Caring for an aging parent is one of life’s most rewarding—and challenging—responsibilities. One of the biggest hurdles caregivers face is navigating Medicare to ensure their loved ones receive the care they need. At South Florida Insurance Brokers (SFIB), we help Florida families understand their options, avoid costly surprises, and plan ahead for long-term health needs.
Medicare Advantage vs. Supplemental Medicare: A Critical Choice for Caregivers
When it comes to skilled nursing and long-term care, the type of Medicare coverage your parent has can make all the difference:
Medicare Advantage (Part C): These plans combine hospital, medical, and often prescription coverage in one. But not all Medicare Advantage plans are created equal:
- Regular MA-PDP plans: These may cover short-term skilled nursing, but do not provide long-term care.
- Dual Special Needs Plans (D-SNPs): For people with both Medicare and Medicaid, D-SNPs offer additional benefits—including Long Term Care (LTC). However, not everyone qualifies for Medicaid. Eligibility depends on income and assets, and many seniors fall outside these limits.
Supplemental Medicare (Medigap): These plans work alongside Original Medicare to cover gaps like deductibles and coinsurance. However, Medicare only covers up to 100 days in a Skilled Nursing Facility (SNF). After that, families are left with two options:
- Pay out-of-pocket—which can lead to financial hardship or even bankruptcy.
- Rely on a Long Term Care insurance policy, if purchased in advance.
Skilled Nursing Facility Coverage: The 100-Day Limit
Many families are surprised to learn that Medicare’s coverage of skilled nursing care is strictly limited:
- Days 1–20: Medicare covers 100% of approved SNF costs.
- Days 21–100: You pay a daily coinsurance, unless covered by Medigap or a D-SNP.
- After 100 days: Medicare stops paying entirely.
At this point, families must make critical decisions. Those without Medicaid or a pre-purchased LTC policy may face staggering costs.
Why Long Term Care Planning Matters
For families with financial means, purchasing a Long Term Care policy can be a lifesaver. These policies help cover expenses for ongoing skilled care, whether in a facility or at home, protecting your parent’s savings and preserving peace of mind.
Examples of when skilled nursing or LTC might be needed include:
- Post-surgical recovery (e.g., hip replacements or cardiac surgery)
- Chronic conditions like advanced Parkinson’s, dementia, or congestive heart failure (CHF)
- Stroke rehabilitation requiring intensive therapy
- Complex medical needs such as IV therapy, feeding tubes, or ventilator support
Skilled nursing provides a vital “clinical bridge” between hospital discharge and home—but long-term care needs can extend far beyond Medicare’s limits.
How SFIB Helps Caregivers Plan Ahead
At SFIB, our licensed medicare agents in Florida:
✔ Explain the critical differences between Medicare Advantage and Supplemental Medicare.
✔ Help you determine Medicaid eligibility for D-SNP plans.
✔ Offer guidance on Long Term Care policies for those planning proactively.
✔ Assist in selecting the right coverage to avoid devastating out-of-pocket costs later.
Don’t Wait Until It’s Too Late
Navigating Medicare and planning for long-term care doesn’t have to be overwhelming. Let SFIB guide you every step of the way.
Call us today at (786) 303-8065 for expert, compassionate Medicare advice—and secure your parent’s health and financial future.
