How Much Budget Does Medicare Allocate for Long Term Care?

Just like most people I maintain an eight-to-five job plus a part-time so I would be able to provide all of my basic needs, little whims included.  I thought once I have a house of my own I can already live anyway I want to until I overheard an officemate asking will Medicare pay for long term care?

 

I suddenly realized that there’s one more thing to prepare for and that is my long term care because Medicare won’t provide coverage should an incident prevent me from living normally as I do now.

 

That officemate of mine who inquired if Medicare provides long term care (LTC) coverage found out that her aunt was declined by an insurance company because she has hypertension.  At 70, her aunt realized that a long term care insurance (LTCI) policy will be very helpful as she didn’t want to be a burden to her niece.

 

Unfortunately, her application was turned down so now her niece, who is my officemate, is asking around if Medicare will be pay for the expenses that her aunt could possibly incur from in-home care.

 

Based on my research, Medicare is not responsible for anybody’s long term care, which is a kind of health care service provided to individuals who are no longer capable of performing the normal activities of daily living (ADL) such as eating, bathing, dressing, and continence among others.

 

Medicare is only designed for people over 65 years old and younger people who are disabled and in need of medically necessary care.  Medicare’s funds are based on payroll tax contributions so if you end up requiring its assistance, the financial support you will receive will primarily depend on the total amount of your contributions.

 

When Will Medicare Pay for Long Term Care?

 

If your physician’s care of plan states that you need medically necessary care, Medicare will provide you 100 days coverage and foot your nursing home bills but only until the 20^th day.  From the 21^st to the 100^th day, it will require you to get into a co-payment agreement.  To simplify, Medicare does not guarantee 100% LTC coverage.

 

That said, you have to look elsewhere if you want to receive full LTC coverage.  Your nest egg is out of the equation because only a handful of Americans earn more than $75,000 a year.

 

Financial analysts say it is only through a long term care insurance (LTCI) policy that people can receive coverage for custodial care.  This type of care is not medically necessary and it’s more focused on providing assistance with one’s ADLs.  It’s what old people usually require because as one ages, his body gets weaker until his movements become limited.

 

Through this research, I hope I never have to wake up one day and ask myself will Medicare pay for long term care?  I will seek the advice of the experts to get my hands on an LTCI policy.

 

Questions About Long Term Care Insurance Policy

Long term care insurance (LTCI) should not be considered a debatable subject because obviously, it’s every person’s only saving grace, at least that’s how my family perceives it to be.

At 84, my grandfather just ceased paying the annual premium of his 20-year-old LTC policy which initially had a maximum benefit amount of $320,000. I say initial amount because his policy has a 5% compound inflation protection so the amount of his benefits has probably doubled by now.

Our family has no history in any genetic health disorder so when my grandfather found out seven years ago from his doctor that he is diabetic he had his heart in his mouth. He feared the days to come because he had absolutely no idea what individuals with diabetes go through.

Grandma constantly egged him on visiting a geriatrician and so he did. Two months after discovering his sickness he was back to his normal self. He went back to fishing, a favorite hobby of his, which clearly indicated that he has absorbed his case and accepted the fact that he will need serious care.

Two years ago, I remember my parents discussing with grandma and grandpa an excellent nursing home that is situated near our place. According to my folks, granddad can stay as long as he wants at home but should the time come that his health would require 24-hour care and monitoring at least we know where to take him already.

Last year, granddad began receiving assistance with his activities of daily living (ADL) specifically in toilet use and continence. Now at 84, granddad can no longer hold his urine for long and his insulin intake had increased so he had to be taken to a nursing home to receive a higher level of care.

With the levels of care that my grandfather has been receiving, I figured that he could be buried in some amount of debt already. It was during this time that I was starting to worry about his finances that I learned about his long term care plan

Grandma told me that granddad had always been the planner between them. She liked doing things at the spur of the moment while granddad would vehemently oppose it. But when an LTCI agent was brought to them by a family friend, both my grandparents agreed to get a joint policy. Grandma recalled that that was the only moment that she and granddad did not resort to exchanging different opinions.

At 38, grandma said I can already purchase a policy. However, she told me to pay close attention to the following questions to ensure that I get a coverage that is suitable for my needs:

• How much has the insurance company paid out in claims? You will know if the company is credible and capable of keeping its promises by the amount of LTCI claims that it has paid out in the past.

• What discounts are made available to you? The annual premium of an LTCI policy may be small for young buyers like me but insurers have the prerogative to increase the premiums of existing policies if there’s a need for it. Spousal discounts, preferred health discounts, and others will help lessen your expenses.

• What are the benefit triggers of your policy? Some insured individuals clash with their insurers because they insist that they qualify for care but their policy’s fine print says otherwise. Read and review your long term care insurance policy very well before signing it so that in the end, you won’t wind up spending more than what you are supposed to receive.