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Long-Term Care Insurance, Medicare, Medicaid
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Medicare covered most of her costs for the first few weeks as she got better. Then she had a stroke which left her unable to move her left arm and leg.
While she was in the hospital for the stroke, her doctors decided Alice should probably not return home. She no longer qualified for Medicare to pay for her nursing home care.
Many people believe that Medicare will pay for long stays in a nursing home, but it doesn’t. The Federal Medicare program and private "Medigap" (Medicare supplemental) insurance only cover short times of home health or nursing home care.
Medicare pays for a short stay in a nursing home for someone who is getting better after leaving the hospital, but still needs nursing care and therapy.
Alice’s husband started to pay for her care on his own, but they didn’t have a lot of savings.
When they had used most of their savings, Alice's husband arranged for her to apply for Medicaid. The good news about Medicaid is that her husband did not have to sell their home for her to qualify for this support.
Many people start paying for long-term care with their own money (private pay). Later they may become eligible for state-run Medicaid.
Each state decides who qualifies for this program. Contact your state government to learn more. Keep in mind that applying for Medicaid takes at least 3 months.
Alice’s children are now looking into buying long-term care insurance for themselves. They don’t want to have the same worries if they need nursing care when they are older.
Long-term care insurance is a private insurance policy you can buy years before you think you might need it.
Each long-term care insurance policy is different. Your state’s insurance commission can tell you more about private long-term care insurance policies.
They can also offer tips on how to buy long-term care insurance. These agencies are listed in your telephone book, under "Government."
Help in planning
Planning for long-term care is not easy. People’s needs change over time. So do the rules about programs and benefits. What someone qualifies for may change from one year to the next. There is some help. The following resources are online.
Care Planner from Medicare, www.careplanner.org, has details about different care options. You can answer questions online about needs and resources to get a list of suggested services, as well as helpful resources.
Medicare has two resources on its website, www.medicare.gov, which may be useful.
First, Nursing Home Compare helps you learn more about nursing homes you may be interested in. It also has a Nursing Home Checklist with tips to use when visiting homes. Second, many states have State Health Insurance Counseling and Assistance Programs (SHIPS). These programs can help you choose the health care plan that is right for you and your family.
Moving to a care facility can be a big change for the whole family. Some facilities or community groups have a social worker who can help you prepare for the change.
Allow some time to adjust after the move has taken place.
Regular visits by family and friends can make this move easier. This reassures and comforts the person getting used to a new place.
Visits are good, too, for keeping an eye on the care that is being given. They also help family to develop a good relationship with the staff caring for their loved one.
Other Resources
Other sources of information on long-term care and other issues of interest to older people include:
FirstGov for Seniors www.seniors.gov
American Association of Homes and Services for the Aging 2519 Connecticut Avenue, NW Washington, DC 20008 202-783-2242 www.aahsa.org
Assisted Living Federation of America 11200 Waples Mill Road, Suite 150 Fairfax, VA 22030 703-691-8900 www.alfa.org
Continuing Care Accreditation Commission 2519 Connecticut Avenue, NW Washington, DC 20008 202-783-2286 www.ccaconline.org
Alzheimer’s Disease Education and Referral Center (ADEAR) PO Box 8250 Silver Spring, MD 20907-8250 1-800-438-4380 www.alzheimers.org
The National Institute on Aging (NIA) has free information on health and aging. You can call or write:
NIA Information Center PO Box 8057 Gaithersburg, MD 20898-8057 1-800-222-2225 1-800-222-4225 (TTY) www.nia.nih.gov
Courtesy of National Institute on Aging, U. S. Department of Health and Human Services, National Institutes of Health.
Read more
Long-Term Care: What You Need to KnowWhat the Long-Term Care Choices Are
How to Choose Long-Term Care
Guide to Affordable Senior Health Care
Senior Health Insurance
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