How To Pay for Long-Term Care

Dealing with a long-term illness can be a stressful and costly experience. In this uncertain time, knowledge of available plans and resources is vital to making an informed decision on how to best pay for care. Due to the increasing costs of health care, the thought of paying for long-term care is often very stressful for families. With expensive advances in technology and an increase in demand for care as the Baby Boom generation ages, costs for long term care are on the rise. Since each person or family faces different financial obstacles, it’s important to explore the available options while keeping in mind the financial situation particular to the family seeking care.
The following plans and strategies can guide care-seekers toward making the best financial decisions for themselves and their families.

About Medicare

In general, Medicare doesn’t pay for long-term care, including in-home care, community-based care, and care in nursing and assisted living homes. Most instances of long-term care are termed “custodial care,” which describes non-skilled personal care such as help with dressing, eating, bathing, moving into or out of a bed or chair, and using the bathroom.

Medicare will cover the costs of medically necessary care in a skilled nursing facility (SNF). Skilled care differs from custodial care in that it’s given for a short period of time for people who require skilled nursing or rehabilitation staff to manage, observe, and evaluate their care. Some examples of this type of care are intravenous injections and physical therapy. To qualify for this coverage, it’s necessary to receive services from a Medicare-certified SNF after a qualifying hospital stay. A qualifying hospital stay is one in which the person receiving care stays in the hospital for at least three days just before being transferred to a nursing home.

Other Resources To Pay For Care

Medicaid
Medicaid is a joint state and Federal program for people with limited income and resources. It will cover most of the costs associated with nursing home care provided in a government-certified facility. Not all nursing homes accept Medicare payment, and coverage eligibility varies by state.

Personal Resources
About half of all residents in nursing homes pay for their care with their own savings. After these savings have run out, many residents become eligible for Medicaid.

Managed Care Plans
Managed care plans cannot pay for the costs associated with living in a nursing home unless the nursing home has a contract with the plan. If a certain plan approves the nursing home, it’s a good idea to find out whether the plan also monitors the quality of care in the home.

Medicare Supplement Insurance
This is private insurance often referred to as “Medigap” since it pays for services that fall between the “gaps” in Medicare coverage such as deductibles and co-insurances. For example, some people use employer group health plans to help cover nursing home costs. Most of these plans can help cover skilled nursing care only when that care qualifies for Medicare coverage.

Long-Term Care Insurance
This is a private insurance policy in which costs and benefits vary greatly. It’s important to do some research to compare costs and coverage between plans and to find out whether a company has a good reputation before deciding on a plan.

Counseling and Assistance
State Health Insurance Assistance Programs can offer advice on finding the right plan for specific needs. They can also answer questions about coverage, payments, or government programs that may supplement any existing insurance.