Will Medicare or Black Lung benefits cover long-term care?

1 answer | Last updated: Nov 12, 2016
Phyl asked...

My dad is critically ill in hospital. He has Medicare and Black Lung benefits. He's 80 and will likely require short or long-term care full-time when he gets out. Does either Medicare or Black Lung provide for a full-time caregiver under these circumstances? All his children work full-time so we will need to hire someone to care for him.

Expert Answers

There are very different answers, depending on whether he needs short-term or long-term care. For short-term care, both Medicare Part A and the U. S. Department of Labor's Black Lung Benefits Program medical coverage can provide nursing and related medical care in a skilled nursing facility or rehabilitation facility (to which your father could be transferred directly from the hospital). If he goes to a skilled nursing or rehabilitation facility, he would receive round-the-clock care. However, both Medicare Part A and Black Lung benefits coverage for skilled nursing facility or rehabilitation facility care require that the patient need regular, skilled nursing care (not just a need for personal care), and they have limits on the length of time they will provide coverage and on how much they will pay. Either program could also provide him with skilled nursing care at home, but this would include only occasional visits to provide skilled nursing while he was recovering, not round-the-clock personal care. To learn more about the rules for Medicare Part A coverage of nursing facility and home care, see this site's article Medicare Coverage for Home Care and Skilled Nursing Care: What's Covered, What's Not. To learn more about medical coverage under the Black Lung benefits program, visit the Black Lung Benefits Program medical benefits information pages. Also, speak to your father's doctor and the discharge planner at the hospital about whether a skilled nursing facility or rehabilitation facility is the best place for him when he leaves the hospital.

Unfortunately, the picture is poor for long-term care under either Medicare or the Black Lung Benefits Program. Neither program provides long-term personal care, and neither program provides round-the-clock care at home, even in the short-term. To get help with long-term personal care, either at home or in a nursing home, your father might look to Medicaid; Medicaid can provide long-term (but not daily) home care, and can pay the full cost of long-term nursing home care. However, Medicaid coverage is only available to people with very low income and few assets other than a home they occupy. Also, if your father is a military veteran, the V.A. may have programs that can help provide long-term care.