Myths about government funding of long-term care.

• Position: Your Life

Many Americans in their 50s or older mistakenly believe the government will always pay the bill for long-term care. According to the Financial Planning Assocation, Denver, Colo., there are several misconceptions about what the Federal and state governments will do when it comes to funding it:

Myth 1. Medicare will pay for long-term care. A 2001 survey sponsored by CareQuest found that four in 10 Americans age 65 and over believed that Medicare, or Medicare supplemental insurance (Medigap), would pay for long-term nursing home stays. The reality is that Medicare will pay for up to 100 days of short-term nursing home care in qualifying circumstances, but not for long-term custodial care. To qualify for short-term care, you must be in the hospital at least three days, not counting the day of discharge. You then must need skilled nursing or skilled rehabilitation services, delivered at a Medicare-certified nursing home and approved by a physician on a daily basis. Thus, you likely will qualify if you need to recover from surgery to repair a broken hip, but not if you have Alzheimer's.

Myth 2. Medicare pays for all short-term costs. Assuming you qualify for short-term care, Medicare will pick up the full allowable tab only for the first 20 days. (The average stay is 23 days.) For days 21-100, you pay the first $101.50 (adjusted annually), though Medigap insurance might pick it up. Keep in mind that you might be discharged from Medicare coverage any time during the 100-day period because you no longer need skilled care, yet still need custodial care at that point, which Medicare won't pay for.

Myth 3. Medicare pays for home care. Again, it will do so only under limited circumstances. A physician must certify that skilled services are needed; the person must be homebound; and the care must be intermittent. That means less often than seven days a week and fewer than eight hours daily.

Myth 4. Medicaid pays for long-term care. It does pick up about 50% of the nation's nursing home tab, but you must be poor to...