Older Seniors Confused About Medicare Nursing Home Benefits

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Results of a new survey show older U.S. residents are confused about Medicare coverage for nursing home care.

Thirty-nine percent of U.S. residents over age 65 still think that Medicare or Medicare supplement insurance might cover long nursing home stays, and 24% are confident that it does, according to Wegge Strategic Research, De Pere, Wis.

Women are more likely to say that Medicare might cover long-term institutional care than men, and survey participants over age 85 are more likely to hold that belief than the younger participants are.

Wegge researchers found that 75% of participants over age 85 said Medicare did cover long-term institutional care or might cover it.

Confusion about Medicare nursing home benefits among older women and U.S. residents over age 85 “is of particular concern, because these are the very groups who are the most likely to require these services in the future,” Wegge researchers note in a summary of their results.

But, even among participants between the ages of 65 and 79, only 40% knew that Medicare puts tight limits on coverage of skilled nursing home care.

Medicaid, a health program for the poor funded by the federal government and state governments, does pay for long-term nursing home care for the poor, and for others who may bend or break the rules to meet the eligibility requirements. But critics say Medicaid limits beneficiaries choice of facilities and often pays too little to cover the cost of high-quality care.

Medicare, the federal health program for elderly and disabled U.S. residents, will not cover more than a few days of skilled nursing home care.

Wegge based its results on telephone interviews with 500 U.S. residents over age 65 conducted in early February.

The research was sponsored by CareQuest Inc., Madison, Wis., a firm that sells private long-term care insurance programs and related services to employers.

Robert Pearson, president of CareQuest, says the Centers for Medicare & Medicaid Services, the federal agency that manages Medicare and the federal portion of Medicaid, has confused older beneficiaries by sending out literature that gives information about what appear to be extensive skilled nursing home benefits.

“We need an authoritative approach to notify beneficiaries that, Youre not covered for long-term care,” Pearson says.

In addition to the survey of older U.S. residents, CareQuest is also sponsoring a survey of baby boomers.

Several major reports on the U.S. long-term care insurance market have appeared in recent months, but more surveys are needed, because much of the private LTC insurance market data now available comes from surveys completed years ago, Pearson says.


Reproduced from National Underwriter Life & Health/Financial Services Edition, July 27, 2001. Copyright 2001 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


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