Medicare Doesn't Pay?Over 2,000 people a day have a stroke in the United States and the majority of them survive.  Here is what the U.S. Centers for Disease Control and Prevention has to say from a statistical perspective.

  • Approximately 795,000 people suffer a stroke each year in the U.S.
  • On average someone has a stroke every 40 seconds in the U.S.
  • About 600,000 of these are first attacks with the remainder recurrent attacks.
  • Approximately 140,000 people die each year from a stroke in the U.S.
  • Nearly 75% of strokes happen to people over age 65.
  • Stroke is the third leading cause of death in the United States.

You will most likely survive a stroke and there is a good chance you may have another one or two down the road.  Medicare will pay for the initial hospital stay and maybe a few days of recovery but after that you are on your own.  Meaning you are in a long-term care situation that Medicare does not pay for.

Here’s how it might play out.  You have a stroke and are rushed to the hospital where you spend the first four days.  They then move you to a rehab center or nursing home where you spend the next two weeks.  Although you still need help getting through the day, the help is not medically necessary so Medicare will no longer pay for your treatment.  This is where it now becomes a long-term care situation.  You will need help (maybe for years) with the activities of daily living (transferring, toileting, bathing, dressing, eating and continence) and you will need help with physical therapy, occupational therapy and speech therapy to try to improve your quality of life.  But none of this is medically necessary so Medicare does not pay.  You either stay in the rehab center and pay out of pocket or you go home and pay for the care to come to you, again out our your own pocket.

Long-term care is different than medical care and people often believe medical insurance or Medicare will pay for many of these services.  It’s simply not true.  Long-term care is when you need help to get through the day and it is not necessarily medically necessary.  A stroke survivor is a classic example of someone who is at risk of spending through their saving and becoming a burden on family members to get the ongoing help they need.

Give us a call at the office, 425-748-8188, if you would like to learn more about protecting yourself and your family from the consequences of a long-term care situation.

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