Who Pays for Long-Term Care?
"...The answer is simple: You do!"
You pay for Long Term Care. It comes from your cash and your assets, and once you no longer have assets or for those without assets it is paid by Medicaid programs administered by state government. More than half of nursing home bills are paid out-of-pocket by individuals and their families, and somewhat less than half are paid by state Medicaid programs. Insurance, and that includes Medicare, Medicare supplemental coverage and health insurance provided by employers, does not pay for most long-term care expenses.
Only in certain cases will Medicare cover the cost of some skilled nursing care in approved nursing homes or in your home, but there is no coverage for custodial or intermediate care or prolonged home health care.
Medicare does not cover homemaker services except in well defined circumstances. The only way for you to receive a home health aide to give you personal care is, if you are homebound, and you are also receiving skilled care, and the personal care must relate to the treatment of the illness or injury and you may only have a limited amount in any week.
- Skilled care only and you must keep showing improvement
- Qualified hospital stay of at least 3 full days
- Enter a Nursing Home within 30 days of discharge from hospital for same condition
- 20 days paid by Medicare as long as you are improving
- Next 80 days, your co-pay is $124.00 per day.
- No Medicare coverage beyond 100 days
Since most long term care is custodial in nature, most people do not qualify.
Medicare supplements will pay the $124.00 for the 80 days, but only if Medicare approves the care since a Medicare Supplement only mirrors Medicare coverage.
Medicaid is a joint federal and state program designed to pay for health services for those with low incomes or high medical bills relative to income and assets. Medicaid will pay nearly half the cost of all nursing home care as well as some home and community-based services.
In order to receive Medicaid help, one must meet their state and federal guidelines for income and assets. Most people who plan to rely on Medicaid to pay for their long-term care stay will first pay out of their own funds and until they are eligible. Medicaid may then pay part or all the cost of nursing home care.
You may have to spend most, or all, of your assets to qualify for Medicaid. The rules differ in each state governing the amount of money and other assets you may keep to be eligible. Find Out More...
|Types of Long-Term Care What are the levels of Long Term Care that are available? Click her to find out more... |
|Why is Long-Term Care Such a Problem? Medical technology today is more advanced than it was even a few years ago. More people are living longer, but they are not necessarily living healthier. Many are faced with having to pay medical and care expenses for a longer period of time. Learn more by clicking here... |
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