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 at the types of long-term senior care and what Medicare will cover.
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 anything else you can think of.
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 are able to 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 & Medicare Costs
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 required skilled care as well. If you do require skilled care, Medicare will cover some in-home non-skilled care costs 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. However, Medicare will not cover non-skilled care if you do not also require skilled care.
Medicare should pay for home care service if your condition is temporary or chronic.
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.
However, assisted living facilities can get crowded. Seniors may have to share a room or be around other seniors during large portions of the day. This can get tiresome and cause agitation.
Assisted Living & Medicare
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.
However, nursing homes don’t allow seniors to have much freedom — which may actually 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, which can seem daunting and get frustrating.
Nursing Homes & Medicare
Medicare generally covers short-term nursing home care, but there are some limitations. Seniors must already have Medicare Part A, have an inpatient stay in a hospital of at least 3 consecutive days, and receive doctor’s orders to go to a nursing home.
There are other stipulations as well. Medicare will usually only cover 30 days in a Medicare-approved nursing home, making it difficult for seniors who need long-term care to cover their costs. Seniors must receive care from skilled professionals on a daily basis.
Even if your nursing home costs are covered by Medicare, they only cover a shared room, meaning seniors won’t be able to get the privacy of their own room. However, some Medigap plans are more flexible and can help you cover nursing home costs.
Choosing the Best Long-Term Care Option
In the end, 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.
If a senior has recently been admitted to the hospital and needs daily medical attention, it may be a better option to be admitted into a nursing home. There they can receive proper treatment before going back home for part-time skilled care or deciding to stay in the nursing 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.