. Everything from illness to injury can strike without warning, leaving many Medicare recipients and their loved ones wondering what to do when you can no longer live independently. The financial stress of a move into assisted living can be difficult for everyone, so it’s important to understand how your Medicare coverage can help.
The Difference Between Skilled Nursing and Custodial Care
If your doctor determines you require skilled nursing care, you may receive care at a Skilled Nursing Facility (SNF) that is certified through Medicare. Care at a Skilled Nursing Facility is covered by Medicare Part A. Part A coverage will help pay for short-term stays in skilled nursing facilities. The criteria set forth in Medicare Part A allows for up to 100 nights in a facility with a graduated out-of-pocket cost after 20 days. Between days 21 and 100, Medicare may require a co-insurance payment. Stays exceeding 100 days will not be covered, and the patient will be responsible for the full cost of treatment after. Most people are automatically enrolled in Part A when they turn 65 years of age if they paid taxes for a certain amount of time while working. Individuals under the age of 65 may qualify for Medicare if they have certain disabilities.
Custodial care, on the other hand, is non-medical care for individuals who need help performing the activities of daily living (ADL), such as eating, bathing, using a toilet, or dressing. Custodial care can take place in the home or in a nursing home. It can include help doing basic chores, like laundry or cooking. As opposed to skilled nursing that is performed by licensed medical professionals, custodial care can be provided by non-licensed caregivers. Medicare does not cover custodial care, also referred to as long-term care. If you are dual-eligible for Medicare and Medicaid, your Medicaid services may help cover the cost of long term care if it is provided in a nursery home setting.