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Maryland Health Care Commission

Consumer Guide to Long Term Care

Medicare

Many people still believe that Medicare or private health insurance will cover long term care services if they need them; but, with the exception of brief stays in nursing homes following a hospital stay, Medicare does not cover long term care. Private health insurance will cover LTC if it is a specific LTC policy.


Medicare is health insurance for people who are age 65 or older, under 65 with certain disabilities, or any person with End-Stage Renal Disease (ESRD). The different parts of Medicare help cover specific services:


Medicare Part A is hospital insurance that helps to cover inpatient care in hospitals


Medicare Part B is medical insurance that helps cover doctor services and outpatient care and some preventative services


Medicare Part C, called Medicare Advantage*, is a special type of Medicare plan that combines Medicare Part A and Part B. In addition, Part C may cover prescription, vision, hearing and dental services.


Medicare Part D is prescription drug coverage. For more information about Part D coverage, click the following link for the Maryland Department of Aging: http://aging.maryland.gov/Pages/MedicarePartD.aspx


*A Medicare Advantage Plan is a way to receive Medicare benefits through a private company approved by Medicare. Many advantage plans cover prescription costs, but are not required to do so. Each plan can vary in cost and in the drugs it covers. If you are considering a Medicare Advantage Plan, it is important to carefully review the plans to be sure you get the coverage you want and need.


Medicare publishes the official U.S. Government handbook "Medicare & You" annually, which gives a summary of Medicare benefits, coverage options, individual’s rights and protections, and answers to the most frequently asked questions about Medicare. Download the handbook here:


The Federal government has two websites that provide comprehensive information about Medicare. Go to the Medicare website at https://www.medicare.gov/ to apply for Medicare coverage online, find out what Medicare costs and what it covers, locate participating providers in your area, and more.


Visit the U.S. Department of Health and Human Services website to find out more about both Medicare and Medicaid at http://longtermcare.gov/medicare-medicaid-more/


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