End of Medicare Coverage…

July 12, 2022 Austin DuBois

The End Is Near: Don’t Give In to Medicare Panic
Bad news, you were admitted to the hospital for a few days. Good news, you got better and you’re being released to a nursing home for aftercare and rehabilitation. Even better news, Medicare is going to help pay for that care for up to 100 days! Good thing, too, because nursing home and rehabilitation costs can easily reach over $10,000 every month.

Now, I’m not going to say “there’s a catch,” but…

Medicare can cut you off at any time before the 100 days ends if it identifies you as no longer needing your rehabilitative services plan. This can also happen in instances when a patient voluntarily stops their rehabilitation plan. Either way, as soon as you don’t meet Medicare qualifications, Medicare coverage stops.

The First 100 Days

Medicare coverage for most people looks like this:

  • Medicare covers the first 20 days at 100%.
  • Medicare partially covers the remaining 80 days, with a co-pay that is your responsibility—typically over $100 per day.

It’s worth mentioning here, that this type of Medicare coverage is not a one-time deal. The 100-day clock resets if you end up back in the hospital, as long as there are 60 days between admissions. The benefit isn’t unlimited either, but you would have to be a very resilient individual to reach the lifetime limit.

Options on Day 101

Do you happen to have long-term care insurance? No? Well, that would have been helpful here, but let’s put a pin in that for down the road. Without it, you have three options when Medicare ends and they are:

  1. Go on claim with Long Term Care Insurance (but most people don’t have that, and you can’t get it last minute)
  2. Pay out of pocket. Clearly a terrible option (remember the over $10,000 per month?)
  3. Get on Medicaid.

Wait–I already know what you’re going to say! “There is no way Medicaid is an option for me,” because of this, that, and the other thing, but mostly because you think you won’t qualify financially. Right?

This is where I get to assure you that you can, in fact, qualify for Medicaid, and that an experienced elder law attorney can help you establish that financial eligibility! In fact, we’ve said it before in this blog. The law provides people avenues to protect their assets and still get this type of important healthcare. Alas, those legal pathways are not the easiest to find or navigate, so trust me when I say that this is not a legal area where you want to be trying to D.I.Y. things.

Misinformation, inadvertent and otherwise, keeps many people from putting the law to work for them when it comes to aging on their own terms. An experienced and attentive elder law attorney knows where to look and what to ask when it comes to getting you qualified for Medicaid.

What No One Is Telling You
It is legal to transfer money to other individuals as a means to protect your assets and qualify you for Medicaid coverage.

I counseled a retired couple with a significant, hard-earned savings, after the husband had been on a prolonged nursing home stay. No one told them about options available to them to qualify for Medicaid. So they dutifully paid every month, from their savings, to the tune of over $100,000, all because they weren’t presented with their options. That money was out the door, but we were able to protect the rest – 100% of what they had left – by transferring it to the wife. Another married couple was told, quite forcefully, by a nursing home finance office that their only option to qualify for Medicaid coverage was to spend down all of their savings (which is simply not true).

What?! We’ve also talked about this before, right here. Rest assured, as soon as we got involved on the family’s behalf, both of these Medicaid applications were approved.

Where Medicaid Begins

When it is your health and your wealth at stake, you should always know your options and the opportunities available to you for protecting both. Let us tell you what those options are. You don’t have to fret about the end of your Medicare coverage. We can help you get qualified, get covered, and get on with your retirement plans.