Q:  What is long term care?

A:  Long term care provides services for people who have functional limitations and/or long term health conditions for an extended period of time. Services can be provided in a few ways including nursing homes or assisted living facilities, adult day care, home or community based settings, etc. Most long term care is non-skilled assistance such as aid in performing daily activities such as dressing, bathing, using the toilet, eating, etc.

Q:  Who receives long term care services?

A:  The average age of nursing home residents is 79. However, one in four people over age 85 lives in a nursing home. The majority or nursing home residents are considered disoriented. Need for long term care can happen to anyone, but typically it results from long-term illness. Unexpected injuries can also trigger the need for long term care.

Q:  What does Medicare and  Medicaid cover?

A:  Medicare can cover every American ages 65 or older, or patients who have a Medicare card reading “Hospital Insurance.” The patient must be admitted to the facility by a physician’s order within 30 days of a 3-consecutive night hospital stay. Typically, Medicare pays for 100% of the first 20 days of care. For days 21-100, a daily co-pay is required. Past 100 days, Medicare does not cover skilled nursing fees. Medicare covers events such as hospitalization and post-hospital rehabilitation. It does not, however, provide financial assistance for basic care placement.

Medicaid is state-managed healthcare and long-term care provisions program for the financially needy. Those with low income and very few assets are typically eligible for Medicaid.

Q:  How much do long term care services typically cost?

A:  Long term care services can add up. In the US, the national home health aide average cost is approximately $55,000, providing 8 hours of service per day. The national average for a private nursing home room is over $77,000. These amounts can be double depending on the area of the country.

For more information, contact Jonathan M. Feigenbaum Esquire online or call our office at 617-409-0539. We are happy to answer any questions you may have.