Knowing the different methods to pay for senior health care will help enable you to make the best decision for you or your loved one. We will go over how to pay for different levels of care in the senior care industry such as Independent Living, Assisted Living, Long Term Care and Rehabilitation/Therapy in a Nursing Home.
Independent Living
Independent Living, or Residential Living, is for those who are more self-sufficient and do not require assistance with their Activities of Daily Living (ADL’s). They are ready to give up the headache of taking care of daily household tasks, like cleaning, so they can spend more time participating in activities they enjoy. Because this is the lowest level and individuals do not require any care, medical insurance or Long-Term Care insurance does not pay. IL residents use the following methods of paying:
1. Monthly income such as SSI or pension
2. IRA’s, CD’s, stocks, or other investments
3. Selling of assets such as their home, land, or car
4. Assistance from family
Assisted Living
Assisted Living is the next step up in the care levels and that is where one may need assistance with ADL’s such as continence, dressing, eating, personal hygiene, transferring/mobility (getting up and down/walking). You can pay for Assisted Living multiple ways:
1. Private pay with monthly income, savings, selling of assets, IRA’s, CD’s, stocks, or other investments
2. Long-Term Care Insurance
3. Aid & Attendance Benefit through the Veteran’s Administration
4. Medicaid
5. Assistance from family
Several are unfamiliar with the Aid & Attendance Benefit/Pension offer through the VA. This benefit is not only for those who served in the military – it also is for surviving spouses. If your loved one served during a declared time of war, had an honorable discharge, and served for more than 90 days then they may qualify for this benefit. Have the DD-214 form ready and give the local Veteran’s Services office a call to get this process started. Depending on the status you can receive from $1,318 to $3,261* a month to help pay for Assisted Living.
Long-Term Care (Nursing Home or Skilled Nursing Facility)
Long-term care in a Skilled Nursing Facility (SNF), or nursing home is for those who need help with several, if not all, ADL’s and require 24/7 care from nursing staff. Some residents in this environment do not have critical medical needs and can complete daily tasks on their own, but they are not fully able to live safely independently without assistance.
Many are under the impression that their private health insurance or Medicare will pay for long-term care and that is not the case – those insurances pay for intensive rehabilitation stays/Skilled Nursing stay. Please call the Admissions or Business Office of the care community you are interested in, and they will walk you through the process. Below are the main ways to pay for a long-term care stay:
1. Private pay with monthly income, savings, selling of assets, IRA’s, CD’s, stocks, or other investments
2. Long-Term Care Insurance
3. Veteran’s Benefit
4. Medicaid
5. Assistance from family
Short-Term Stay for Rehab (Skilled Nursing Facility)
For those needing intensive therapy or skilled nursing services due to major injury, illness, or condition, a short-term stay at a SNF is a great choice to get you back to your baseline quickly and safely. This is where Medicare Part A, or your private health insurance, will cover an inpatient skilled stay for a certain amount of time.
If you have traditional Medicare, you typically need a 3-night stay at a hospital for it to kick in. Medicare can cover 100 days – the first 20 days are covered 100% by Medicare and the next 80 days are covered at 80% by Medicare with a set daily co-insurance amount beginning on day 21. Or you can privately pay if you don’t have a supplemental insurance. This can be confusing so please talk to your discharge planner at the hospital if you have any questions.
Below are the ways to pay for a Short-term rehab/skilled stay:
1. Medicare
2. Private health insurance
3. Private Pay
*As of this 2022. This amount may increase annually.
Author: Amanda Gray, Area Market Coordinator, Mulberry Creek Assisted Living & Mulberry Creek Nursing & Rehab
