Medicare offers some assistance when a relatively brief stay in a long term care facility is medically necessary. While there are some exceptions to this rule, in general, care coverage under Medicare is limited to patients who are recovering from illness, injury, or other acute medical incidents. Coverage is not provided to those who have an irreversible chronic condition or those who only need custodial (personal) care, rather than medical care. For patients who meet the criteria, Medicare will pay the entire cost of covered services in a Medicare-certified facility for the first 20 days. From day 21 to day 100, Medicare recipients will be responsible for 20 percent of costs. Patients who have a Medicare Supplemental Insurance plan can receive coverage for that 20 percent from that plan. From day 101 on, there is no Medicare or supplemental coverage, and all costs are the responsibility of the patient.
Alabama Medicaid will cover the costs of medically necessary long term care facility services for eligible patients. Medicaid is a means-tested program, which means that to be eligible for assistance, certain financial criteria must be met. These vary from one year to another, as well as according to the age and marital status of the person applying for the program. In general, as of 2016, eligibility requires that a person's monthly income cannot exceed $2199, and financial resources cannot be greater than $2,000. However, there are many exceptions to this rule – especially when the applicant has a spouse or dependents – and certain resources are considered exempted from the resources calculation.
War-time veterans with limited financial means may be eligible for assistance from the Aid and Attendance Benefit, also known as the Improved Pension program. In addition to financial qualifications, veterans must require assistance to perform activities of daily living to be eligible for benefits that can be used to offset the costs of care.
If you or your loved one has a long term care insurance policy in place, these can offer some assistance. Just how much and under what circumstances varies according to the particular policy.
Basically, a reverse mortgage is a loan taken against a home that is paid off. This gives the owner a lump sum to pay for care, which is repaid following the death of the homeowner via sale of the home.
Planning for the expenses of long term care can be a complex process. If you're still feeling unsure about what you or your loved one may be eligible for in terms of assistance or how to make the most of the options available to you, the Alabama Care Planning Council can be a good resource to help you figure it all out. They offer a lot of resources for long term care planning, including information on government assistance programs, eldercare services and where to find help in navigating the planning process.