How To Prepare Financially for Long-Term Care

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1) Is long term care insurance an option for me? Long term care insurance is purchased by you, to cover medical and nursing services not covered by your current health plan or Medicare. Consider a long term care insurance policy before your health begins to fail and before you are in your 70’s and 80’s, as you will be in a better position of being eligible for a policy and premium costs will be lower.

2) What are the co-pays? Familiarize yourself with your insurance co-pays for managed care. Co-pays can range from $25 – $125 per day and are your responsibility from day one of admissions. If Medicare is your primary insurance, it will typically cover 100% of the skilled nursing stay for the first 20 days of care. After that you will be responsible for the federally mandated co-pay of $128 (for 2008). There are secondary insurances that can be purchased to cover the $128 co-pay through Blue Cross, AARP, and other private insurance carriers.

3) Can I benefit from medical assistance? Services exist for those who are financially burdened and do not have medical insurance or cannot afford to pay the required co-pays. You can apply for medical assistance; however, it is not an automatic approval process. You must first apply, and to be eligible you must meet your specific financial criteria, including a 5-year history of your financial income and assets. You will be required to receive care in a medical assistance building or care may be administered in the home by a medical assistance provider.

4) Short term vs. long term care. am I covered? If the care you need is classified as short term, such as physical therapy needed to regain mobility, then short term insurance will cover the majority of the costs occurred. However, if the care you need is considered long term, then you are responsible for the costs occurred. Options for covering long term care costs include 1) paying privately, 2) long term care insurance, 3) medical assistance.

5) What is respite care and should I consider it? If your caregiver is temporarily unable to provide the care you need, you may want to consider respite care to ensure you still receive the assistance you require. If you are considering respite care in a skilled nursing facility or assisted living facility, the costs you incur will be your responsibility, unless you have long term care insurance. There may be federal and/or state programs that offer financial assistance, and will vary on the type of agency and services needed.

Michelle Russo is an Administrator at Harlee Manor located in Springfield, PA.

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