Why consider Long-Term Care?Long-term care consists of a variety of services, including medical and non-medical care to people who have chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in a nursing home. It is important to remember that you may need long-term care at any age. Medicare and Long-Term Care While there are a variety of ways to pay for long-term care, it is important to think ahead about how you will fund the care you get. Generally, Medicare does not pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for this type of care. Medicare does not cover long-term care to assist people with support services or “custodial care”. Custodial Care is defined as non-skilled care that helps people with activities of daily living. It may also include care that most people do for themselves, such as diabetes monitoring. Some Medicare Advantages Plans (Medicare Health Plans) offer limited skilled nursing and home care coverage if the care is medically necessary. However, you may still have to pay some of the costs. Choosing Long-term Care is an important decision. Planning for long-term care requires you to think about possible future health care needs. It is important to look at all your choices. You will have more control over decisions and be able to stay independent. It is important to think about long-term care before you may need care or before a crisis occurs. Even if you plan ahead, making long-term care decisions can be difficult. Here’s some helpful guidance on choosing long-term care: Community-based services Many communities provide services and programs to help seniors and people with disabilities with a variety of personal activities. These services include Meals-on-Wheels, transportation services, personal care, chore services, adult day care and a variety of activities in senior centers. These services are usually free or at low cost to individuals who qualify. Local organizations, called Area Agencies on Aging coordinate these services to promote the independence and dignity of older adults. The local community Area Agency on Aging can be found by visiting www.medicare.gov or calling 1-800-677-1116. The following community-based services may be available in your area:
Home Health Care Depending on your needs, you may be able to get help with your personal activities at home from family members, friends, or volunteers. If you think you need home care, talk to your family to see if they can help with care or help arrange for someone to come to your home to help. Some home care can only be given by a licensed health worker, such as skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury. Skilled nursing care included services and care that can only be performed safely and correctly by a licensed nurse or a licensed therapist. Remember, Medicare only pays for home care if you meet certain conditions. You can also hire a home health care agency for care in your home if Medicare does not cover it. In this case, you will need to pay for this care on your own. Home care costs can vary depending on where you live, the type of care you need and how often you need care. Usually home care is charge by the hour. The following home health services may be available in your area:
In-Law Apartments An in-law apartment is a separate housing arrangement within a single-family home or on your lot. It may also be referred to as a second unit, accessory apartment, or accessory dwelling unit. An in-law apartment is a complete living space and includes a private kitchen and bath. An in-law apartment may provide living space for a caretaker or may be rented to provide additional income to you. Many local and state governments have restrictions about the addition of a second apartment on your property. You should consult your local city or county government zoning. Board and Care Homes This group of living arrangement provides help with activities of daily living for people who cannot live on their own but do not need nursing home services. It is sometime called a “group home”. In some cases, private long-term care insurance and other types of assistance programs may help pay for this type of living arrangement. Many of these homes do not receive payment from Medicare or Medicaid and are not strictly monitored. The monthly charge is usually a percentage of your income. Assisted Living This group living arrangement provides help with daily activities. Residents often live in their own room or apartment within the building or group of buildings and have some or all of their meals together. Social and recreational activities are usually provided. Some assisted living facilities have health services on site. Costs for assisted living facilities can vary widely depending on the size of the living areas, services provided, type of help needed, and where the building is located. Residents usually pay a monthly rent and then pay additional fees for the services they get. Continued Care Retirement Communities These housing communities have different levels of care based on your needs. Where you live depends on the level of care you need. In the same community, there may be individual homes or apartments for residents who still live on their own, an assisted living facility for people who need some help with daily care, and a nursing home for those who require higher levels of care. Residents move from one level of care to another based on their needs but still stay in the Continued Care Retirement Community. Nursing Homes Nursing homes provide care to people who cannot be cared for at home or in the community. Nursing homes provide a wide range of personal and health services. For most people, this care generally is to assist people with support services1 and is for people who cannot take care of themselves due to physical, emotional, or mental problems. Medicare does not pay for this type of care and does not pay for most nursing home care. Some nursing homes may provide skilled care after an injury or hospital stay. Medicare pays for skilled nursing care for a limited time period if you meet certain conditions. When choosing a nursing home ask these questions:
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