What payment options are available?
What questions should I ask?
What medical services can be provided?
Community living can include all of the following: Senior low income apartments, independent living, assisted living, and nursing home.
Community living does not include: Skilled rehabilitation, long term acute care, acute rehabilitation. These are places to go temporarily, for medical needs.
What Payment Options are Available?
The first thing to know is that Federal Medicare health insurance does NOT pay for any living environment. Medicare does not pay rent, even if it is at a nursing home. Medicare does pay for skilled or acute rehabilitation or acute or long term hospitalization, as most insurance will do. When we think about our parents needs, we may be thinking about how our parents need to live in a place that also provides some medical support. Remember that this is still comparable to paying rent. You are just also paying for other supports too. Medicare does NOT pay for this. It is considered support just like paying for a house keeper or having groceries delivered is support for you.
Each state runs its own Medicaid program. Most state Medicaid health insurance programs will pay for a nursing home, if your parents are under a certain income level. That income level is different in each state, but in all states, it is a low income. In each state, there also may be a handful of assisted living centers that take state Medicaid. This is because it actually saves the state money to pay for assisted living if your parents do not need a nursing home. There are usually very few assisted living centers that take Medicaid or are in-network with Medicaid.
Long term care insurance is available and definitely needs to be considered, especially if you do not want to use all your parents money and sell their home to pay for an assisted living or nursing home. Often these insurance plans cover support and care at home, assisted living, and nursing home living. There are insurance companies that work with senior agency's like AARP, that can accommodate people in all states, and there are plans in each state. A search on the internet will easily bring up some options for you.
What Questions Should I Ask?
When looking for a place for your parents to live, if they need to or want to move out of their home, there are key things to look for. The more you can include your parents, the happier they will be, because they are choosing where they will live. Here are some thoughtful questions:
1) Rent - how much is it, and who pays for it? Will your parents long term care insurance or Medicaid cover it, or do your parents have to pay for it?
2) What kind of support is provided, how often, and is this support included in the rent or is it an extra fee?
3) What are the safety features that are provided? Locked doors? Pull cords in the bathroom? Staff on site and how often? Will someone be responsible to be sure my parents take their medications everyday? Will food be served that meets my parents medical diets?
4) What kind of amenities are provided? Will we have to come over and do their laundry or will someone do that for them? What kinds of other services are available (e.g. rides to the doctor)?
Make your list of questions and compare the answers from a few different places.
What Medical Services Can Be Provided?
It is important to know if a doctor or mid-level provider will come to see your parents where they live, or if your parents will have to go out to the doctor. It is also important to know what can be done at their residence and what cannot. It gets a little confusing when it comes to other medical care. Many medical services like home dialysis and IV antibiotics can be completed at home as long as your parents live in their own home. However, if an assisted living is their home, they cannot have these medical services in their home. Your parents would have to go somewhere else for that care. There are real licensing reasons involved for the facility, so it is good to know what medical services can and what cannot be provided as you compare living options.
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