Maintaining a loved one in a nursing home can be quite expensive. In California, the average annual cost of having one person living in a private room in a nursing home (which provides skilled nursing) is over $87,000. Even in an assisted living facility, where residents are expected to be more independent (and are less supervised), the average annual cost is $42,000.
One way in which these high costs can be covered is through long term care insurance. Many insurance companies offer long term care insurance policies; however, there are stipulations included as well. To begin with, the individual considering long term care insurance must take out the policy before he or she needs assisted living or skilled nursing and long term care. Second, the person taking out the policy must be reasonably healthy.
Oftentimes, people assume that their Medicare insurance program will cover the costs of a nursing home. Unfortunately, Medicare does not cover nursing home care, except in the case where a person is hospitalized for at least three days and that person’s physician recommends skilled nursing home care. At that point, Medicare does pick up the cost of nursing home care for the first 100 days. After those 100 days are up, Medicare coverage ceases and the patient is on his or her own.
Some people try to obtain coverage under the Medi-Cal program in order to pay for assisted living and long term care costs. Medi-Cal is California’s Medicaid program and covers needed health services for low-income individuals and families. To obtain Medi-Cal coverage, applicants must go through a series of complex legal qualifications and determine what assets they must divest themselves of and what assets they can keep. Many quasi-legal “firms” exist and claim that they can obtain Medi-Cal coverage for their clients; however, it is best to seek out the services of a qualified lawyer who has an in-depth understanding of long term care laws and regulations. This is especially important because the rules for Medi-Cal qualification change year-to-year.
Individuals can also call organizations that deal specifically with Medi-Cal and know its rules intimately. One such organization is the Seniors Advisors Network, which can be reached at (800) 640-5626 (California only).
Tags: assisted living, california, long term care, Long Term Care Insurance, Medi-Cal, Medicaid, Medicare, nursing home, skilled nursing
