As seniors age, long-term care becomes more of a reality. However, long-term care can get expensive quickly. Luckily, Medicare does cover some costs of long-term care, but it doesn’t cover all your expenses. Cost is one of the most influential factors when considering long-term care. So, is it better to opt for in-home care or move into a nursing home or assisted living facility? Let’s take a closer look.
Home care is the most versatile form of long-term care because you can dictate the services you wish to receive and the hours that an in-home caregiver or home health aide is with you. Seniors can get help with personal care, grooming, transportation, meals, medication reminders, and other services.
This type of personalized care allows seniors to remain in the comfort of their own home, which can be very comforting. Seniors receiving in-home assistance retain their independence as they can continue their routine with a helping hand. Plus, they can receive one-on-one care that other long-term care options might not offer. Home care is the most versatile form of long-term care because you can dictate the services you wish to receive
Assuming you qualify for Medicare’s home health benefit, Medicare will cover the costs of in-home skilled care. Skilled care is medical care performed in your home by a licensed or certified nurse. Medicare will generally cover up to 8 hours per day and 28 hours per week. Some circumstances may grant additional coverage. To qualify for home care under Medicare, you must require skilled care as well. Non-skilled care refers to care that doesn’t need to be performed by a medical professional, like personal services, errand running, bathing, dressing, etc.
Assisted Living Facilities
Assisted living facilities offer housing for seniors. An assisted living facility often provides personal assistance with grooming, bathing, medication, meal preparation, etc. But these facilities don’t offer around-the-clock medical attention. Assisted living is a great option for seniors who can no longer live safely at home but who don’t yet need daily medical attention.
Typically, Medicare does not cover assisted living costs because seniors are receiving personal care assistance and not medical help. Medicare will, however, cover any medical expenses incurred while living in assisted living housing.
If you or a loved one can no longer live independently at home and require more medical attention than an assisted living facility provides, then a nursing home is your best option for care. Nursing homes offer round-the-clock attention and care from trained staff. Doctors will often make their rounds to ensure seniors are doing well. And seniors can receive therapy in-house.
Lack of freedom in a nursing home may be a drawback— but may be a good thing for your loved one if they are no longer able to complete tasks themselves or are losing cognitive abilities. Another drawback, like assisted living facilities, is the number of people in each nursing home. Seniors are surrounded day and night with other individuals.
Most nursing home care is custodial care. Medicare doesn’t cover custodial care if it’s the only care you need. Medicare Part A (Hospital Insurance) may cover care in a certified skilled nursing facility (SNF). It must be medically necessary for you to have skilled nursing care (like changing sterile dressings).
Choosing the Best Long-Term Care Option
The best long-term care option depends on your needs and your budget. A senior who doesn’t require medical attention may want to remain at home with assistance from a caregiver. Instead of moving to an assisted living facility, they can save on costs by being at home.
The discussion about affording long-term care can be a difficult one, especially because many services are not covered under Medicare. However, long-term care can help seniors maintain a good quality of life throughout their golden years.
For more information and help in choosing the right path for you contact your Medicare Consultant for guidance.
Kenneth Kiker, CHC spent 49 years in the insurance industry before retiring in 2011 after working in United Healthcare’s Tucson office for 6 years specializing in their Medicare division. He continues to work with Medicare beneficiaries helping them with their Medicare coverage decisions. Ken achieved his Certified Health Consultant (CHC) designation in 1990 after attending The CHC School of Marketing at Purdue University and passing a series of national program exams. Email: firstname.lastname@example.org