Long Island Medicaid planning attorneys provide you with help in understanding when Medicare and when Medicaid will cover the costs of care. One of the key factors that will determine whether or not your care can be covered is whether the care is classified as skilled nursing care or whether it is considered to be custodial care.
Mark S. Eghrari & Associates, PLLC help you to understand the key definitions of skilled nursing care and of custodial care and can provide insight into why this distinction matters so much.
Our compassionate and knowledgeable legal team can also help you to take necessary steps to ensure that the care you required will be covered so you do not have to impoverish yourself. To find out more about how Long Island Medicaid planning attorneys can help you, give us a call today.
What Does Skilled Nursing Care Mean and Why Does it Matter?
Medicare defines skilled nursing care to include care that can be provided only by a registered medical professional or by someone who has received medical training. The example that Medicare provides includes the administration of intravenous (IV) injections.
Medicare specifically excludes any type of care that could be performed by someone without any specialized medical skills. For example, if a person is getting older or becomes disabled and needs help bathing or getting dressed or consuming food, medical training is not required to provide any of this type of help. A person who needs assistance with basic activities of daily living is classified as requiring custodial care.
Medicare also indicates that care which could be classified as medical, but which does not customarily require a medical professional, can also be considered custodial care. For example, putting in eye drops may have a medical purpose but because specialized training is not required to do it, it is considered to be custodial care and not skilled nursing care.
The distinction between skilled nursing care and custodial care matters a great deal because skilled nursing care can be covered by Medicare but custodial care cannot. If you need skilled nursing care and you meet eligibility requirements, Medicare will pay for your stay in a skilled nursing care and will also cover equipment used to provide care, physical and occupational therapy, and a variety of other care needs including ambulance transfer under certain circumstances. However, Medicare covers nothing if you need custodial care — so if you must move to a nursing home or have a home health aide come to your house to provide care, Medicare will not pay for it.
Medicare is not the only insurer that does not pay for custodial care. Private insurance policies typically also do not provide any coverage if custodial care is the only type of care that you need. As a result, you could end up having to pay for this care out of your own pocket if you require care. The costs of this care could total thousands of dollars every single month.
Unfortunately, if you need custodial care that Medicare and other insurance does not pay for, you could wind up impoverishing yourself and being left with few assets. You could lose the chance to hand your wealth down to your loved ones and could lose the opportunity to leave the legacy that you desire.
If you hope to avoid this, you could look into purchasing a long-term care insurance policy but this often ends up being too costly for most people as they get older. Coverage limitations on long-term care policies also make buying this type of insurance an impractical and inefficient way to protect against the possibility of high nursing home care costs.
Another option is to work with Long Island Medicaid planning attorneys who can provide assistance with the creation of a plan to get Medicaid to cover nursing home care. Medicaid does pay for custodial care, but benefits are means-tested so you will need to put a plan in place to get Medicaid to cover you without you having to impoverish yourself if you don’t want to spend all of your own money on nursing home care before the coverage kicks in.
Getting Help from Long Island Medicaid Planning Attorneys
Long Island Medicaid planning attorneys at Mark S. Eghrari & Associates, PLLC will help you to make a Medicaid plan so you can get custodial care covered if you need it. To find out more about how we can help, join us for a free seminar. You can also give us a call at (631) 265-0599 or contact us online at any time for assistance.