Will Medicare or Medicaid pay for nursing home care?

Attorney Tom Olsen: You talk about misconceptions, and we deal with it every day, so we understand the difference between Medicare and Medicaid, and a lot of people don't, but a lot of people just have a misconception if mom goes in a nursing home, Medicare is going to pay for it. She's over 65. She's got Medicare. Medicare is going to pay for it. What are the rules with Medicare and nursing homes?

Attorney Robert Hidock: Medicare will not pay for room and board at a skilled nursing facility, period. They will pay for room and board for rehabilitation, and in that rehabilitation, it depends if you have Medicare, Medicare and a supplement, or you have an advantage plan, and that will dictate how many days of rehab that you get. Typically, most policies are around 20 or 30 days of rehab, then you have another 90 or 100 days, where there's like an 80-20 split, where the Medicare will pay for 80, if you don't have a supplement, you'll private pay that 20.

That works if you're rehabbing, but if at any point in time in that process, they say, "No, you're not rehabbing," or you refuse to rehab, then you are expected to private pay, and at $10,000 to $12,000 a month, I don't care how much money you have, that's a lot of money to spend to take care of someone, and so, at that point, we can protect whatever assets they have. They don't have to spend it on a facility. There's different methods that we can use to protect assets, whether you're single or married. It just depends on the issues.

I was talking to Alexis, our probate attorney. Her grandmother-in-law lives in Ohio, she unfortunately was in an accident, and she is in a rehab center, but she's not able to rehab, and we talked to an attorney over in Ohio, same attorney that I do, and they can't do anything. It's a five-year look-back period. You need an irrevocable five-year trust that you can't benefit from, and they do have non-countable assets, like your house and your retirement account, like we have, but here's the kicker.

If you are on Medicaid for six months or longer, those non-accountable assets, they become countable, and the state takes them. In Florida, we are not like that. We have so many different Medicaid asset protection tools. There's not one that we can't protect.

Tom: The point about that is that Medicaid is a combination of both state and federal law. What's true here in Florida is not necessarily true in other states.

Robert: That's true. Another misconception, Tom, is that people think when they're on Medicaid, that they lose their Medicare, they're going to lose their doctors, and they're not. Medicaid is the payer of last resort. Your doctors will still be your doctors.

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