Government Long Term Care
Some government programs were established to help pay for long term care. However, there are limits:
1. Medicare – In general, Medicare does not pay for long term care but they can help pay for a maximum of 100 days rehabilitative care in a skilled nursing facility. The coverage for the first 20 days is 100% but beginning the 21st up to the 100th day, a co-payment of $144.50 is required. No benefits will be paid after the 100th day.
2. Medicaid – Medicaid can help pay for your long term care but there are eligibility requirements that you must meet. In most states, you can only apply for Medicaid benefits if your asset value, excluding your home and car, is lower than $2,000. And if you have a monthly income, it should not be more than $2,094.
Medicaid also imposes a 5-year look back period to all applicants, which means if you applied for benefits on January 1, 2012 and you transferred a property for less than its fair market value within the 5-year time frame, you will be subjected to a penalty disqualification period. The length of the penalty disqualification period depends on the value of the asset you transferred and the cost of care in your area. If the cost of long term care is $75,000 per annum and the value of the property transferred is $150,000, Medicaid will only start paying 2 years after the date of your application.
Furthermore, Medicaid is mandated to recover its long term care expenses. This means that your home, the only property with substantial value you would probably have by the time you qualify for benefits, will be subjected to asset-recovery procedures in the event of your death, or when you leave it with no intent to return.
3. Programs of All-inclusive Care for the Elderly (PACE) – PACE is an optional benefit under Medicare and Medicaid. Its primary goal is to help seniors receive the long term care in their homes and community.
To be eligible, an applicant must meet the following requirements:
- Aged 55 and older
- A resident in the service area of a PACE organization
- With a condition that requires nursing home level of care but is still able to live safely in the community at time of enrollment
- Services provided under PACE include personal care, meals, social services, restorative therapies, nutrition counseling and others. These services are often provided at adult day care centers but may also be provided at home.
4. Veteran Affairs Long Term Care Benefits – The Department of Veterans Affairs (VA) helps pay for long term care for service-related disabilities. Veterans who do not have service-related disabilities but are unable to pay for long term care may also be eligible for benefits but a co-payment might be required depending on their income. Benefits include nursing home and in-home care but they can only be received in VA facilities.