To speak with Russ, a licensed agent, call 918-906-6598 (TTY 711 M-F, 9am-5pm) or email

Understanding Your Options for Medicare and Long-Term Care

Posted by Russ Scott
Estimated Reading Time 1 minute 44 seconds

Understanding Your Options for Medicare and Long-Term Care

As we enter our sixties, planning for long-term care becomes increasingly important. Understanding what Medicare covers—and what it doesn’t—can help you and your family make informed decisions about future healthcare needs. While Medicare provides substantial coverage for many health services, its support for long-term care is limited.

Medicare Coverage Basics

Medicare, a federal health insurance program for individuals 65 and older, has several parts.

  • Part A: Hospital Insurance. Covers inpatient hospital stays, care in a skilled nursing facility (SNF), hospice care, and some home health care.
  • Part B: Medical Insurance. Covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
  • Part C: Part C: Medicare Advantage Plans. Offered by private companies, these plans provide all Part A and Part B coverage and may include a Prescription Drug plan.
  • Part D: Prescription Drug Coverage. Helps cover the cost of prescription drugs.

Long-Term Care Coverage Under Medicare

Medicare covers some aspects of long-term care but does impose some significant limitations.

  • Skilled Nursing Facility (SNF) Care: Medicare Part A covers up to 100 days in an SNF following a qualifying hospital stay of at least three days. The first 20 days are covered in full, but days 21-100 require a daily co-payment. After 100 days, Medicare provides no coverage.
  • Home Health Care: Medicare covers home health care if it is medically necessary and ordered by a doctor. This includes part-time or intermittent skilled nursing care, physical therapy, and other services, but not full-time long-term care or custodial care (help with daily activities like bathing and dressing).
  • Hospice Care: Medicare provides comprehensive hospice care coverage, including medical and support services, for individuals with terminal illnesses.

What Medicare Does Not Cover

Medicare does not cover long-term custodial care in a nursing home, assisted living facility, or home if that is the only necessary care. Custodial care involves assistance with activities of daily living (ADLs) such as bathing, dressing, and eating.

Exploring Additional Options

Given these limitations, it’s essential to consider other options for long-term care funding.

  • Medicaid: For those with limited income and assets, Medicaid can provide long-term care coverage. Eligibility and benefits vary by state.
  • Long-Term Care Insurance: Policies are available to cover long-term care services, including custodial care specifically.
  • Personal Savings and Assets: Some individuals may need to rely on personal savings, investments, or the sale of assets to fund long-term care.

Understanding Medicare’s limitations regarding long-term care is crucial for effective planning. Contact us if you have any questions or if we can be of assistance.

Russ Scott //

I was born and raised in Tulsa, Oklahoma. I played rugby at Oklahoma State University where I graduated with a degree in Finance and a minor in Accounting. My wife, Erica, and I married in 2009 and have three wonderful children Rory (8), Sydney (6) and Reince (5). I've also been a licensed insurance professional with Medicare in the center of it all for more than 15 years.

One thing I don't take for granted is getting the privilege to meet with individuals and independent agents every week to discuss insurance needs in today’s ever-changing benefits environment. The companies that our agency has chosen to represent have become leaders in their markets and our vision is to develop a strong, capable distribution force to bring their insurance products to the public.

Legacy Insurance Advisors' mission is to sell and service all forms of health and life insurance by representing the best carriers in the industry, by maintaining a superior client base, by partnering with and retaining the most qualified professionals, and by providing all agency personnel with the training and tools available to give the very best possible service to our clients and companies. Our agents, managers, and staff are committed to educating and empowering our policyholders. We will provide guidance and expertise while managing our clients’ risk. Because of Legacy Insurance Advisors’ access to multiple providers in nearly every line of insurance, we will customize plans to fit our clients’ wants and needs.

Get Free, Friendly, and
Local Medicare Help Now

Local, licensed professionals are available to answer all of your questions. Call 918-906-6598 or complete the form below and we’d be happy to reach out to you.

      By submitting this information, you acknowledge a licensed insurance agent may contact you by phone, email, or mail to discuss Medicare Advantage Plans, Medicare Supplement Insurance, or Prescription Drug Plans.

      Close Accessibility Tools
      Accessibility Controls Reset
      Content Adjustments
      Font Size


      Line Height


      Content Scaling


      Highlight Titles
      Highlight Links
      Highlight Forms
      Align Left
      Align Center
      Align Right
      Focus Mode
      Color Adjustments




      Accessibility Statement

      Despite our attempts to make this website accessible for everyone, there may still be some pages or sections that are not completely accessible, are in the process of becoming accessible, or do not have a suitable technological solution to make them accessible. Nevertheless, we are always striving to enhance our accessibility by adding, updating, improving its options and features, and incorporating new technologies.

      We want to provide our users with the best experience possible, so we strive to support as many browsers and assistive technologies as possible.

      If you wish to contact this website's owner, please use the contact form on the website.

      Our User Interface Adjustment Options

      Font adjustments - With this tool, users can modify font size, style, letter spacing, and line height for improved alignment and readability.

      Color adjustments - Users can customize their color contrast profiles to light, dark, desaturated, and monochrome.

      Content highlighting - Users can prioritize key elements such as links, forms, and titles.

      Content focus - Users can enable focus mode to highlight the current page information based on their mouse movement.