Q. My 85-year-old father is in a nursing home and his long-term care insurance has nearly run out. I'm told that under the new law he will have to sell all his assets to be eligible for 100 percent Medicare benefits in the nursing facility. Is this true?
A. No — at least, not in the way you seem to think. As so many people do, you're confusing Medicare and Medicaid. These programs are entirely different. And nothing in the new law changes existing laws that relate to paying for nursing home care*.
Medicare is a federal program that covers a wide range of medical services for people age 65 and older and some younger people with disabilities. Medicare covers these services regardless of whether enrollees live in a nursing home or in the community — for as long as they live — provided that their monthly premiums continue to be paid. But Medicare does not cover any "custodial care" — that is, the costs of a room, meals and help with daily tasks such as dressing and bathing that a nursing home provides — and never has. (The only exception is coverage for short-term stays in a skilled nursing facility, most often for a few days or weeks of continuing care or rehabilitation after being in the hospital, as explained in this previous Q&A.)
Medicaid is the nation's medical safety net, providing health care assistance for certain groups of people (including those over age 65) whose incomes and financial resources are very low. Though mainly funded and guided by the federal government, Medicaid is run by the states and eligibility rules vary among them. (The program is also known by different names in some states — for example, Medi-Cal in California, TennCare in Tennessee and MassHealth in Massachusetts.) But, nationwide, Medicaid does pay the costs of nursing home care for people who are eligible.