What is Custodial Care and Why Does it Matter?

Glastonbury Medicaid attorneys will help you to take steps to make certain that you can get essential healthcare services covered. For many people who are getting older or who are affected by illness or disability, the need for medical services and caregiving help is substantial. Unfortunately, the costs of many important types of care can be very high and not all care that you may need is covered by insurance, even if you have Medicare. 

Nirenstein, Horowitz & Associates will assist you in understanding coverage rules for the different kinds of care that you may come to require as you get older, if you get sick or if you get hurt.

In particular, our Glastonbury Medicaid attorneys will help you to understand a specific kind of care – called custodial care – and will assist you in making sure you can get this important care paid for. Give us a call if you want help getting your care costs covered, or if you have concerns about the kinds of care that you may need as you get older.

What is Custodial Care?

Custodial care is a specific kind of care that is provided in a nursing home or that is provided by long-term care providers who come to your home, such as nursing aides. Custodial care is defined by Medicare to include help with routine activities of daily living. Some examples that Medicare gives include caregivers helping with things like showering, bathing, or getting dressed. If you cannot do these basic life activities on your own, then you need custodial care.

Custodial care also encompasses basic healthcare needs which most people handle on their own. For example, Medicare explains that putting in eye drops is a type of custodial care. This kind of care is considered custodial care because people don’t go to the doctor or get a skilled nurse to put in eye drops; they simply do it on their own.

Custodial care is distinct from skilled nursing care. Skilled nursing care is care which must be provided by someone with some medical training, like a doctor or a registered nurse. Changing surgical bandages following a medical procedure is an example of skilled nursing care because not anyone can do this task and because changing surgical bandages isn’t a routine activity that most people do in their daily lives.

Why Does it Matter if Care is Considered to be Custodial Care?

It is important to understand the difference between skilled nursing care and custodial care because Medicare – and most insurance policies – cover one type of care but not the other. Under appropriate circumstances, Medicare will pay for you to receive skilled nursing care for a limited period of time. However, Medicare will never pay for custodial care under any circumstances, or for any length of time, if custodial care is the only kind of care that is required.

Medigap, Medicare Advantage policies, and private policies also typically won’t pay for custodial care. If you want an insurance policy that covers this kind of care, you would have to buy long-term care insurance. And, unfortunately, many of the long-term care policies that are sold are prohibitively costly and have limitations on coverage – such as restrictions on eligibility and capped daily payment rates for services – which make the policies ineffective at actually covering the costs of custodial care.

Since most insurers won’t cover custodial care, either provided at home or provided in a nursing home, those who need this kind of care could be in a difficult position. If you can qualify for Medicaid, Medicaid will pay for your custodial care when you need it. However, Medicaid has strict limits on the amount of assets you are allowed to own while becoming eligible for benefits. This forces many people to spend their own money on nursing home, thus losing the chance to leave a legacy. Only after you’ve become impoverished will Medicare kick in to pay for custodial care.

Getting Help from Glastonbury Medicaid Attorneys

It is important to understand the problems associated with getting custodial care covered, because there is something you can do to solve the problem. You can work with Glastonbury Medicaid attorneys at Nirenstein, Horowitz & Associates to make a Medicaid plan so you can get Medicaid coverage when you need it without having to impoverish yourself first.

You should join us for a free seminar to find out about how Medicaid planning works and about what making a Medicaid plan involves. When you are ready to make your personalized plan to keep your assets safe, you can reach out to Nirenstein, Horowitz & Associates for help. Just give us a call at 860-548-1000 or contact us online to talk with a member of our legal team and put your plan in place.