Quote:
Originally Posted by reed303
Anyone know of a website or document that explains the different levels of care for Seniors ? ISTM that a lot of folks mis-use words like independent, assisted, nursing, personal care, memory care, etc.
Ideally this info would cover all the possible stages, from "0ver-55" to Hospice. And would include info on which are or are not covered by Medicare or Medicaid or LTCI.
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Though there are plenty of websites that might give explanations - you can't count on the information being totally accurate for an individual case.
As a general rule, Medicare does not cover anything other than skilled nursing care. They do cover
some personal care, but only if the person is also receiving skilled care. For instance, in my area, a person receiving skilled care home health visits, they also qualify for personal care services - but that would generally just be someone coming by and giving them a bath - not day to day personal care.
For Medicare to cover skilled care in a nursing home, the person would first need to be be admitted to a hospital for several days (immediately proceeding, or within a given amount of time) prior to the nursing home admission. Medicare will pay
up to 100 days, however, that is not automatic. For instance, if the
skilled care the person needs (that qualifies them) is physical therapy, they also have to keep showing
progress for Medicare to pay. So you really can't count on a full 100 days.
To find out what Medicare covers, you can go to the Medicare website, which has a wealth of information on their guidelines. Don't just go by what some random website says about what Medicare covers, because they often just hit the highlights, and don't cover the details.
As far as Medicaid is concerned, that would differ by state. But many state Medicaid programs do pay for custodial care (i.e. help with ADLs - activities of daily living). In my state (Illinois) they will pay for it in Supportive Living Facilities, which is similar to Assisted Living Facilities, but licensed a bit differently by the state. However, you have to be assessed at a certain level of need before they will pay for it.
To find out what Medicaid covers in your state, you would want to go to the state's Medicaid website to start your search.
As far as Long Term Care Insurance goes, that can depend on the insurance company. It also seems to be complicated by the fact that different terms are used in different areas and a different times, which is something I am dealing with right now - trying to decipher all the different terms. Add to that the fact that many LTCI companies try to deny claims complicates that further.
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