Paying for Care

Paying for Care

With the exception of a few government programs for low-income seniors, most in-home and community-based services are paid for privately by the senior or disabled adult, their family members or through long-term care insurance. There are some programs available for seniors who have limited incomes to assist with care in the home setting, or in the community, thus allowing living at home for as long as possible.  Most long term care is not fully paid for by health insurance.

Private Pay

If a resident or their spouse has the personal funds to pay for care, they are required to pay out of pocket until their finances and assets are spent.  Because of the high cost of long term care, this can often quickly use up a family’s or individual’s resources.  It is highly recommended that one consult an estate planner to help you pay for care while protecting your assets.

Medicaid

Medicaid is a program funded by state and federal government for people with limited income and assets. Eligibility varies.  Call your local County Department of Social Services for information on eligibility.  Medicaid will pay only for nursing home care in a Medicaid certified facility.  For more information, contact Division of Medical Assistance (DMA). State/County Special Assistance is a program for low income adults over 65 years (or if they are disabled and between the age of 18 and 65) that helps cover the cost of  Adult Care Home room and board.  Contact your local County Department of Social Services for more information.

Medicare

Many people assume that Medicare will cover their Long Term Care needs.  However, Medicare will cover only skilled nursing facility care (nursing home care) under limited conditions and very limited time frames, usually not over 100 days.  To be covered, you must receive services from a Medicare Certified Facility after a qualified hospital stay.  Further, Medicare will not cover custodial care  (care that assists with activities of dailiy living such as eating, bathing, getting in and out of bed, etc…) that if that is the only care you need.

For more information on Medicare coverage for Skilled Nursing please visit:

http://www.medicare.gov/Publications/Pubs/pdf/10153.pdf

NC Seniors Health Insurance Information Program: www.ncshiip.com