Planning & Payment Sources
Resident is completely responsible for payment. They can use LTC Insurance, Private Insurance, Sale of House or Adult Children to assist in covering the cost of care and housing. They may also include retirement income, annuities and any other source of income the resident has available to cover their care and housing needs.
Private insurance, LTC and Commercial Insurance
Medicare is a federal government insurance program for most people over the age of 65. Medicare does not pay for independent or assisted living. It only covers Medical Care, Short Term Skilled Nursing stay and Hospice care that is ordered by your doctor and authorized in advance by Medicare.
Medi-Cal is a state run and federal funded government program for the financially indigent. It pays for some limited long term residents in a Skilled Nursing Community. The patient must have depleted all of their assets before they can apply for Medi-Cal. They must show that they are indigent. Qualifying residents will have all of their room and board paid for until they pass away if they qualify through the state program.
The PACE program is an All-Inclusive Care for the Elderly program that provides comprehensive long term services and support to Medi-Cal and Medicare enrollees. An interdisciplinary team of health professionals provides individuals with coordinated care. For most participants, the comprehensive service package enables them to receive care at home rather than receive care in a nursing home.
Financing for the program is capped, which allows providers to deliver all services a participant needs rather than limit them to those reimbursable under Medicare and Medi-Cal fee for service plans. The PACE model of care is established as a provider in the Medicare program and as enables states to provide PACE SERVICES TO Medi-Cal beneficiaries as state option.
P A C E Eligibility
- Age 55 or older
- Live in the service area of a PACE organization
- Eligible for nursing home care
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The Veterans Affairs (VA) offers benefits that can improve the lives of Veterans and their families. You can review available benefits and services, learn how to apply and get tips to simplify the application process. The simplest way to apply for most benefits is on line
NOTE IF YOU ARE A WAR TIME VET- SEE THE INFO BELOW BEFORE YOU GO ON LINE - CONTACT US
War Time Veterans Benefits
The Veterans Administration offers Aid and Attendance as part of an “Improved Pension” Benefit that is largely unknown. This Pension is for War Time Veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing, undressing, medication dosing, or taking care of the needs of nature to receive additional monetary benefits. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an Assisted Living facility and at times in home care may qualify.
- A Veteran may be eligible for up to $1,732 per month
- A surviving spouse may be eligible for up to $1,113 a month
- A Veteran with a Spouse may be eligible for up to $2,054 per month
- A Veteran with a Sick Spouse may be eligible for up to $1,360 per month
Long Term Care Insurance (LTC Insurance)
Long Term Care Insurance includes a wide range of medical and support services depending on the insurance you take out. Older Insurance policies only cover a stay in a skilled nursing facility. Newer policies may cover In Home Care Services, Assisted Living Communities and Skilled Nursing Facilities. Long Term Care is not always skilled nursing care. It can be “custodial care”. Custodial care involves providing an individual with non-medical care that may include supervision for someone with memory care needs and assistance with Activities of Daily Living.
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