Mom has LTC insurance on her secondary AARP insurance. How does that work in conjunction with her Medicare if she is placed in LTC?


I a a medical RN I don't deal with insurances. How does Medicare and Long term care insurance work together? Does having the LTC insurance mean she dosent need Medicaid ?

This question has been closed for answers. Ask a New Question.
Find Care & Housing


Somehow a paragraph got left out on my post......IF the gap between what the LTC pays and what their SS & retirement pays covers their monthly, then they don't need Medicaid. Personally if "all in" is a small gap & if its an affordable for family to cover the NH charge, I'd try to private pay the gap rather than apply for Medicaid. I'd wait to apply for Medicaid after all the LTC funds are paid out as per policy.

Everybody's financial situation is different, I'd suggest to look carefully at the $ & timeframe on the LTC to see what's what as a first step.
Helpful Answer (0)

Medicare & medicaid are very different in what they pay for in regards to LTC. Really read & re-read the articles on this site to understand the difference.

In a nutshell, Medicare will pay for a post-hospitalized individual rehab placement to a NH for 21 days @ 100% and the up to 100 days @ 80% if progressing in their rehab (which my experience most frail elderly don't get past 6 weeks). After that either is private pay, LTC insurance or applies for Medicaid (and spends down to get to medicaid required impoverishment).

If your elder is moving into NH/LTC from living at home, in IL or AL, then they will not have medicare paying for rehab. So it's either private pay, be a Medicaid Pending resident, or have LTC insurance paying (& it may not cover the entire amount, so the gap is private pay). With NH average cost of 8K a mo., the amount of funds needed gets huge in short order.

Please make sure the facility takes LTC insurance. My moms NH would not take any LTC as the paperwork required could be just too much to be worthwhile for the usually low amount paid or lengthy wait for reinbursement payment.
Helpful Answer (0)

This question has been closed for answers. Ask a New Question.