Seniors in the U.S.A. qualify for the government senior health insurance programs once they turn 65-years-old. At this age, they must sign-up for either Medicare or Medicaid. Medicaid is the option for very low-income seniors with few financial assets. The benefits are different for each of these insurance programs and Medicaid is provided in partnership with the federal government and each state government.
Medicare will be the option for most seniors and provides adequate insurance coverage for doctor’s visits, hospital stays and rehabilitation care in a nursing home.
Very low-income seniors will receive Medicaid insurance instead of Medicare. Each state creates their own Medicaid program and this means the financial requirements and benefits will vary slightly in each state. Overall, assets owned must be very low to qualify for Medicaid insurance as a senior.
Nursing home care has become an extension of hospital care for seniors. After a stroke or hip replacement, for instance, Medicare insurance will pay for some rehabilitation in a nursing home. Medical doctor preapproval is required for Medicare to pay for a nursing home stay, with benefits available for up to a 100 day stay. Medicare will pay for the first 20 days of a nursing home stay after a qualifying hospital stay (minimum 3 days in a hospital).
Medicaid, as a state and federal program, will pay most nursing home costs for those who qualify as low-income seniors with assets of less than $2,000 (asset amount varies slightly in each state and you can review the Medicaid qualifications in your state on Caregiverlist).
As nursing homes can cost from $100 to $400 per day, seniors who will require long-term nursing home care will often “spend down” their financial assets and then qualify for Medicaid health insurance. Nursing home stays are fully paid for by Medicaid, for as long as the nursing care is needed (this is why some seniors with progressive age-related illnesses will opt to spend-down their assets and go onto Medicaid, which will pay for ongoing residency at a nursing home).
Long-term care insurance is another option, if a senior has purchased a long-term care insurance policy. Veterans of certain wars do qualify for Veteran’s Aid & Attendance home care and veteran’s retirement care nursing homes. If you are not a veteran and do not have long-term care insurance, then you must privately pay for your senior care, until you spend-down your financial assets and qualify for Medicaid.
Seniors who choose to move to an assisted living community or stay in their home may hire a private duty senior caregiver through a licensed senior home care agency. Private duty caregivers will cost between $16 and $25 per hour and $180 to $300 per day for 24-hour live-in care, depending on where you live (metropolitan cities have higher costs of living than rural areas). Senior home care agencies provide training, payroll taxes, insurances, benefits and active care management for the senior caregiver.
Research the nursing homes in your area before you need them. Understand the daily nursing home costs for private and shared rooms and their ratings from their health inspection reports. Some nursing homes will not accept a new resident who is on Medicaid, but if you enter the nursing home paying privately and spend down your assets, they will allow you to stay as a Medicaid resident.
Understand which nursing homes accept Medicare and Medicaid and know your preferred choice should the need arise suddenly, which is often the situation. Nursing homes usually are not a preferred choice for senior care, but some of the more modern nursing homes do offer quality services and comfortable accommodations. Ad Medicare and Medicaid will pay for rehabilitation in a nursing home, you should plan ahead the same way that you would when choosing a college. Research the options, visit their facilities and understand the services offered. This way, if the time arises when you will need nursing home care, your family members and medical doctor will know your senior care preference and you will not have the added stress of making a last-minute choice. Nursing home accommodations vary widely, which is another reason to research the options before you need the services.
This was a guest post by Caregiverlist, which provides the only resource with the daily costs of nursing homes nationwide and provides easy-to-understand star-ratings to make the research process easy for seniors and their family members.