Understanding Insurance Options

There are a variety of government and private insurance programs that cover senior care. We’ve put together a short description of your insurance options to help get you started on finding the financing you need.

Government Insurance Programs
Medicare

The Medicare Plan is divided into Part A, which covers hospital expenses, and Part B, which covers all other medical expenses. Generally, most Americans over the age of 65 qualify for Part A, and they don’t have to pay a premium. Medicare Plan Part B does require a premium, however. Some people under age 65 may still qualify for Medicare if they have certain disabilities, and anyone of any age who has end-stage renal disease qualifies. To find out if you or your loved one qualifies for the Medicare Plan you can visit the Medicare website.

The Medicare Plan will typically pay for skilled medical care that is provided by a nursing facility or home health care agency that offers services such as nursing, wound care, and physical therapy. More than likely, however, the Medicare Plan will not pay for long-term custodial care, or assistance with Activities of Daily Living (ADLs), which include personal care services such as bathing, dressing, and grooming.

Medicaid

Medicaid helps cover the cost of health care for low-income individuals who meet certain eligibility requirements. It is administered by state governments, but receives both federal and state funding. Medicaid will cover some or all of the cost of long-term care, as well as general medical care. The long-term care services covered usually include senior care provided in facilities or at home, such as custodial care, assistance with Activities of Daily Living (ADLs), and companionship.

Veteran’s Long Term Care

This program is sponsored by the Veteran’s Administration and helps United States military veterans and/or their surviving spouses with the cost of care. Anyone who served on active duty in the military as well as those called up for active duty while in the reserves or National Guard may be eligible for at least some V.A. healthcare benefits.

Private Sources
Medicare Supplemental Insurance and Medigap Insurance

Medicare supplemental insurance or so-called Medigap policies are special insurance plans offered by private companies to help pay for some of the health care costs that Medicare does not cover. Although these plans are offered by the private sector, they are governed by both federal and state laws for consumer protection.

Long-Term Care Insurance

Long-term care insurance can be purchased to help cover the costs of long-term care not covered by Medicare or Medicare supplemental insurance. Typically this insurance covers care expenses provided in an assisted living facility and at home by non-medical in-home care agencies. Usually long-term care insurance does not cover acute care provided in a hospital.

Life Settlements

Senior life settlements are special arrangements that can be made to get access to the market value of a life insurance policy, rather than the cash surrender value offered by the insurance company. In this type of arrangement, a life insurance policyholder can transfer ownership of an unneeded or unwanted policy to a third party, who pays the original policyholder more than the cash value currently offered by the life insurance company. The third party then assumes all future premium payments and becomes the beneficiary of the policy when it matures.