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Health & Fitness

Who Pays for Long Term Care?

Private payment options can help bridge the gap.

Consumer surveys reveal common misunderstandings about which public programs pay for long-term care services. Many people believe they can rely on Medicare to pay for their long-term care services. However, Medicare only pays for long-term care if you require skilled services or rehabilitative care for a short period of time. Medicare does not pay for non-skilled assistance with Activities of Daily Living, which makes up the majority of long-term care services. You will have to pay for long-term care services that are not covered by a public or private insurance program.

Medicaid is a joint federal and state program that pays for the largest share of long-term care services. However, Medicaid only covers you if your income is below a certain level and you meet minimum state eligibility requirements. Such requirements are based on the amount of assistance you need with Activities of Daily Living. Other federal programs such as the Older Americans Act and the Department of Veterans Affairs pay for long-term care services, but only for specific populations and in certain circumstances.

Most employer-sponsored or private health insurance, including health insurance plans, cover only the same kinds of limited services as Medicare. If they do cover long-term care, it is typically only for skilled, short-term, medically necessary care.

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There is an increasing number of private payment options that can help you pay for long-term care services. These include long-term care insurance, reverse mortgages, life insurance options, and annuities.

It is important that you understand the differences among the public programs and private financing options for long-term care services. Each public program and each private financing source has its own rules for the services it covers, and its own eligibility requirements, copayments, and premiums.

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