Resources

There are a variety of government and private insurance programs that cover senior care. We’ve put together a short description of your insurance options to help get you started on finding the financing you need.

Government Insurance Programs

Medicare

The Medicare Plan is divided into Part A, which covers hospital expenses, and Part B, which covers all other medical expenses. Generally, most Americans over the age of 65 qualify for Part A, and they don’t have to pay a premium. Medicare Plan Part B does require a premium, however. Some people under age 65 may still qualify for Medicare if they have certain disabilities, and anyone of any age who has end-stage renal disease qualifies. To find out if you or your loved one qualifies for the Medicare Plan you can visit the Medicare website.

The Medicare Plan will typically pay for skilled medical care that is provided by a nursing community or home health care agency that offers services such as nursing, wound care, and physical therapy. More than likely, however, the Medicare Plan will not pay for long-term custodial care, or assistance with Activities of Daily Living (ADLs), which include personal care services such as bathing, dressing, and grooming.

Medicaid

Medicaid helps cover the cost of health care for low-income individuals who meet certain eligibility requirements. It is administered by state governments, but receives both federal and state funding. Medicaid will cover some or all of the cost of long-term care, as well as general medical care. The long-term care services covered usually include senior care provided in communities or at home, such as custodial care, assistance with Activities of Daily Living (ADLs), and companionship.

Private Sources

Medicare Supplemental Insurance and Medigap Insurance

Medicare supplemental insurance or so-called Medigap policies are special insurance plans offered by private companies to help pay for some of the health care costs that Medicare does not cover. Although these plans are offered by the private sector, they are governed by both federal and state laws for consumer protection.

Long-term Care Insurance

Long-term care insurance can be purchased to help cover the costs of long-term care not covered by Medicare or Medicare supplemental insurance. Typically this insurance covers care expenses provided in an assisted living community and at home by non-medical in-home care agencies. Usually long-term care insurance does not cover acute care provided in a hospital.

Life Settlements

Senior life settlements are special arrangements that can be made to get access to the market value of a life insurance policy, rather than the cash surrender value offered by the insurance company. In this type of arrangement, a life insurance policyholder can transfer ownership of an unneeded or unwanted policy to a third party, who pays the original policyholder more than the cash value currently offered by the life insurance company. The third party then assumes all future premium payments and becomes the beneficiary of the policy when it matures.

Social Security

This is a federal program that provides retirement income for seniors. In order to qualify, seniors must have paid into the program during their working years. As seniors receive payment directly from the government, they are free to apply those dollars toward long-term care.

Supplemental Security Income

This is a federal program that provides income to financially needy seniors in addition to Social Security funds.

Survivors’ Benefits

The Survivors’ Benefits program redirects a deceased individual’s Social Security benefits to their surviving spouse, ex-spouse (provided they were married 10 years before divorcing) or dependent children.

State SSI Supplementary Payments

These payments are additional cash benefits paid out by states to supplement the federal Supplemental Security Income payment. Currently 45 states administer a supplementary payment program.

Tax Credits

Elderly and Disabled Tax Credit

This is a credit that reduces the amount of taxes owed, and therefore makes more funds available for long-term care expenses. It is granted to eligible persons over 65, or under 65 and disabled.

Federal Tax Credits for Elderly Dependent Care

Also referred to as the Child and Dependent Care Credit, this is a tax credit for expenses an individual or family incurs for the care of a dependent or other person living with them, such as home care or adult day care. It is intended to free the taxpayer(s) to work elsewhere while taking care of the dependent.

State Tax Credits for Elderly Dependent Care

This is a state version of the Federal Child and Dependent Care Credit. The tax filer receives a credit for care expenses incurred, such as home care or adult day care, so that they are able to work elsewhere.

Medical Expenses Tax Deductions

Tax filers can reduce the amount of tax they owe by deducting medical and dental expenses, under certain conditions. For tax year 2017, they can take these deductions if their total sum exceeds 7.5% of the tax filer’s adjusted gross income.

Veteran Resources

Veteran’s Long Term Care

This program is sponsored by the Veteran’s Administration and helps United States military veterans and/or their surviving spouses with the cost of care. Anyone who served on active duty in the military as well as those called up for active duty while in the reserves or National Guard may be eligible for at least some VA healthcare benefits.

Veteran’s Health Care

The VA offers a variety of long-term care services for those who qualify. Benefits are offered to all veterans with 24 months of continuous active duty military service and a discharge status other than Bad Conduct or Dishonorable. Veteran seniors who have a disability as a result of military service are much more likely to qualify for benefits.

Veteran’s Pensions

This is a cash benefit paid to wartime veterans or their surviving spouses over the age of 65 who have limited income and net worth.

Veteran’s Respite Care

A program that provides care for up to 30 days a year to give the primary caregiver time to relax and attend to his or her own needs. When combined with other resources and cost reductions such as tax credits, respite care can make a critical difference.

Veteran’s Directed HCBS

Full name: Veterans Directed Home and Community Based Services program. This program allows veterans who are potential candidates for nursing home placement to receive that level of care in their homes. It provides a budget and allows veterans to choose their own care providers in place of receiving care services from the VA health care system. In some cases, family members of the veteran can be paid for the care they provide. This program is sometimes referred to as Cash and Counseling for Veterans, or the VD-HCBS program.

Tricare for Life

TRICARE for Life (TFL) is an extension of TRICARE for seniors enrolled in Medicare. Provided by the Department of Defense, this is a health insurance and care program for active or retired members and family of all seven uniformed services. As a secondary payer, it minimizes veteran seniors’ out-of-pocket expenses by covering the Medicare’s coinsurance and deductible.

CHAMPVA for Life

CHAMPVA for Life (CFL) is an extension of CHAMPVA benefits to seniors 65 years and older. It is a health insurance and care program provided by the VA for the families of veterans permanently disabled or killed in the line of duty who are not eligible for TRICARE. As a secondary payer, it minimizes veteran seniors’ out-of-pocket expenses by covering the Medicare’s coinsurance and deductible.

Resources available at Osmond Senior Living Memory Care in Salt Lake.