Financial Information

How Can We Afford Assisted Living Care?

Is Mom taking her medicines? Is Dad socializing enough? Are they eating nutritious meals? It's hard to balance the responsibilities in your own life with the needs of your parents. But aren't assisted living communities expensive?

Let's start with some basics about care, and what assistance you might be eligible to receive:

What does it cost to live in an assisted living community?

An assisted living community provides housing, personal support and health care services. Costs vary with the part of the country, the community, apartment size, level of care needed and types of individual services required. Across the nation, basic daily fees range from $15 to $200 - generally less than the cost of home health care services and nursing home care. These fees may cover all services or there may be additional charges for special services. Most assisted living communities charge month-to-month rates, but a few require long-term arrangements.

In all cases, finances should be discussed openly in detail with the community admissions staff. Residents or their families generally pay the cost of care from their own financial resources. Some costs may be reimbursed through an individual's health insurance plan (consult your insurance provider), and communities may offer financial assistance programs. Some state and local governments offer subsidies for rent or assisted living services for low-income seniors, but generally, government payments for assisted living services have been limited. Contact your state Department of Health and Human Services for more information.

Does Medicare pay for assisted living?

Medicare/Medicaid services are provided by the individual states, and coverage varies from state to state, especially when it comes to assisted living. Most states do, however, offer many other options to Americans needing assistance with daily living activities.

In the past, many assisted living communities were private-pay only. Now, thanks to much-needed legislation in some states, Medicare helps cover the cost of some assisted living care services for those who are age- and income-qualified. Fortunately, Medicaid also provides additional funding for assisted living care and services not covered by Medicare.

In Illinois, a pre-admission screening process must be completed to qualify for Medicare/Medicaid. Individuals are not eligible who have a primary or secondary diagnosis of developmental disability, a serious and persistent mental illness, or who are concurrently participating in any other federal home and community-based services waiver program.

It should be noted that all states accept funds from Medicaid for placement in skilled nursing communities, which are normally more expensive than assisted living.

What if I have long-term care insurance?

When you see a family member receive a $3,000 to $7,000-per-month bill for long-term care, it's often enough to spark a personal interest in long-term care insurance. People usually don't discover that Medicare won't pay for long-term care until they need it. Then they find the only way to cover a $50,000-per-year cost is long-term care insurance or personal funds.

Cost savings associated with buying a policy at a younger age make it attractive to buy earlier. The average cost of a policy is about $888 a year at age 50, but it can reach $1,850 a year at age 65 and $5,880 a year at age 75, according to the National Association of Insurance Commissioners in 2009. Buying a policy at a later age is still less expensive than paying the full cost of care, although it may be difficult to get coverage at later ages.

What about financial care assistance for veterans?

The Veterans' Administration provides a special pension through an Aid and Attendance (A&A) program, offering veterans and surviving spouses additional monetary benefits to help cover the costs of all levels of senior living services. This A&A program helps cover independent living, assisted living, memory care and skilled nursing - essentially covering a significant portion of health care fees.

This most important A&A benefit is often overlooked by many families with veterans or surviving spouses who require additional monies to help care for family members. It is a "pension benefit" and not dependent upon service-related injuries for compensation. Some restrictions apply; however, most veterans in need of assistance qualify. A&A could pay up to $1,950 per month, helping to cover the costs of care, prescriptions, recurring medical bills and other expenses. These payments can be made for care not only in the home, but in all levels of senior living communities, as well.

To find out more about the Aid & Attendance special pension offered through the Veterans' Administration, contact your state V.A. representative.

What are the average costs of care services in the United States and in Illinois?

 

Health Care Service Average Annual Cost - U.S. Average Annual Cost - Illinois
Assisted Living $43,539 $46,770
Home Health Care $46,332 $50,336
Adult Day Care $17,680 $18,762
Skilled Nursing Care $82,125 $67,160

Resource: www.genworth.com, April 2016.

Benevolent Programs

If care is greatly needed but the funds simply aren't available, your family member may qualify for financial assistance through a community's charitable programs. Presbyterian Homes provides more than $7.5 million annually in residential, medical and community services to older adults in financial need.