Long Term Care
How can we pay for long term care if one or both of us need assistance, whether at home or in an assisted living facility or nursing home?
Long-term care encompasses a broad array of living arrangements and services. It includes home health aides for people who choose to age in place but need help with daily living tasks and medications, for example. Community-based facilities such as adult day care, which clients attend during the day, and assisted living facilities also offer long-term care services. Nursing Home care.
What is long term care? What services are included?
- In assisted living communities, staffers help residents with daily living tasks, medications and housekeeping. Residents live in private apartments, and the communities usually offer social activities and local transportation. Some have units for residents with dementia, including Alzheimer’s Disease. Assisted living is mostly paid by residents’ private funds but some communities accept Medicaid.
- In nursing homes, residents can receive round-the-clock skilled nursing care and assistance from aides. Residents have private or shared rooms and typically eat meals in a central dining room. Some homes have separate units for Alzheimer’s and dementia patients. Numerous nursing homes now offer short-term rehabilitative stays for patients recovering from an injury, illness or surgery. Medicaid covers costs of long-term nursing home stays but not all nursing homes accept it. Medicare sometimes covers short-term rehabilitative stays.
- For people who choose to age in place, home health care agency workers can help with tasks like bathing, dressing, moving from a chair or wheelchair to a bed and back, paying bills, and transportation to appointments. Medicare stipulates conditions under which it will pay for home health care. Among them: You need to be under the care of a doctor and require skilled nursing care; your condition must be expected to improve in a given period of time; your home health agency must be Medicare-certified; a doctor must certify you’re homebound; and you must need home health care only part-time, not round-the-clock. Also, Medicare does not cover home health agency services unless the resident is receiving skilled care like nursing care, physical therapy, occupational therapy or speech-language pathology services from the agency.
- Adult daycare facilities give frail elderly people and Alzheimer’s patients daytime supervision and care. That ranges from basic health services, meals and activities to intensive health services for those who might otherwise have to be in a skilled nursing center. Many adult daycare centers offer transportation to and from their facilities. Medicaid covers adult daycare in some case in most states, particularly if the elderly person would otherwise require full-time nursing home care.
How to pay for Long Term Care?
- Cash – or Out of Pocket
- Long Term Care Insurance
- Hybrid Insurance with long term care options.
- Annuities with long term care option.
Options for Retirees Without Long-Term Care Coverage
If you possess few or no assets when you need long-term care, your care options could be limited considerably. Many people decide against long-term care insurance or other means of financing care, assuming Medicaid or Medicare will cover the costs. But Medicare generally does not cover long-term care, except for short stints of rehab, and Medicaid carries strict limits on income and assets.
Like most long-term care insurance policies, to receive Medicaid to cover long-term care costs, you must be unable to perform at least two activities of daily living. Also, you must have spent down your own assets to meet Medicaid stipulations before you can receive coverage for long-term care. In some states, if a couple has $100,000 in assets when one of them enters a nursing home, the resident can receive Medicaid only when the couple’s assets have been reduced to $52,000 ($50,000 for the spouse and $2,000 for the nursing home resident). All assets count except for one motor vehicle if it is used to transport the nursing home resident, the resident’s home (in some cases) and prepaid funeral plans.
Disabled or aging veterans with long-term care needs may be able to get help from the U.S. Department of Veterans Affairs. Its benefits pay for care in VA nursing homes and for certain services at home. Veterans without service-related disabilities who can’t cover necessary care costs may qualify for veterans’ benefits, with copays depending on income. The VA’s Housebound Aid and Attendance Allowance Program helps cover home- and community-based long-term care services for eligible veterans and their spouses as a cash supplement to eligible veterans’ pension benefits. The Veteran-Directed Home and Community Based Services program helps veterans purchase services and offers counseling provided by the National Aging Network, part of the federal Administration on Aging, in partnership with the Veterans Administration.
- Community Services
The federal Older Americans Act aims to coordinate and provide home- and community-based services to elderly adults and their families, with an emphasis on keeping them in their community and living independently when possible. Services through the act, provided by state and local agencies and other organizations, include personal care in the home and local transportation. The Older Americans Act is designed for low-income, frail or disabled people over 60, elderly people who are minorities and older adults living in rural communities.
You are never too early to begin planning for retirement. Schedule a 30 minute phone meeting for a free analysis of your current financial status and suggestions as to how to make your retirement worry free and secure.