Few people, when they dream about the future, want to factor in what can happen when a disabling illness or injury comes along. But with more people aging and living longer due to the great advances in modern medicine, the odds increase constantly that at some point, you might need elder care either skilled care or home care.
And if that happens, the big challenge you have to face is how to pay for the help you need. Whether youre in a nursing home, assisted-living facility, or being home cared, you do have several options that you can rely on, including your own long term care insurance, as well as government programs such as Medicare, Medigap and Medicaid.
If youre not sure that come what may, you will have the financial resources during aging to pay for your own care, regardless of the level and the duration, you need to know about the types of long term care or elder care available through private and public options. Long term care or elder care is generally broken up into three categories: skilled care, intermediate care, and custodial care.
Skilled care is defined as care that is ordered by a physician and rendered by a skilled medical professional, such as a registered nurse or a therapist. Skilled care is round the clock care. Intermediate care is care that is needed often, but not on a constant basis. Intermediate care is provided by workers trained in different aspects of patient care and under the supervision of a physician. And custodial care is the least skilled type of care, and includes help with performing basics of daily living, like bathing, eating and dressing. Custodial care or home care does not require doctors orders, and can be performed by someone with or without professional medical training.
How Skilled Care Is Handled
Medicare pays 100% of the charges for the first 20 days a participant spends in a skilled care facility during each benefit period. In order to qualify for benefits, a Medicare covered individual must have been in the hospital for at least three straight days for the same medical condition, must have been hospitalized within 30 days of having been admitted to the skilled care facility, and must receive care in a Medicare certified facility. Once the initial 20-day period has passed, the participant is expected to pay $133.50 per day for the next 80 days. After that period has passed, Medicare pays nothing the entire cost of care is shifted to the participant.
Medigap is supplemental insurance that is sold under federal guidelines as a way of filling in the gaps in the coverage Medicare provides. In general, Medigap plans pay cover the period between the 21st and 100th days, when Medicare requires the participant to pay a copayment for their care. Long term care or elder care, sold by private insurance companies, pays a set dollar amount per day for the benefit period selected by the policy holder at time of issue. If you want coverage beyond the 100th day, the only way to get it is with your own long term care insurance. Most stays in skilled facilities go for beyond 100 days, so long term care insurance plays a critical role in protecting the finances of individuals and their families.
How Intermediate Care is Handled
Medicare often covers some types of intermediate care, but only in very specific situations, such as when an individual is confined to his or her home, and a physician orders the intermediate care services. In general, however, Medicare does not cover intermediate nursing care, physical therapy or speech therapy.
Medigap policies do not typically cover intermediate care that is received in a nursing home. However, if a physician orders intermediate care services as treatment for an illness or injury, Medigap plans often cover a portion of the costs for intermediate care when treatment is received in the home.
Long term care or elder care policies, on the other hand, provide for intermediate care services to be covered when received in a skilled facility or in the patients home. Care can also be received in other places, including retirement communities, assisted living centers, and even in adult day-care centers.
How Custodial Care is Handled
Neither Medicare nor Medigap provide any coverage for custodial care because, as important as custodial care can be, it is considered to be non-medical by definition or home care. Long term care insurance does provide for custodial care. In addition to personal care, many long term care policies also cover home care services like light housekeeping, the preparation of meals, and even laundry, among others.
Paying for Long Term Care Expenses
While Medicaid provides for more long term care coverage than Medicare does, in order to qualify for Medicaid an individual must have real financial need. For most people that means exhausting their aging savings, retirement assets, Social Security and other pension plans. If youre concerned about your financial future during aging in light of long term care or elder care expenses, you owe it to yourself and to your loved ones in look at long term care insurance. Please call (866) 972-3262 to speak with an experience long term care insurance specialist to learn more about long term and critical care insurance and best & most affordable quotes and rates or complete the life insurance quote request now.

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Last Modified October 12, 2010 @ 9:54 pm
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