Posts Tagged Long Term Care Insurance

How To Pay For Nursing Home Care

One of the most difficult transitions people face is the change from independent living in their own home or apartment to living in a long term care facility or nursing home. There are many reasons why this transition is so difficult. One is the loss of a home…a home where the person lived for many years with a lifetime of memories. Another is the loss of independence. Still another is the loss of the level of privacy we enjoy at home, since nursing home living is often shared with a roommate.

Most people who make the decision to move to a nursing home do so during a time of great stress. Some have been hospitalized after a stroke, some have fallen and broken a hip, still others have progressive dementia, like Alzheimer’s disease, and can no longer be cared for in their own homes.

Whatever the reason, the spouse or relative who helps a person transition into a nursing home during a time of stress faces the immediate dilemma of how to find the right nursing home. The task is no small one, and a huge sigh of relief can be heard when the right home is found and the loved one is moved into the nursing home. For many, the most difficult task is just beginning; how to cope with nursing home bills that may total $2,500 to $6,000 per month or more?

One of the things that concerns people most about nursing home care is how to pay for that care. There are basically four ways that you can pay the cost of a nursing home:

  1. Long Term Care Insurance – If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of the nursing home. Unfortunately, long term care insurance has only started to become popular in the last few years and most people facing a nursing home stay do not have this coverage.
  2. Pay with Your Own Funds – This is the method many people are required to use at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging between $4,000 and $6,000 per month in our own area, few people can afford a long term stay in a nursing home.
  3. Medicare – This is the national health insurance program primarily for people 65 years of age and older, certain younger disabled people, or people with kidney failure. Medicare provides short term assistance with nursing home costs, but only if you meet the strict qualification rules.
  4. ALTCS (Arizona Long Term Care System) – This is a federal & state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met.

If you are looking for assistance in qualifying for ALTCS please reach out to one of our specialists at Legal Awareness for Seniors.


What is Long Term Care Insurance and What Does It Cover?

Long Term Care Insurance1 out of every 2 people will need to have long term care at some point in their life. Long Term Care Insurance can help alleviate the costs when you are in need of long term care.

You must set up Long Term Care Insurance before you need it. Once you have been diagnosed with a long term care illness, you will not be able to qualify for the insurance. Obtaining this insurance is a preventative measure.

Most Long Term Insurances cover:

  • nursing homes
  • Alzheimer’s care
  • personal care in your home
  • assisted living facilities
  • hospice care
  • adult day care
  • respite care
  • home health care

Depending on the choices you make (such as the maximum amount the policy will pay per day in long term care, maximum amount of days it will cover, etc.) will depend on the cost of the premiums. Be sure to investigate the insurance company you decide to go with. It is a good idea is to check the company’s premium rate history. Many companies increase their premium rates regularly which can stick you with a high monthly cost. You may want to meet with a professional to help you choose the best plan for you.

How Do I Pay For Assisted Living?

When it comes time for your loved one to be in assisted living it can be a shock at the expenses that are involved in the day to day care. There are three ways that you can pay for assisted living.Pay for Assisted Living

  1. King Midas Approach (Private Pay)
  2. Long Term Care Insurance
  3. Benefits
    1. ALTCS (Medicaid)
    2. VA Aid & Attendance

King Midas Approach

This is also known as private pay. This can be the simplest route, but the cost of assisted living can quickly eat up any savings, 401K’s, IRA’s and other investments in your portfolio. Often paying out of pocket can only last for so long.

Long Term Care Insurance

Having this insurance can be very beneficial when paying for assisted living. However, this must be set up well before you are in need of assisted living. The cost of the insurance can vary as well and is usually based on your age, the amount the policy will pay per day, the maximum amount of years that will be covered, and any other optional benefits you choose. The insurance company may require medical underwriting as well.

It is very common for insurance companies to initially decline payment. In many cases you or the staff at the facility must contact the insurance company to discuss the situation in order to get approval. Most insurance companies will require that you will need help in at least two areas of daily living (such as bathing, dressing, toileting, walking, transferring from the bed to a chair, eating, etc).

Benefits: ALTCS

ALTCS is Arizona’s version of Medicaid (Arizona Long-Term Care System). In order to qualify for ALTCS you must meet asset, income and medical eligibility requirements. There are ways to strategically plan for ALTCS before applying and in so doing save substantial money.

Benefits: VA Aid and Attendance Pension

VA Aid and Attendance is for veterans that are in need of assistance. Just like with ALTCS you must meet certain requirements in order to qualify. This is monetary assistance that is given in order to supplement the cost of assisted living. There are also ways to strategically plan for this Pension before applying.