Long Term Nursing Home Care is NOT covered by Medicare
Over 70% of the American population will need some form of Nursing Home Care at some point during their life. The average Nursing Home stay can easily cost $7,500 per month. Add a Respirator in order to breathe and the cost could escalate to $25,000 per month. Whether a serious injury or a sudden or progressive illness, few people are prepared to handle the high cost of Nursing Home Care when a loved one is struck with a Catastrophic Illness.
Catastrophic Illnesses include Dementia, Alzheimer’s, Parkinson’s, Stroke or a broken hip can often require lengthy nursing home stays. Many families are able to provide appropriate in home care in the early stages of Dementia, Alzheimer’s and Parkinson’s diseases, however as these illnesses advance, Nursing Home Care may become necessary and is an expense that few individual or families are prepared to handle. These families discover that Medicare, private health insurance, and HMO’s do not cover ongoing nursing home care.
Long-Term Care Insurance is an option to assist with the cost; however, it is often inadequate to meet the full cost of a nursing home stay. Long-Term Care insurance is generally paid on a daily basis with the benefit being $50 to $150 dollars per day for a period of time, usually not to exceed 3 to 5 years. Along with the problem of long-term care coverage not being adequate to fund the average nursing home stay of $7,500 per month, the other major issues with long-term care coverage are high premium costs and often inability to qualify due to pre-existing medical conditions.
In California the solution is Medi-Cal, a Middle Class Program created by the government to help families facing a Catastrophic Illness. In other states it is some form of the federal Medicaid program. The good news with Medi-Cal is that there is no limit to length of stay or type of care your loved one can receive from Medi-Cal in a skilled nursing home and over 80% of the Nursing Homes in California are approved for Medi-Cal.
However, many Middle Class Families mistakenly assume they are not eligible for Medi-Cal Benefits and believe that Medicare and/or their health insurance policies will pay for Skilled Nursing Home Care. Because most people do not realize that Medi-Cal is an option and do not know that its benefits are available to them, they pay privately. Private paying could result in the loss of an entire lifetime of savings. It is not necessary that an individual, in order to be eligible for Medi-Cal benefits “spend down” all of their assets, or, in the alternative, be poor or impoverished.
As with any government program, there is an application process and rules to be met. The process is not an easy one, but with the proper assistance and pre-planning, most Middle Class families can obtain long-term nursing home benefits.
For more than 30 years, NHS has helped numerous families obtain excellent Long-Term Nursing Home Care paid through government benefits (Medi-Cal) while preserving and protecting the family home and assets. NHS is considered one of the nation’s leading experts on long-term illness care and federal benefits. For more information visit PRO’s Wellness Village – Elder Law Attorney Zoran Basich