 | | Care Seekers | |
|  | | | Who Pays For Long Term Care | How Much Does Long Term Care Cost?
When it comes to long term health care, many Americans incorrectly assume
that Medicare, supplemental policies or standard health insurance policies will
cover the expenses. Consequently, many people do not plan ahead financially to
provide for their care in the event of infirmity or extended illness. Costs of
services provided by a nursing facility can exceed $50,000 annually, or more
than $4,000 per month. Costs for residing in an assisted living facility
average $24,000 annually, but can cost much more in urban settings or if a
resident needs a high level of services.
As these figures show, paying for long term care calls for financial planning
for your health needs, especially as you approach retirement. The following
information is designed to give you a better sense of the financial programs and
options available, as well as the benefits you can expect.
| | | Medicare:
Medicare is a federal health insurance program for
people 65 and over and certain disabled people under 65. Medicare may pay for skilled care in a nursing
home for a very short period of time - no longer than 100 days, and only when the patient meets all the
Medicare requirements for daily skilled care. It does not provide a
comprehensive long term care component and generally does not cover assisted
living costs but may pay for short term services (e.g. physical and other
therapies) contracted through a home health care agency and provided to the
resident at the assisted living facility. Medicare covers only those skilled
nursing facility services rendered to help a beneficiary recover from an acute
illness or injury. Medicare is administered by the federal government’s Centers
for Medicare and Medicaid Services (CMS) and is divided into two parts: Hospital
Insurance (Part A); and Medical Insurance (Part B).
| | | Medicaid/Medi-Cal:
Medicaid is a joint federal-state government program designed
to provide health care assistance to low income people, and it has become the
major payer of services for care in a nursing facility. In many states, Medicaid
will pay for assisted living services, although in most cases such coverage is
limited. Medicaid will pay for nursing facility care for those persons who meet a
state-determined poverty level and certain health related criteria, provided the
nursing facility is certified, and meets a stringent set of government
standards. Medicaid will pay for care in a nursing facility (NF). The amount paid is
determined by each state, and covers room, board, nursing care and social
activities.
| | | Personal Resources:
The cost for most assisted living facilites is the responsibility of the individual from personal
income and savings. People who use up their assets paying for long term care are "spending down" and
may become eligible for Medi-Cal as a result.
| | | Long-Term Care Insurance:
Long Term Care Insurance is designed to pay a portion of long term care costs. It is available
from private insurance companies and covers care in long term care settings such as nursing and
assisted living facilities.
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