By Eileen Doherty
Today, most Americans have had experience with a loved one who has suffered from Alzheimer’s, a stroke or other debilitating chronic disease that has forced them to seek long term care. For many people, the opportunity to age in place in their own home is the best option, but sometimes people need more care than is available there.
Paying for long term care is a challenge. Many people have spent their life saving for their later years and still don’t feel they have adequate funding either for their retirement or their need for care.
In the 70’s & early 80’s, alternatives such as home care was almost non-existent. Assisted living, hospice care, adult day programs, and retirement communities were not available options. As these options for health care have evolved, so have the costs of care increased.
In 1974, the cost of a nursing home bed was approximately $12.50 per day. Today, a private pay patient pays upwards of $250 per day for the same bed in the same facility. Many older adults spend more than a half million dollars in long term care costs using most, if not all of their funds. Many times families do not seek help because they are afraid they can’t afford to pay for care or are unaware there is help.
For individuals who use all of their funds, Medicaid can help pay for the cost of long term care. To qualify for Medicaid, the individual must have less than $2000 in assets excluding their house, car, a revocable burial policy and term life insurance. If the individual is married, the spousal allowance is an additional $120,900 in cash or other resources, so as to not totally impoverish the spouse.
In addition to the resource qualification, the individual must meet income requirements of less than $2205 per month from all sources including Social Security, pensions, and investment income. If the individual makes more than $2205 and still needs long term care, a Medicaid Qualifying Trust can be established.
The last qualification to receive Medicaid benefits for long term care is to meet the functional requirements. An assessment is conducted by the Options for Long Term Care agency in the county in which the older adult resides to determine if the person meets the criteria for nursing home care.
If the person meets the income, resource, and functional requirements, Medicaid can help to pay for care in the home, in an assisted living or in a nursing home. There are approved programs that help provide services in the home, including someone come to your home, paying a family member, or directing your home care with an aide. The same program also pays for care in an assisted living or nursing home.
The application for Medicaid can be cumbersome. Records to prove income, resources, and expenses. A physician must certify the person one needs more care. Selecting a home care agency, an assisted living and/or a nursing home can be challenging as well.
For more information call 303-333-3482 and ask to talk with a counselor. You may also visit our website at www.senioranswers.org or pick up a copy of the Senior Resource Guidebook at your local library.
~ Eileen Doherty, MS is the Executive Director of the Colorado Gerontological Society since 1982. She can be reached at doherty001@att.net.