Housing
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care. Services of nurses provided by a hospice or home health company are covered by Medicare. Twenty-four-hour home care or assisted living is not covered.
Long-Term Care Insurance
not cover expenses if you require only custodial services regardless of your condition. Continued eligibility is dependent on your continued rehabilitation progress. Medicare rules are extremely complicated, but nursing home staff can usually explain how they relate to your situation. Medicare Part A pays all the cost, including prescriptions, for the fi rst 20 days of covered skilled care. If you continue to receive skilled care during the next 80 days, Medicare will continue to pay, but a $164.50 (2017) per day co-payment is required from you or your other coverage.
Co-payment Coverage All your Medicare co-payments will be
covered if you have Medicaid, QMB, TRICARE for Life, or Medicare supplement standard plans C, D, F, G, M or N. Plan K covers 50 percent of co-payments, and Plan L covers 75 percent. Standard Plan B’s (such as Blue Cross C+) do not cover any of these co-payments. Civil service retirees usually have coverage for at least 10 days of co-payments.
Skilled Care Beyond 100 Days If you need skilled care beyond 100 days
and have TRICARE for Life, it will pay 75 percent of your nursing home cost for as long as you receive skilled care. You or your spouse may have a union or company plan that provides some coverage, but this is rare.
What if I Need Only Assisted Living or Home Care?
None of the sources previously listed will cover the cost of assisted living or home
Long-term care insurance may provide peace of mind that you will be cared for when you can no longer care for yourself. You should speak to several insurance companies to learn more about available options. Policies may cover one or a combination of nursing home, assisted living, or home care. You must choose the length of coverage, which may be unlimited or limited to a number of years or a cap on the amount of money expended by the insurance company.
Another option increases annually the amount paid per day or per month. Before purchasing a long-term care policy, you should ask what you must do to receive payments and how long it takes. When purchasing a policy you should consider all of these issues as well as your ability to pay. Your goal should be to acquire a policy that will pay at least the difference between your income and the cost of your long-term care. (For more information, call National Association of Insurance Commissioners to request “A Shopper’s Guide to Long-Term Care Insurance” by calling 1-816-783-8300 and selecting (5) for publications.)
What If I Have Long-term Care Insurance?
If you will soon need assisted living, nursing
home, or paid home care, you or a family member should read your policy carefully to determine the coverage provided. If you have an older policy, be certain it does not require an inpatient hospital stay before it begins to cover your long-term care. Notify your insurance company as soon as possible when you need care.
VA Benefi ts Veterans and their widows or widowers
who have signifi cant expenses for assisted living, nursing home, or home care are usually eligible for VA benefi ts if the veteran served during an offi cial “war time” period. To qualify for VA Aid
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