You may think that Long-Term Care services are
covered by your Health Insurance, Disability insurance or
Medicare... Unfortunately, that's usually not the case!
Who Will Actually Pay for Long-Term Care Services?
Not Health Insurance : It is
designed to cover acute care medical expenses, illnesses or injuries
like cancer, a broken arm, or a stroke. It will pay the hospital
bills you incur for a stroke, but it won't pay for any long term
assistance you may need once you go home, such as help dressing or
using the bathroom.
Not Disability Insurance: It is
designed to replace the income you lose if you're unable to work.
Disability benefits can help you pay your mortgage or normal household
expenses, but it won't provide additional benefits for long-term care
Medicare:Many people mistakenly
believe Medicare will cover their Long-Term Care costs. Although
Medicare does provide health coverage for those over age 65, it
provides limited Long-Term Care coverage. In fact, in 2000, only
about 14 percent of all Long-Term Care expenditures were covered by
Medicare will pay the cost of some
skilled care in an approved nursing home or in your home but only
in specific situations. This benefit will only cover if a
medical professional says you need daily skilled care after you
have been in a 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. In 2008, that fee was $128.00 per
Medicare does not pay for costs of care in an assisted
living facility, homemaker services, 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 a week.
Medicaid will cover the cost of some types of Long Term
Care, but to qualify, a person must meet Medicaid's strict income
and asset eligibility requirements. See your state's guidelines.
Some people consider simply reducing their assets in order to
meet Medicaid's eligibility requirements. Unfortunately, once a
person goes on Medicaid they lose control over what care services
they receive and where they receive them. Only certain
facilities accept Medicare patients, and they may not be close to
your family or friends. You also may find that many of the
facilities that accept Medicaid patients are not as nice as
Long-Term Care Insurance is another way you may pay for
long-term care. This type of insurance will pay for some or all
of your long-term care. It was introduced in the 1980s as
nursing home insurance but has evolved and now covers, nursing
home, home care, assisted living facilities, etc. Long Term Care
insurance allows the insured to pay an affordable premium to
protect an unaffordable catastrophic event.
Paying With Cash: If you have a sizable net worth, this
may be an option. Keep in mind that the average cost of an
average stay in a nursing home is nearly $168,985 (3) , and
nearly half of all nursing home residents run out of money and
qualify for Medicaid within the first year (4).