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  • John Todd

“I thought Medicare would cover that . . .”

I was talking to my nephew last week, and he was trying to remember which government office handled setting up a new business. We are pretty sure that to register an LLC, we have to file paperwork with the Secretary of State office. Of course, depending on the business, there might be a variety of government offices involved in-licenses, insurance, inspections, permits, etc. It’s a maze! And unless you work with setting up businesses regularly, you could be excused for not knowing exactly how it’s done.

-------------------------- I’ve noticed that there is a similar confusion around Elder Care. We all have this general understanding that through our working years, we pay a Social Security tax. (Well, it is withheld from our paycheck.) We assume that when we get to be about 65 and when we retire, we will start collecting Social Security and Medicare. If you are a little older, you might have learned that Medicare is not just ONE guaranteed medical insurance coverage. There is a whole alphabet of Medicare coverage: A, B, C, F, G . . . and who knows what more. Some of it is automatic, some of it costs a premium and you are penalized if you don’t sign up, some of it is for prescriptions. Basically, we are at the mercy of a good insurance agent to explain the differences and help us find the right combination. Then, when our parent or spouse suddenly has a stroke, they are sent to the hospital . . . and then to rehab. . . and if their recovery is not fast enough, you find yourself sitting in the office of the Rehab Manager, and hear them ask: “How are you going to pay for their care?” “Well . . . I thought Medicare would cover that . . .” Medicare DOES cover a lot of the medical bills – mostly doctor and hospital care, to help us recover from a medical emergency. However, when it is determined that the patient is not “Getting Well” fast enough, it is called “custodial care” and Medicare doesn’t cover that. Custodial care – when someone is not getting BETTER, but still needs assistance with daily activities, really only has FOUR payments options:

  • Option 1 – Private payout of your life savings.

  • Option 2 – Access your “Long-Term Care” Insurance Policy – If you don’t have Long-Term Care Insurance, it is too late to buy it.

  • Option 3 – If you are a Veteran, you may have some veteran benefits.

  • Option 4 – Long-Term Care Medicaid – This is the most common.

Just briefly, here are a few comparisons between Medicare and Medicaid. Kindly see the image below.

Have you ever seen families think that MEDICARE would cover the Nursing Home bill, only to be surprised?

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