You Have Options
Many seniors believe that if they need permanent nursing home care later in life, Medicare benefits will cover those costs. However, Medicare only covers a person’s stay in a nursing home for rehabilitation purposes after a qualifying hospital stay. The number of days of rehab that an individual may get covered by Medicare varies, but it never exceeds 100 days. Seniors who expend their Medicare days but continue to need 24-hour care become private-pay residents, or must look for alternatives.
Individuals who have long term care insurance may be able to afford the costs of care in a facility of their choosing, even after Medicare stops paying. Some long-term care insurance also covers the costs of help in the home or assisted living.
For seniors with a substantial amount of assets, some senior care communities offer buy-in options which allow seniors to pay a large lump sum up front and a reasonable monthly fee for their care needs.
Without other options, even seniors who saved responsibly may not be able to afford care for very long without running out of money. Two-thirds of Indiana nursing home residents turn to the Medicaid system for assistance with the costs of care.
Unlike Medicare, Medicaid benefits are only awarded to individuals who meet certain income and resource criteria. As a result, many seniors believe that they cannot be eligible for Medicaid. That may not be the case. The category of Medicaid benefits that assists seniors with the costs of long-term nursing home care has rules that are different from other categories of Medicaid. For example, the income limit for the nursing home category of benefits is much higher than in other categories. Additionally, many assets are considered exempt, especially when one has a spouse at home. Surprisingly, many seniors may qualify for Medicaid if the need for long term care arises, without going broke first.
The Medicaid Waiver program may also be available to seniors who require some level of assistance, and who qualify for Medicaid, but who wish to stay home instead of entering care in a nursing home. The Waiver program never
covers 24-hour help in the home, but it can provide enough support to keep some seniors at home longer. The Wavier program can also help with the costs of assisted living for some seniors in assisted living facilities that accept the Waiver.
Contact Voelz, Reed, & Mount, LLC in Columbus if you have a loved one in need of long term care.