Seniors and their families are already struggling with the costs of everyday living, if you add the costs of long term care to the picture it is a back breaking scenario for most Americans. A critical element of preparing for the costs of long term care is to understand the variety of “Private Pay” sources that can give you access to funds designed to help them pay for the various forms of long term care. Statistics show that the majority of people do not understand the differences between different forms of long term care, the variety of means to pay for it, and most do not plan for long term care until they are beset by a health care crisis.
There are four specific types of long term care:
- Home Health Care: Living support and care at various levels provided at home by licensed or unlicensed workers as well as designated family members. Home health is primarily private pay, but Medicare and Medicaid will reimburse some forms of “medically necessary” home health services provided by licensed practitioners for people meeting eligibility requirements. Private pay is accepted and will cover a wider variety of medical and non-medical services.
- Assisted Living: Housing for the elderly or persons unable to live independently that will provide mid-level custodial care, medication support, lifestyle activities, transportation, and meals. Assisted Living is a “private pay” environment not covered by Medicare and Medicaid.
- Nursing Home: Higher level “skilled or SNF care” provided in a licensed facility with transfer agreements in place with hospitals for people requiring long term medical or nursing care; or short term rehabilitation services for injured, disabled, or sick persons. Medicare will reimburse 100 days of “medically necessary” rehabilitation care, and Medicaid will reimburse long term care for those people meeting medical necessity and eligibility requirements. Private pay is accepted and will allow for more choice such as private rooms, enhanced lifestyle options, and wider selection of locations.
- Hospice: A specific form of care to manage pain, symptom relief, and emotional/spiritual support provided to people typically in the final 6 months of life as certified by a physician. Hospice care can be provided at home, in an assisted living community, a nursing home, or a free standing care center. Medicare and Medicaid will reimburse for certain levels of Hospice care. Private pay is accepted and not subject to requirements to be medically re-certified every 60 days.