Long Term Care is usually paid directly by cash, by welfare, or by private Long
Term Care insurance policies. This section will put to rest any common
misconceptions and outline the things you need to know about who pays for Long
Term Care.
1999 Stats from Health Care
Financing Administration, March 2001 |
Your Long Term Care
needs are NOT usually covered by health care or a disability plan. Health care
pays for medical treatment and care designed to get you better. Treatments for
a broken foot, pneumonia, or a stroke, are well covered under Health Care.
However, any Long Term needs, such as the daily custodial assistance you may
need after a stroke, are not covered.
Disability insurance is not designed to meet Long Term Care needs either. It
will insure you if you lose your ability to work, due to accident or injury and
will pay for things like your mortgage or your normal household expenses. It
does not pay for Long Term Care.
Medicare is a federal program administered by the Center for Medicare and
Medicaid. It is available to most people at age 65 and up.
Medicare is a very misunderstood government program. Many people think that it
will pay for most of their Long Term Care needs, but that is not the case.
Medicare only pays for skilled care, and since most nursing facility care is
non-skilled, the majority of people in nursing facilities do not receive
Medicare benefits. If you only need custodial care, you will not receive any
Medicare benefits. An Alzheimer’s disease patient, for example, wouldn’t
receive financial aid from Medicare, because of their complete need for
custodial care only.
Even as it applies to skilled care, Medicare can only approve a maximum of 100
days in a nursing home. But because much care does not meet Medicare
guidelines, the average number of days that patients collect Medicare in
nursing homes is only about 23. 2
For more information, about Medicare you can visit
www.medicare.gov or call a Medicare Representative Toll free at
1-800-Medicare (1-800-633-4227).
Medicaid is a federal and state welfare program designed for those with minimal
financial assets. State laws regarding Medicaid vary by state and may be very
complicated.
Medicaid is different from Medicare in that is pays for both skilled and
non-skilled care. A large portion (almost 40%) of the total annual Medical bill
is paid by Medicaid.3 Much of
this money comes out of private pockets.
The good news is that Medicaid is fairly easy to get, the bad news is that you
have to be nearly broke to receive it. Many patients have “spent down” and
depleted their assets to become eligible for Medicaid. Nursing homes are
growing wary of Medicaid patients, because a Medicaid patient represents
financial loss to most nursing homes. Some nursing facilities no longer accept
Medicaid patients.
Also, because Medicaid patients can only go to facilities
that have available Medicaid spaces, it is not unusual for
them to be placed hours away from other family members.
Medicaid also provides very little money for home care and
assisted-living care facilities, further limiting options.
Medicaid is available to help seniors who have spent assets
down to set levels which differ by locale. It can also be
available if income is below set standards. The following
web links should assist you in determining how these limitations
effect your situation.
Virginia Medicaid Payment Limit Document
Virginia Medicaid Payment
National Medicaid
If you are concerned about protecting your future assets and meeting your Long
Term Care needs, Private Long Term Care Insurance is undoubtedly your best
choice. Long Term Care Insurance will give you more options in where you
receive your care and how. It will protect you and your family from the
financial burdens that arise with Long Term Care.
We have written an entire section discussing the benefits, costs, and have
provided various other information you might like to know about Long Term Care
Insurance.
Find out more in our Long Term Care Insurance Section
or Click the Next Page button below.
