Paying for Care

LongTermCare

Ways to Pay for Care

We have created an easy tool for understanding what programs and services are available to pay for different types of Long-Term Care (LTC.)

 

Click on a Topic Below

 


privatepay

Assisted Living Facilities
Nursing Homes
Home Care Agencies

They All Take Cash

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medicare

Assisted Living Facilites

Medicare DOES NOT pay for ALF care

Nursing Home

Medicare DOES pay for nursing home care, but only for a short period of time after hospitalization to Medicare-Certified nursing facilities
Medicare DOES NOT pay for LTC in a nursing home

Home Care Agencies

Home Health Agencies/Nurse Registries

Skilled Health Care-given by RNs & LPNs
Medicare DOES pay for home health care, but only for part-time or “intermittent” skilled care
Medicare DOES NOT pay for full time LTC for home health
Personal Care-given by HHAs
Medicare DOES NOT pay for personal care when this is all the care you need (must be with skilled care) and does not pay for LTC personal care

Homemaker/Companion Agencies

Medicare DOES NOT pay for chore and sitter services when this is all the care you need and does not pay for LTC chore and sitter services

Hospice Care

Medicare DOES pay for hospice care

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medicaid

 Assisted Living Facilities

Medicaid DOES pay for assisted living facility care with the following programs*:

• Assistive Care Services (ACS)
• Assisted Living for the Elderly Medicaid Waiver (ALE)
• Nursing Home Diversion Waiver (NHD)

Other state program that DOES pay for Assisted Living Facilities

• Optional State Supplemental (OSS) This is not a Medicaid program

Nursing Homes

Medicaid DOES pay for LTC in nursing homes with the following program*:

• Medicaid Institutional Care Program (ICP)- Unlike Medicare, Medicaid can pay for custodial care for an unlimited time period

Home Care Agencies

Medicaid DOES pay for LTC for home care from:

• Home Health Agencies/Nurse Registries
Skilled Care-given by RNs & LPNs
Personal Care-given by HHAs

• Homemaker/Companion Agencies

Medicaid has several programs under Home and Community Based Services* (HCBS) to help individuals stay at home. They are:
•Aged/Disabled Adult Waiver (ADA)
• Consumer-Directed Care Plus Program (CDC+)
• Nursing Home Diversion Waiver (NHD)

Hospice Care*Recipient must meet both functional and financial criteria for eligibility for all programs. Not all providers participate in these programs. To receive benefits care must come from an authorized participating program provider.

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careinsurance

  Depending on the type of policy you purchase, a long-term care insurance policy DOES pay for care provided by:

Assisted Living Facilities
Nursing Homes
Home Care Agencies

Standard Provisions

Long-term care policies are not standardized, resulting in many different policy designs. It is important to know the types of coverages available, then compare each policy before purchase, to make sure the policy being quoted has the benefits that are wanted.
Coverage

While LTC policies vary in coverage, they usually will pay either a fixed-dollar amount (an indemnity) or the actual costs of care. However, policies that pay for actual costs usually have a specified daily benefit amount that puts limits on how much can be paid out each day. There may be a limit on how many days the benefits will last.
Florida LTC Partnership Program

To encourage individuals to purchase private long-term care insurance, the State of Florida has developed a partnership program between Medicaid and private insurers. Florida Long-Term Care Partnership Program policies are: • tax qualified
• provides inflation protection
• provides dollar-for-dollar asset protection in the event you need to apply for long-term care Medicaid assistance.

 

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reversemortgage

The funds from a reverse mortgage can be used for any purpose. Just remember that a reverse mortgage is a loan against the equity you have built up in your home. Be prudent as to how you use these funds. Before you borrow, you should carefully consider whether it’s right for you.

Assisted Living Facilities
Nursing Homes
Home Care Agencies

Reverse mortgages were originally designed as a tool for allowing aging, low-income homeowners to keep their homes by providing a source of additional monthly income to meet expenses. Many insurance companies market reverse mortgages to seniors to use the equity they have in their home to help pay for LTC at home. The idea is that most people would rather stay in their home and receive home care instead of being institutionalized for their LTC needs. A reverse mortgage can help turn the equity from your home into cash you need, and unlike a home equity loan, you don’t have to pay back the money as long as you remain in your home.
How They Work

Reverse mortgages are not repaid until the last living borrower dies, sells the home or permanently moves away, at which point the loan, including interest and other fees, becomes due. Because you make no monthly payments, the amount owed grows larger over time, while the amount of cash left after selling and paying off the loan generally grows smaller. But you can never owe more than your home’s value at the time the loan is repaid. Since reverse mortgage borrowers continue to own their homes, they must pay for property taxes, insurance and repairs. If they don’t, the full loan may become due.
Who Is Eligible?

Borrowers must usually be at least 62 years old and list the home as a principal residence. All owners of the home, whether they are residents or family members, must sign the loan papers

 

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veterans

Assisted Living Facilities
Nursing Homes
Home Care Agencies

Veterans DOES pay for the above types of care if you meet certain criteria

All Veterans enrolled in VA’s health care system are eligible for home and community based long-term care services. A series of clinical indicators and conditions help VA staff identify the need for these services. Specific eligibility and admission criteria are unique to each venue of nursing home care: Under the Millennium Health Care Act, 1999, VA must pay for nursing home care for Veterans who require nursing home care and meet the following criteria:

• A Veteran who has a service-connected disability rating of 70 percent or more
• A Veteran who needs nursing home care for a service connected disability
• A Veteran who is rated 60 percent service-connected and is either unemployable or has an official rating of “permanent and total disabled”
• Non-service connected Veterans and those officially referred to as “zero percent, non-compensable, service connected”
• Veterans who require nursing home care for any non-service connected disability and who meet income and asset criteria are eligible for VA CLC care on a resource available basis.

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