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Ensure Mom Has the Care She Needs
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Select a question below:
- What is long term care?
- Long term care is personal care and other related services provided on an extended basis to people who need help with activities of daily living* or who
need supervision due to a severe cognitive impairment, such as Alzheimer's disease. It can be provided at home or in an adult day care center, assisted living facility, or nursing home.
*Activities of daily living (ADLs) are the basic activities of caring for oneself, such as eating, dressing, bathing, toileting (using the bathroom), transferring (moving back and forth
from a bed to a chair), and continence. Insurance companies use the inability to perform a specified number of ADLs to help determine eligibility for long term care benefits. The Federal
Long Term Care Insurance Program (FLTCIP) uses the inability to perform at least two of the ADLs listed above.
- What is long term care insurance?
- It is insurance that helps you pay for long term care services, such as home care or care in a nursing home or assisted living facility.
- I'm healthy. I won't need long term care. Or, will I?
- The odds are that you may need long term care at some point in your life. It is estimated that at least 70% of people over the age of 65 will require long
term care services at some point in their lives.2 But the need for long term care does not only result
from the effects of aging. You may have an accident or experience a debilitating illness (e.g., a stroke, multiple sclerosis, or Parkinson's disease). While no one knows what their
future holds, everyone should have a plan for meeting possible long term care needs. Many will do so through the purchase of long term care insurance.
- Is long term care expensive?
- Yes, long term care provided in your home or in a facility can be very expensive. We developed a tool to help you determine how expensive long term care
is in your area. Go to the Cost of Care in Your Area tool.
- Doesn't my health care plan already cover long term care?
- In most cases, long term care expenses are not covered by traditional medical insurance plans such as the Federal Employees Health Benefits (FEHB) Program,
TRICARE, and TRICARE For Life, or by disability income insurance. Health care plans may cover some of the skilled medical services you may need when you can't care for yourself after an
illness or injury, but usually for a limited period and only as long as you are showing improvement.
Health care plans typically do not cover ongoing chronic care such as an extended stay in an assisted living facility or a continuing need for a home health aide to help you in and out
- Will Medicare cover long term care?
- In most cases it will not. Medicare is a Federal health insurance program for people who are age 65 or older, some people with disabilities under age 65, people with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant), and people with Lou Gehrig's disease (ALS, amyotrophic lateral sclerosis).
Medicare will cover the first 100 days of care in a nursing home if:
There are also some deductibles and co-pays (meaning you have to pay part of the cost). Medicare also covers limited home visits for skilled care.
It is very important to realize a few things about long term care versus Medicare coverage:
- You are receiving skilled care, and
- You have a qualifying hospital stay of at least 3 days and enter the nursing home within 30 days of that hospital discharge.
- Most long term care is not skilled care
- Most long term care does not take place in a nursing home
- Most people who require care in their home usually need more or different types of care than Medicare covers
- Most people won't start Medicare coverage until age 65
- Will Medicaid cover long term care?
- Medicaid is a state-based program supplemented by Federal funds that acts as a safety net to provide health services to the poor and impoverished.
Medicaid covers long term care services and might cover you if you meet your state's poverty criteria and receive care that meets your state's guidelines.
Usually this means that your assets and savings (except for perhaps your house and your car) do not exceed $2,000. It also means receiving care from a limited number of state-approved
caregivers (mostly institutions like nursing homes) that are willing to accept Medicaid payments.
If you have minimal assets and income, Medicaid may be your best prospect for covering long term care expenses.
If you can afford long term care insurance and want to control the type and location of care that you receive, the FLTCIP deserves your attention.
- Will the Veterans Administration cover long term care?
- The Department of Veterans Affairs (VA) health system makes certain long term care services available to veterans based on a priority ranking system, with
highest priority given to those with severe service-related disabilities.
VA-funded long term care may be worth investigating, especially for veterans with service-related disabilities and/or low incomes and assets.
Keep in mind, however, that in addition to the priority ranking system, the availability of long term care services from the VA may vary by geographic area.
Federal family members can apply for coverage anytime—you do not have to wait for the next open season. Premiums are based on your age and the premium rates in effect at the time we receive your application—the younger you are when you apply, the lower your premium will be.