A recent communication from a reader is a reminder that there is an aging population and Upper Saddle River is not without its share of them. The town has a mixed age population and while it is apparently leaning younger with hoards of families rushing into all the new construction there are numerous older residents who continue to reside contributing to the population. The needs of the families are met with playing fields and recreation programs, library gatherings but it is worth considering are the needs of the older residents being met? What actually is available to help residents move into their sunset years with care, comfort and companionship?
With this in mind here is a first of occasional posts that have relevance to seniors residents. Hazel Bridges has a useful website AgingWellness.org that contains a lot of information covering many issues of interest to seniors as well as a wealth of resources. She has contributed the following article on an issue close to many seniors minds and is well worth reading.
Most of us will need long-term care services at some point. However, the unpredictability of long-term care makes this expense challenging to plan for, especially as COVID-19 cases continue to rise. While some seniors only need a few months of part-time care while recovering from an illness or injury, others require full-time care for years. Unfortunately, Medicare offers limited coverage for long-term care services.
Read on to learn what Medicare will cover and how you can make up the difference when you need long-term care.
Medicare Coverage for Skilled Nursing Care
Medicare pays for up to 20 days of care at a skilled nursing facility. From day 21 to 100, however, Medicare pays 80 percent of skilled nursing costs. A Medigap plan may cover a senior’s 20 percent coinsurance.
This coverage is limited to seniors recovering after an inpatient hospital stay. It doesn’t extend to non-skilled nursing home care (also known as custodial care) or assisted living. Learn more about what type of nursing home care qualifies at Elder Law Answers.
Seniors who are homebound may also receive home health care under Medicare. To qualify, homebound seniors must require skilled care and be under the supervision of a doctor. Medicare coverage for home health care is limited to part-time or intermittent nursing care.
The types of home care seniors receive is wide-ranging, and there are many non-medical options. If you need care, you’ll have to consider whether live-in, personal, or companion care is required.
Medicare Coverage for Long-Term Care
Outside of short-term skilled nursing care, Medicare doesn’t provide coverage for long-term care. This includes custodial care provided at home, in a nursing home, or in an assisted living facility. However, Medicare coverage can offset the costs of medical services provided in a long-term care setting.
Although Medicare doesn’t pay for personal care, it does cover medical care when a patient lives in a long-term care setting. Seniors should ensure their Medicare coverage offers maximum medical benefits to reduce out-of-pocket healthcare spending. A Medigap policy covers coinsurances required by Original Medicare, but seniors can benefit from adding more coverage through a Medicare Advantage policy. One in three seniors with Medicare already has a Medicare Advantage plan, but those who don’t may miss out on important benefits like dental and vision, prescription drug coverage, and health and wellness services. Additional services offered under Medicare Advantage vary from plan to plan.
Other Ways to Pay for Long-Term Care
Without Medicare footing the bill, seniors must find other ways to pay for long-term care. Adults who are still working can prepare by saving extra for retirement or purchasing a long-term care insurance policy. Unfortunately, long-term care insurance premiums increase with age and adults with pre-existing health conditions may be denied coverage.
Some seniors use a whole life insurance policy to pay for long-term care services. A life insurance policy may be sold, surrendered, or borrowed against to provide cash flow. Some life insurance policies also include long-term care benefits. Seniors can learn more about hybrid policies at NerdWallet.
Paying into a life insurance policy for years isn’t the right move for everyone. Life insurance can be a beneficial investment vehicle for adults who are maxing out other retirement contributions, but adults with fewer retirement savings may be better off dropping a life insurance policy when their children are grown and putting the money they save into investment accounts instead.
Seniors who need long-term care but lack the funds to pay for it are in a tough spot but not without options. Senior homeowners can tap into home equity by selling their home or applying for a reverse mortgage. For an instant home-value estimate, you can use an online home-worth tool. Seniors with low income and few assets may qualify for Medicaid coverage, which offers more extensive long-term care benefits than Medicare.
There are no easy choices when it comes to long-term care. Saving money throughout your working years, investing in long-term care or life insurance, and tapping into equity to pay for necessary care all require financial sacrifice. However, the comfort of knowing you can afford the care you need to age safely is worth the money.
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