There are various ways of paying for senior housing and long-term care. The following information is designed to give you a better sense of the program and the options available.

Private Pay:
Private pay simply means using your income and resources to fund the cost of your care.

Long Term Care Insurance:
Long term care insurance covers extensive range of services such as home care, assisted living and long term stays in various types of facilities like personal care homes, assisted living facilities and nursing homes. By purchasing this type of coverage, the risk is transferred from you to the insurance company. The premiums are based on you attainted age and health status and your policy can be customized to meet you needs.

Medicare:
The Health Care Financing Administration (HCFA) administers Medicare, the nations largest health insurance program, which covers 39 million Americans. Medicare is a health insurance program for people 65 years of age and older, some disabled people under 65 years of age, and people with End Stage Renal Disease – treated with dialysis or a transplant.
To be covered, you must receive services from a Medicare certified skilled nursing home after a qualifying hospital stay. Medicare will assist in funding your skilled care for a maximum of 100 days per benefit period, following a 3-day hospital stay. Medicare covers 100 % of skilled nursing care or skilled rehabilitation services and other related health services for the first 20 days. You are responsible for a daily deductible for the next 80 days. After day 100, Medicare will not pay toward you skilled stay.

Medicaid:
Medicaid is a State and Federal program that will pay most healthcare costs in a nursing home or assisted living facility for people who meet ht medical criteria as well as the income and asset criteria required by the program. Eligibility varies by state. Medicaid will pay only for nursing home or assisted living care provided in a facility certified by the government to provide service to Medicaid recipients.

Managed Medicare: (Medicare HMO)
In a Medicare HMO plan, the insurance company or sponsoring organization functions as both the insurer and the provider of health care services. If a beneficiary enrolls in a Medicare HMO plan, they “give up” their traditional Medicare coverage. Medicare then give s the managed care plan the Part B premium and a designated Part A fee for each beneficiary enrolled in the plan. With these funds from Medicare, the company assumes the responsibility for care for the beneficiary through the network of physicians, hospitals, diagnostic services, and ancillary services managed by the plan.

Managed Care:
A method of delivering, overseeing, and coordinating health care, often through an HMO or other network of doctors and hospitals. The system uses primary care providers as “gatekeepers” to specialist and more costly medical care. The goal is to reduce unneeded care; control costs and assure access to effective treatment.

Veteran’s Programs:
The Department of Veteran’s Affairs (VA) provides care in its own facilities to veterans in need of skilled and intermediate nursing care. The VA also provides both skilled and intermediate care to veterans through contracts with community nursing homes. Beds are available to all veterans on a space available basis. Contact your local VA office for more information.

Supplemental Security Income (SSI):
SSI is a state-regulated, federally financed financial assistance program for seniors in some assisted living residences (or their equivalent). SSI benefits are paid directly to the individual, who then pays for the services provided by the facility. Only some communities accept SSI, and are not required to admit residents who will use the program.

Mr. Gary Crooms is President and founder of Senior Information Services of America®, a long term care financial planning firm that specializes in assisting seniors and their families with late life planning issues. If you have any questions, please contact Mr. Crooms at gary@seniorinformation.com