UNITED STATES─Morning, Toni: I read your recent article about COVID-19 and Medicare and recently my husband has contacted this terrible virus. He has been in ICU due to his delicate health issues because he is an insulin dependent diabetic with heart issues. Doctors are suggesting that he may need 24-hour care since his lungs are failing.

I am concerned that his current health issues may wipeout our retirement, 401K, or savings if a long-term care need arises.

Can you please explain how Medicare covers a long-term care issue such as one that my husband has and what will happen if 24-hour care is needed? Thanks, Paula from Sugar Land.

Paula: Baby Boomers and retirees are concerned about a prolonged illness or chronic conditions such as COVID-19 being one of their biggest retirement expenses, if not planned properly.

One’s medical needs will be covered by Medicare Part A (In-patient Hospital) and Medicare Part B (Medical) for Medicare medical needs. COVID-19, as well as other health issues such as diabetes, heart issues, cancer, etc. which meet Medicare’s medical requirements are covered. Medicare will not pay more for one health condition than Medicare will for another.

Medicare Part A covers skilled nursing and pays for a maximum of 100 days of skilled nursing care before those on Medicare must absorb the cost themselves. Because Medicare is controlling healthcare costs, most Medicare beneficiaries are receiving $0 co-pays for days 1-20 in a skilled nursing facility and days 21-100 is a $176 per day co-pay for 2020.

Medicare does not pay for long-term care. It is private pay or by a long-term care policy that may not pay all the long-term care expenses.

A long-term care can be very costly with the average annual cost ranges from $60,000 to $85,000 per year for semi-private nursing home stay to $80,000 to $93,000 per year for private nursing home stay.

However, depending on the level of assistance that you need, there are some inexpensive care options and ways to protect your retirement from excessive long-term care costs.

Long-Term insurance plans are based on one’s health at time that the application is issued. Paula, hopefully your husband already has a policy in effect due to his health conditions. If not, then you will be using your retirement funds to pay for the care.

Below are a few options for affordable long-term care policies or email info@tonisays.com for more information:

1)       Traditional Long-Term Care:  The younger you are when you purchase a long-term care policy, the lower the premiums can be. Seek policies before 65 and in relatively good health for lower rates.

2)       Hybrid Life and Annuity Policies: Many life/annuity insurance policies have a provision if you need long term care and you can receive a certain amount of long-term care with your policy’s face amount.

3)       Aid and Attendance benefits: There is over $20 billion dollars for long-term care pension money just waiting for Veterans to apply for their Aid and Attendance benefits.  You need to have a long-term care issue to qualify

4)       Medicaid: Check to see if you can qualify for Medicaid.  Many have to “spend down” to qualify.

Long-term care planning can be very complex. Seek the advice of an Eldercare attorney who can help with long-term care and estate planning. **Be sure to have a power of attorney, living will and durable power of attorney in place before serious medical conditions start. **

Toni King, author of the Medicare Survival Guide® Advanced edition, is having a $5 Toni Says® readers discount at www.tonisays.com. If you have any questions regarding this article or any Medicare issues reach out to Toni at 832-519-8664 or email at info@tonisays.com.