Hofmann: The LTC Basics #6

U.S. Dept. of Health and Human Services offers insights into Long Term Care:

Column by SUE HOFMANN

Consumers may hear many confusing statements regarding the topic of long term care, both published in the public domain and repeated by misinformed individuals. Over the next few weeks, I will be submitting a series of columns containing accurate information provided by the U.S. Department of Health and Human Services, website http://longtermcare.gov. I encourage you to watch for and read these informative columns.

The LTC Basics #6:

Who pays for Long Term Care? 

The facts may surprise you.

Consumer surveys reveal common misunderstandings about which public programs pay for long term care services. It is important to clearly understand what is and isn’t covered.

Medicare:

Only pays for long term care if you require skilled services or rehabilitative care:

  • In a nursing home for a maximum of 100 days, however, the average Medicare covered stay is much shorter (22 days.)
  • At home if you are also receiving skilled home health or other skilled in-home services. Generally, long term care services are provided only for a short period of time.
  • Does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long term care services.
  • You will have to pay for long term care services that are not covered by a public or private insurance program.

Medicaid:

  • Does pay for the largest share of long term care services, but to qualify, your income must be below a certain level and you must meet minimum state eligibility requirements.  Such requirements are based on the amount of assistance you need with ADLs.

Other federal programs such as the Older Americans Act and the Department of Veterans Affairs pay for long term care services, but only for specific populations and in certain circumstances.

Source:  U.S. Department of Health and Human Services, http://longtermcare.gov.

Sue Hofmann is an Agent and Long Term Care Professional (LTCP) at The Jemez Agency, http://www.thejemezagency.com, 2610 Trinity Dr., Los Alamos, and can be reached at sue@thejemezagency.com or 505 662 5181.

 

 

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