Long Term Care in the Community: Staying Home When You Want To.

From 2012:

By Arthur C. Weinshank, Esq., Dolores R. Schiesel, Esq., and Peter J. Harrison, Esq.

Long term care is a scary topic for many families in America. Older couples wonder how they will care for each other while retaining their independence and quality of life. Adult children wonder how they can balance raising their children, caring for their parents, and saving for themselves. However, there are many ways to pay for long term care. The top two ways that people think of are out of investments or savings (private pay) and Medicare. Unfortunately, Medicare is not a long-term care program. As a general rule, Medicare only covers up to 100 days skilled nursing facility care for any illness. Private pay is certainly an option, but with nursing facilities costing as much as $11,000 per month, many people will not be able to afford to pay for their care for very long. Medicaid is a different government program that does pay for long term care, but is subject to income and asset restrictions. For skilled nursing facility care, a single person must have less than $1,600 in countable assets and less monthly income than the cost of care to be eligible for Medicaid. In-home services cost less than skilled nursing facilities, but are unable to offer the same level of care as a skilled nursing facility. If a person does not need the level of skilled care required at such a facility, choosing in-home services can represent a substantial savings.

For in-home care, family members cannot always provide all of the services required. Connecticut has a program called Connecticut Home Care Program for Elders (CHCPE) to provide assistance for those who could benefit from in-home care but may not be able to afford it on their own. After certain eligibility requirements are met, CHCPE can provide several services such as adult day care, chore, companion, homemaker, and transportation services. In addition to the programs through CHCPE, there are private companies that offer in-home assistance. These companies often offer two kinds of services at different rates: the first being homemaker or companion services such as helping run errands, tidying, helping with the mail and bills, or simply dropping by to have a conversation and provide company.

Another approach to paying for long term care needs both in the home and at skilled nursing facilities is acquiring Long Term Care Insurance or enrolling in the Connecticut Partnership for Long Term Care program. Long term care insurance are insurance policies originally designed to cover skilled nursing facility care. As the market for this product has evolved, policies have expanded to cover additional or different long term care needs, such as in-home care. The coverage benefit is often expressed in a per diem dollar value. Because there are many different options for long term care insurance, if you wish to take out such a policy, be sure to examine the benefits and try to find one that is tailored to your needs. The Connecticut Partnership for Long Term Care program is a state overseen program which allows the policy holder to disregard assets for purposes of applying for Medicaid in the amount the policy has paid for the person’s care. For example, if a person’s Partnership policy has paid $200,000 in coverage on the person’s behalf, up to $200,000 of the person’s assets will be disregarded on his or her Medicaid application. In addition, the Partnership policies must permit policy holders to reduce their premium costs by reducing their benefit period if they cannot afford the premium; cover a range of in-home and community services as well as the costs of care management; and offer automatic inflation protection on an annual basis.

Finally, an option for veterans and their spouses are the Veteran’s Benefits, such as the Veteran’s Pension and Aid & Attendance. Aid & Attendance is an additional benefit to the Veteran’s Pension, which is subject to service, income, and asset limitations. The actual amount an individual receives under the Veteran’s pension is determined by the Department of Veteran’s Affairs, but can be a considerable sum for those who couldn’t afford the care otherwise. Those veterans or their spouses needing in-home care should inquire with the VA as to their eligibility.

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