There are various types of long-term care services, and the scope of coverage varies depending on the type of insurance. While it is well known that Medicare Parts A and B provide only limited short-term care services and that it is difficult to afford the costs without Medicaid or long-term care insurance, we often encounter many cases of seniors who find themselves in difficulty because they failed to prepare for long-term care services in advance.
Medicare is a federal health insurance program for people aged 65 and older and certain individuals with disabilities. It provides short-term medical services, such as hospital care and doctor visits, and offers limited coverage for long-term care services. Medicaid, on the other hand, is a health insurance program jointly operated by the federal and state governments for low-income individuals, providing a wide range of medical services, including long-term care.
Medicare-covered long-term care services include Skilled Nursing Facilities (SNFs), Home Health Care, and Hospice Care. Medicare Part A covers the cost of a Skilled Nursing Facility (SNF) for up to 100 days following a hospital stay of at least three days, provided it is medically necessary. Medicare covers the full cost for the first 20 days, and the patient is responsible for the cost of the remaining 80 days.
Home health care is covered by Medicare Parts A and B based on a doctor’s prescription, and services such as physical therapy and speech therapy—including in-home visits by nurses—are provided at the beneficiary’s home. Hospice care for terminally ill patients is also fully covered by Medicare Part A.
Medicaid provides a wide range of long-term care services, including nursing homes, home care services, and adult day care programs, all of which are available at no cost. Assisted living facilities provide on-site medical care and meal services for seniors who are not yet ready for a nursing home but have difficulty living alone, and Medicaid covers the costs.
Medicare beneficiaries must pay out of pocket or use long-term care insurance to receive home care or adult day care services. Additionally, while there is concern that all assets may be transferred to the government upon long-term admission to a nursing home, under the Federal Spousal Impoverishment Act, even if one member of a middle-class couple is admitted to a nursing home, the remaining spouse can protect half of their joint assets and a portion of their income.
The thought of long-term care facilities, such as nursing homes, inevitably weighs heavily on the minds of both the residents and their families. This is because, in Korean culture, there is a reluctance to place elderly parents in such facilities, and the individuals themselves often try to avoid entering them. However, it is worth considering that for those in need of assistance, these facilities offer professional care, and for family caregivers, they can be a way to reduce the stress of providing care at home while still doing their best by visiting the facility frequently.
To that end, it seems important to choose a facility located nearby so that family members can visit frequently. For more information on the costs and benefits of long-term care facilities, please consult with a facility representative.
- Son Ji-seon / Executive Director, Hanul Comprehensive Welfare Center (Chicago)
B.A. in International Studies, M.A. in Social Work, Washington University in St. Louis
Over 20 years of experience working in the nonprofit sector
Source: Christian Journal (https://www.kcjlogos.org)
