03- May2017
Posted By: Tony Fischer

Five Long Term Care Options That Aren’t The Nursing Home

Many people think of long-term care as the nursing home.  However, the fact is there are many levels to the senior healthcare continuum, several of which are considered long-term care.  As people age and make their way through the senior healthcare continuum it is inevitable that they will use a service classified as long term care.

That probably changes your view of long term care. So let me give you a simple definition to determine whether a service is or isn’t a long term care service.

Simply put, any health problem that can’t be “fixed” with a doctor’s visit, hospital, or rehab stay is considered long term care.  This includes chronic illnesses or conditions such as Alzheimer’s, Dementia, Arthritis, and COPD, decreased mobility or memory care.  What more is that insurance coverage for these conditions are short term, once the patient is stabilized insurance coverage often stops.  For this reason almost all of long term care services are paid for out-of-pocket.

A common question asked by seniors is about insurance coverage of long term care services.  The majority of the time our Senior Care Sherpas have to tell them services aren’t covered under Medicare or traditional health insurance.

READ RELATED: How to pay for long term care

The post referenced above explains some different payment options for long term care services, so we won’t go into those here. Instead, now that we know how long term care is defined, let’s look at five options that don’t include going to the nursing home.

Private Duty Home Care

This service features non-medical personal who are hired to come into the home and help the senior with day-to-day tasks.  Healthcare professionals call these tasks “Activities of Daily Living” and they include things like bathing, grooming, housekeeping, laundry, and meal preparation.  Private Duty Home Care companies can also provide companion services for patients suffering from a Dementia based diagnosis.

Home Chore Services

Need work done outside the house? Home Chore services can help.  Many communities offer these services through Area Agencies on Aging or community groups funded by private and government grants. Home Chore service workers will mow lawns, remove snow, clean gutters, clean-up debris and anything else an elderly home owner may need to maintain their property.

Transition Services

With the passing of the Affordable Care Act, many traditional services have evolved to include services for seniors who are at risk for returning to the hospital. Consequently, one of these evolutions is the transitions care manager.  They are nurses who visit the senior’s home and set-up services to help them maintain their independence.  Insurance companies sometimes offer these services as well.  They are often limited in scope but can provide the insight and resources a senior needs to remain at home.

SeniorCareSherpa.com also offers transition services that include a senior care plan.  CLICK HERE for more information.

Independent Senior Living

These are communities of seniors who can live independently with minimal services.  These communities often feature services such as outdoor maintenance and housekeeping.  They also work in conjunction with home care companies to provide additional services as needed.

Assisted Living

With more service offerings than Independent Living, Assisted Living offers services that can almost mirror that of a nursing home.  Assisted Living communities offer a variety of services that enable the seniors to age in place without leaving the community. A senior care get 24-hour care in an assisted living environment if they have the resources and medical conditions warrant.

Senior Care Planning

Want more information? Our Senior Care Sherpas can help guide you through the process of understanding services and identifying needs.  Use the form below and we will be happy to guide you through the list of long term care options.

22- Jul2016
Posted By: Tony Fischer

What Does Medicare Cover?

Getting Medicare has turned into an aging milestone for most Americans.  For most, getting the government insurance card in the mail means you are officially retired. Every taxpaying citizen of the United States is automatically enrolled in Medicare when they are 65.  In fact you should be getting your care around 3 months before your 65th birthday.

Everyone knows what Medicare is but most still don’t understand what exactly it covers especially when it comes to senior care. This post will give you a brief summary of what types of senior care Medicare covers and for how long.

The Purpose of Medicare

Many assume that because you get Medicare automatically at age 65 that it covers all types of senior care including long-term care. But Medicare was only intended to cover short-term care services like those at the hospital or rehab center. In fact when it comes to long-term care, Medicare’s coverage is very limited and varies based on the type of care being received.

Read Related: How To Pay For Long-Term Care

Medicare is the Default Hospital Coverage for 65 Year Olds and Older

Medicare is the default hospital coverage for folks who are 65 years or older.  The length of stay depends on why the patient was admitted and how they respond to treatment.

Nursing Home Rehab

Today’s nursing homes offer two levels of care.  The level most people are familiar with is long-term care. That is when the patient (referred to as a resident) is expected to stay anywhere from 3 months to multiple years.

Short-term rehab (or Sub-Acute) is they type of care that requires interventions from a physical therapist or registered nursing.  Patients needing short-term rehab may be recovering from an extended hospital stay, stroke, heart failure, Chronic Obstructive Pulmonary Disorder or joint replacement just to name a few.

Doctors often recommend short-term rehab in a nursing home for seniors who cannot keep up with the pace of an inpatient hospital rehab unit.  That is not to say that patients in the nursing home rehab setting aren’t required to show progress.  In fact a patient must show progress and participate in therapy in order to keep their Medicare coverage.

Coverage can last up to 100 days if progress is being shown but even then Medicare doesn’t cover the entire bill.  Medicare covers 100% of a nursing home rehab stay for only 20 days.  If the stay lasts beyond 20 days, Medicare covers roughly 80% with the remaining 20% being covered by a Medi-Gap insurance or coming out of the patient’s pocket.

Home Care

When the senior is ready to discharge from the hospital or nursing home rehab; home care may be prescribed by the doctor.  Home Care is approved in 60-day increments and is typically covered 100% by Medicare. However like short-term rehab coverage the patient must show progress in therapy treatments.

Read Related: Home Care: How It Works.

Outpatient Rehab

If the patient doesn’t require a skilled nursing environment like that of a nursing home or meet the home bound criteria for Home Care, outpatient rehab may be needed.  Medicare covers outpatient therapy but co-payments may be needed depending on the type of diagnosis and length of care.  Check with the outpatient rehab clinic for coverage details.

More Questions?  Senior Care Sherpa Can Help

We are here to help.  Our Senior Care Sherpa’s are experts in senior care and can help you develop a senior care plan.  CLICK HERE for more information about how one of experts can help you.