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Medicare and Assisted Living

 The Facts about Long Term Senior Care and Medicare

As we get older the need to reach out and ask for assistance often exists. They can be small requests like asking a relative to help around the house and cook a hot meal for you. They can also be larger, more prioritized tasks like figuring out your medical coverage in your senior years. When it comes to a large task like seeking the proper plan for covering your prescriptions, appointments, medical emergencies, and other health-related events, it is best to have the right information.

Seniors these days want to make sure that they can live the best years of their life in confidence and free from stress. However, the reality is that a significant percentage of seniors are not confident in enrolling in certain medical care plans because they don’t think they can afford it when they need it. Due to this uncertainty, seniors are unsure of their future, but with a little knowledge and the right assistance, many can be assured that enrolling in a plan is an optimal choice.


Can seniors get Medicare to cover their assisted living care?

Does Medicare cover assisted living care? Generally, most health insurance plans do not cover nursing home care and long term care for seniors; the same goes for Medicare. However, it is wise to keep your medicare coverage and other health care plans if you are in a senior living facility. While they may not cover the facility room and board, you will still be covered for doctor visits, medical emergencies, medication and other health necessities while staying in a nursing home.

For example, Gertrude is an 75-year old senior who made the decision to move into a senior living community in Arizona. She also has a skin condition that requires her to take a small daily dosage of pills and medicated cremes. Her family is worried that they can’t handle supporting her, given the monthly payments for room and board and helping her get the medications she needs. Gertrude is able to use her Medicare Prescription Drug (her Part D Rx Plan) to cover medicines while all the family needs to be concerned about is negotiating the payments to the assisted living facility. Her Medicare will also cover her doctor visits when she needs to be seen.


Financial Assistance for Senior Living Through Medicare Alternatives

The biggest issue when financing the better years of one’s life is how to do it without breaking the bank for you and your family. Paying out of pocket is not the best option, as you and your supporting family’s funds will dry up quickly.  However, this issue can be resolved by discovering the alternatives to curbing fees.

Enrolling in Medicaid to Assist in Senior Living Expenses and Fees

As previously mentioned, Medicare won’t cover assisted living care. However, there is another method to have your senior life financed without paying out of pocket:Medicaid.

Medicaid is a joint program that is run by both the federal and state governments. It’s main purpose is to help take care of medical costs for people with limited income and resources — people who are considered indigent by the government.

In other words, people who qualify for Medicaid must meet a low income threshold and cannot have a significant amount of money in savings. This type of coverage can cover the living expenses of nursing home care and other personalized care services/needs.

If you are are senior that meets the state and federal qualifications for Medicaid, you will be able to obtain some help to pay for the cost at living in most nursing homes and senior living communities.

For example, if Robert (a retired senior with a heart condition) was living in an independent living community in Florida, he and his supporting family members would normally pay out of pocket for his day-to-day expenses. This includes Robert’s room and board, his medications, his weekly doctor visits and other necessities. All because they didn’t do the research beforehand. If they spent a bit of time and discovered that Robert can have Medicaid in addition to his Medicare, then his state’s Medicaid program would help cover the costs of Robert’s monthly room and board payments and take stress off his family.

In order to find out whether or not you qualify for Medicaid, contact your state’s Agency for Medicaid services. Qualifications vary by state and it’s important you apply before assuming you qualify.


Other Methods to Finance Your Senior Living

When Medicare alternatives are out of reach, there are other methods to make sure that the better years of your life are well-financed and taken care of. While they cannot cover your medical expenses, they can take care of the monthly payments to the residential management.

Private Funding Options Offered to Residents

Depending on the choice of facility or community you decide on, some places offer private funding options for their residents. So when you can have a program cover for you, it is best to do your research and find out if the place you are planning to become a resident at has a privatized funding program to help cut down on the monthly costs.

Financial Assistance for Veterans in Nursing Homes & Senior Communities

With the growing number of retirees, there is also a growing number of veterans who will become retirees. Because of this, the Department of Veteran Affairs created two programs that will provide assistance to veterans in return for their past services.

  • Aid and Attendance (A&A) – A program that offers an increased pension amount if you are a veteran and meet one of their conditions.
    • You require assistance in daily functions (bathing, eating, dressing)
    • You are currently bedridden.
    • Have an eyesight that is limited to certain conditions.
    • Are a patient in a senior living/nursing home.
  • Housebound – This is a program that offers a increased monthly pension if you are confined to a premises or facility because of a disability.

If you are a retired veteran and meet any of these programs’ conditions, you will be able to live in a senior community, knowing it is well financed thanks to your past commitments and services.

Getting Financial Assistance Through a Nonprofit for Seniors.

There are a number of nonprofit organizations out there that are dedicated to helping seniors who need assistance in their day-to-day life.  These organizations help seniors obtain such necessities such as groceries, mental health and even assistance for residential senior living. Examples of organizations include:

  • American Baptist Homes of the West (ABHOW)
  • Lutheran Senior Services
  • Volunteers of America National Services
  • Local, community-based organizations specifically serving your area

These organizations and many others are making sure that seniors get the right assistance in housing and care that they require. Discover if there is a non-profit organization in your area to see if they offer any kind of assistance for senior living by contacting your local county switchboard hotline.

Doing Research and Living a Better Senior Life

As previously mentioned, programs like Medicare won’t cover your entire senior living lifestyle. However, it shouldn’t stop you and your family from obtaining residency in the senior living community or nursing home you have your eyes set on. With bit of time and some research, you and your family will find the right way to finance your goals, whether it be through a different medical program or through the help of a nonprofit’s program.

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