Who Pays For Long Term Care?
Long term care is paid for in a number of ways. The primary methods are: using the personal resources of the individual or family, long term care insurance, and some
assistance from Medicaid for those who qualify. Medicare, Medicare supplement insurance, and the health insurance you may have at work usually will
not pay for long-term care.
Individual Personal Resources
Usually savings accounts and investments are used when individuals or their families pay for part or all of the costs of long term care. Some people sell assets to pay for their long term care needs (homes, cars, etc).
Long Term Care Insurance
Long term care may also be paid for using long term care insurance. Long term care insurance will pay for some or all of your long term care expenses. For a detailed description of long term care insurance, click here.
Medicare and Medicare Supplement Insurance
Medicare has a "skilled nursing facility" (SNF) benefit but is only applies in specific situations. The SNF benefit only covers you if a medical professional says you need daily skilled care after you have been in the hospital for at least three days and you are receiving that care in a nursing home that is a Medicare-certified skilled nursing facility. While Medicare may cover up to 100 days of skilled nursing home care per benefit period when these conditions are met, after 20 days beneficiaries must pay a coinsurance fee. According to the Centers for Medicaid and Medicare Services, in 2001, that coinsurance was $101.50 per day. Also, while Medicare may pay for nursing home care sometimes, it doesn�t cover the costs of care in assisted living facilities.
While many people would like to receive care in their own homes, Medicare does not cover homemaker services. In addition, Medicare doesn�t pay for home health aides to give you personal care unless you are homebound and are also getting skilled care such as nursing or therapy. The personal care must also relate to the treatment of an illness or injury and you can only get a limited amount of care in any week.
Simply said, you should not rely on Medicare to pay for your long-term care needs.
Medicare Supplement Insurance
This type of insurance is private and helps pay for some of the gaps in Medicare coverage (hospital deductibles, excess physicians's charges, etc.). It is important to understand thet Medicare supplement policies do not cover long-term care costs but policies �Plans D, G, I, and J� do pay up to $1,600 per year (Centers for Medicare and Medicaid Services) for services to people recovering at home from an illness, injury, or surgery. You must qualify for Medicar ecovered home health services before this Medicare supplement benefit is available.
Medicaid
Medicaid is the government-funded program that pays nursing home care only for individuals who are low income and who have spent most of their assets. Medicaid pays for nearly half of all nursing home care on an aggregate basis, but according to CMS National Health Expenditures in 2002, many people who need long term care never qualify for Medicaid assistance. Some home and community-based services are also paid for. You must meet federal and state guidelines for income and assest to get Medicaid help.
If you would like to learn more about long term care and receive a shopper's buying guide, please click here for a quote.
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Individual Personal Resources
Usually savings accounts and investments are used when individuals or their families pay for part or all of the costs of long term care. Some people sell assets to pay for their long term care needs (homes, cars, etc).
Long Term Care Insurance
Long term care may also be paid for using long term care insurance. Long term care insurance will pay for some or all of your long term care expenses. For a detailed description of long term care insurance, click here.
Medicare and Medicare Supplement Insurance
Medicare has a "skilled nursing facility" (SNF) benefit but is only applies in specific situations. The SNF benefit only covers you if a medical professional says you need daily skilled care after you have been in the hospital for at least three days and you are receiving that care in a nursing home that is a Medicare-certified skilled nursing facility. While Medicare may cover up to 100 days of skilled nursing home care per benefit period when these conditions are met, after 20 days beneficiaries must pay a coinsurance fee. According to the Centers for Medicaid and Medicare Services, in 2001, that coinsurance was $101.50 per day. Also, while Medicare may pay for nursing home care sometimes, it doesn�t cover the costs of care in assisted living facilities.
While many people would like to receive care in their own homes, Medicare does not cover homemaker services. In addition, Medicare doesn�t pay for home health aides to give you personal care unless you are homebound and are also getting skilled care such as nursing or therapy. The personal care must also relate to the treatment of an illness or injury and you can only get a limited amount of care in any week.
Simply said, you should not rely on Medicare to pay for your long-term care needs.
Medicare Supplement Insurance
This type of insurance is private and helps pay for some of the gaps in Medicare coverage (hospital deductibles, excess physicians's charges, etc.). It is important to understand thet Medicare supplement policies do not cover long-term care costs but policies �Plans D, G, I, and J� do pay up to $1,600 per year (Centers for Medicare and Medicaid Services) for services to people recovering at home from an illness, injury, or surgery. You must qualify for Medicar ecovered home health services before this Medicare supplement benefit is available.
Medicaid
Medicaid is the government-funded program that pays nursing home care only for individuals who are low income and who have spent most of their assets. Medicaid pays for nearly half of all nursing home care on an aggregate basis, but according to CMS National Health Expenditures in 2002, many people who need long term care never qualify for Medicaid assistance. Some home and community-based services are also paid for. You must meet federal and state guidelines for income and assest to get Medicaid help.
If you would like to learn more about long term care and receive a shopper's buying guide, please click here for a quote.
<< Back to About LTC