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How do I Pay for Care?

Some funding sources are available only for certain types of care, such as skilled nursing, and not for others, such as assisted living. Further, there are income and asset limitations on some types of public funding such as Medicaid. Almost every community resident uses a substantial amount of their own assets to pay for care. For non-skilled nursing communities, almost all funding comes from private sources, either the resident's assets or a private long-term care insurance policy. Not all of your loved one's assets need be exhausted before they may take advantage of publicly funded insurance sources such as Medicaid. Below is a description of commonly used funding sources other than the resident's own assets.

Medicare

Medicare is a health insurance program for people 65 years old and older, some people with disabilities under the age of 65, and people with End-Stage Renal Disease. Medicare has two parts: Part A, hospital insurance, and Part B, medical insurance. Part A helps pay for care in hospitals, skilled nursing centers, hospice care and some home health care. Most people get Part A automatically when they turn age 65. Part B helps pay for doctors' services, outpatient hospital care, and some other medical services that Part A does not cover. You must enroll in this program and pay a monthly premium to receive benefits. To be covered for a nursing home stay under Medicare, you must generally move from a qualifying hospital stay (at least three days) to a Medicare certified skilled nursing community.

Medicaid

Medicaid is a state and federal program that will pay most nursing home costs for people with limited income and assets. Most often, eligibility is based on your income and personal resources. Sometimes, you must spend down your personal resources in order to qualify. However, with proper planning, there are legal avenues that protect certain assets you would otherwise have to spend down to qualify. Medicaid will pay only for nursing home care provided in a community certified by the government to provide service to Medicaid recipients.

Medicare Supplemental Insurance

Also referred to as Medigap, this is private insurance. It helps pay for gaps in Medicare coverage such as deductibles and co-insurances. Most Medigap plans will help pay for skilled nursing care, but only when that care is covered by Medicare.

Long-Term Care Insurance

Long-term care insurance is a private policy, and the benefits and costs of these plans vary widely. Some policies may cover only nursing home care, and others include coverage for a range of services like assisted living. Long-term care insurance can be expensive, depending on your age and health status when you buy the policy and how much coverage you want. Most long-term care insurance policies offer certain tax benefits. If the policy is "tax qualified", you can include some or all of the premium as a medical deduction on your tax return.

Other Options

Managed Care Plans (HMOs) will sometimes pay for nursing communities, but will not help pay for care unless the community has a contract with the plan. Some life insurance policies may be applied to nursing care, but this varies widely from plan to plan.

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