As you look at making a move to a retirement community, assisted living facility or a nursing home, there is great concern over how to pay for it. There are several different options depending on the level of care. Here is a breakdown of various financing option that are available.
Private Pay – This is the most common way that independent living, assisted living and skilled nursing is paid for. The person or couple use their income including social security, pension and any other regular income to cover the cost. In many cases, they will also need to use some of their savings as well. This would be, but not limited to stocks, bonds, check and savings, CDs, IRA or annuities, real estate and any other investments.
Housing Subsidizies – There are some housing options that may be government subsidized to offer affordable housing or rental assistance. Specific income guideline must be met in order to qualify for this type of housing. The most common subsidized housing in the Western New York area is offered through HUD programs or through Belmont Housing Resources.
Veteran’s Aid & Attendance Benefits – Veterans who served during wartime and their spouses may be able eligible to receive a benefit through the Veteran’s Administration. This benefit is for those who are unable to care for themselves and are in need of assistance with activities of daily living (ADLs). There are certain income guidelines that must be met and the person’s assets must be under $80,000 (excluding their house and car). Generally, those who may be able to apply for this benefit are getting services in their home or are living in an assisted living or skilled nursing facility.
Supplemental Security Income (SSI) – This is different than the social security income that seniors receive each month, although it is also administered through the Social Security Administration. SSI is used to supplement payment for assisted living facilities and housing for seniors with low income. Like housing subsidies, there are specific income guidelines that must be met to eligible for SSI. If you qualify for SSI and are looking for an assisted living facility, you will want to make sure that the facility accepts SSI.
Medicare/Medicaid – These two programs are often confused with each other. Medicare is a federal health insurance program that offers limited coverage for nursing home care or home health care. Medicaid is a federal, state and locally financed program that covers health care expenses generally in a nursing home or for home health care services for those whom have spent down their assets. There are both financial and medical qualifying factors. Generally someone in a nursing home will be able to meet the medical qualifiers. The financial qualifiers vary for an individual and for someone whose spouse is still living in the general community. More simply, the community spouse will be able keep a certain amount of income, assets, house and car while the spouse in the nursing home qualifies for Medicaid coverage. An important factor that Medicaid will look for, is if there has been any asset transfer in the last 5 years.
It is frequently asked if Medicaid covers assisted living. It generally does not with the exception of New York State Assisted Living Program (ALP). Again, to qualify for Medicaid there must not only be a financial need but also a medical need. Generally most individuals in an assisted living facility will not meet the medical qualifiers even though they may meet the financial qualifiers. There are only a few facilities in Western New York that offer the Assisted Living Program.
Long Term Care Insurance – Long term care insurance is a policy that will cover services provided generally in a nursing home or assisted living facility. Typically the person must need assistance with two to three activities of daily living in order to use this policy. Most plans have a dollar amount or time period cap. Some plans may also cover home care services. It is important to talk with a qualified insurance professional or elder law attorney to see if a policy of this nature is beneficial for you.