Long Term Care

Protect your Assets, Get Quality Care, and Prepare for the Future

Today, Long Term care comes in many forms. There are Assisted Living Facilities, Home Health Care, and Adult Day Care.

Long Term Care Definition

Long term care insurance helps you pay for your extended medical needs in a nursing home facility or in the comfort of your own home.

Who needs it?

Long term care insurance should be an important part of every family’s planning. While we’d like to think that we will never need this type of care, or that we could easily afford it, the statistics suggest otherwise:

• 70 percent of people over age 65 will need some type of care services during their lifetime.
• 3 years constitutes the average duration of this type of care needed per individual.
• $91,250 constitutes the average annual cost of private nursing home care.
• $80,300 constitutes the average annual cost of home nursing care.

Traditional medical insurance programs and government Medical Insurance programs don’t usually provide enough help. According to the Department of Health and Human Services, Medicare only pays for long term care services for a maximum of 100 days, with a copay after the 20th day, and only if you meet certain criteria. Medicaid does pay for this care, but only if your income falls below a certain level, and you meet state requirements.

Long Term Care

This generally refers to non-medical care (ie, custodial care) for patients who need assistance with basic daily activities such as dressing, bathing, and using the bathroom. This program can provide care at home or in facilities that include nursing homes and assisted living.

Medicare

Generally, Medicare does not pay for custodial care for long periods of time, whether it’s in a nursing home or provided in-home. Medicare will pay for medical care provided in addition to long term medical care (for example, if a nursing home resident suffers a heart attack, Medicare will pay for the treatment necessary for the heart attack, despite the fact that Medicare does not pay for the monthly nursing home bill).  And Medicare will also pay for physical therapy, occupational therapy, or other medical care received in a skilled nursing facility.  However, the patient must meet certain criteria, including at least a prior three-day hospital stay.

Medicaid

Medicaid provides a separate program for low-income Americans and administered by the State and Federal Government.  Most Importantly, It does cover long term medical care for people who have exhausted their resources. Nearly two-thirds of nursing home residents in the US have Medicaid coverage. Seniors who qualify for both Medicaid and Medicare are called dual-eligible.