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How Will I Pay for Long Term Care Services?
Long-term care can be very expensive and you could either run out of money or seriously deplete your estate in your final years. In general, health plans and programs do not cover long-term care at home or in nursing homes. Here is some general information about long-term care coverage:
- Medicare is the federal health insurance program for people age 65 and older and for some disabled younger people. Medicare generally does not pay for long-term help with daily activities. Medicare pays for very limited skilled nursing home care after a hospital stay. If you need skilled care in your home for the treatment of an illness or injury, and you meet certain conditions, Medicare will pay for some of the costs of nursing care, home health aide services, and different types of therapy.
- Medicaid is a federal-state program that pays for health services and long-term care for low-income people of any age. The exact rules for who is covered vary by state. Medicaid covers nursing home care for people who are eligible. In some states, Medicaid also pays for some home and community services.
- Private Insurance. If you need long-term care now, it is probably too late to be purchasing long-term care insurance. In eight out of 10 couples aged 65 and older, at least one spouse will enter a nursing home (HIAA, "A Guide to Long-Term Care Insurance," 2002). If it is not too late, you should be seriously considering long-term care insurance. Insurance companies are becoming more and more aware of the growing need for long-term care. Most insurance companies today offer long-term care insurance policies. These policies may cover services such as care at home, in adult day care, in assisted living facilities, and in nursing homes. But plans vary widely. If you have such a policy, ask your insurer what it covers. If you think you may need long-term care insurance, start shopping while you are relatively young and healthy, and shop carefully.
- Personal Resources. You may need to use resources such as savings or life insurance to pay for long-term care. Most people who enter nursing homes begin by paying out of their own pockets. As their personal resources are ravaged, many people who stay in nursing homes for a long time eventually become destitute and eligible for Medicaid.
Other Resources to Find Help
Your State Health Insurance Program (SHIP) can give you general information about Medicare, Medicaid, managed care plans, and the types of health insurance that can supplement Medicare, including Medigap and long-term care insurance. Counselors also can help you with questions about your medical bills, insurance claims, and related matters. These services are free. To find the phone number of the SHIP office in your State, call the Medicare Hotline at 1-800-638-6833. Or, look at the consumer Web site for Medicare services.
| Relative Costs Comparison |
| Nursing |
Help with Daily Activities |
Help with Health Care Needs |
Relative Costs |
| Home Care |
X |
X |
Low to High |
| Community Services |
X |
|
Low to Medium |
| Supportive Housing Programs |
X |
|
Low to Medium |
| Assisted Living |
X |
|
Medium to High |
| CCRC* |
X |
X |
High |
| Nursing Homes |
X |
X |
High |
* Continuing Care Retirement Communities
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