How to Pay for Long-Term Health Care

*Please note: This information is provided for educational purposes only. The availability of each program is determined by that government agency and the individual’s situation. Please consult directly with your insurance company or the government program.


Senior citizens often cannot rise from bed on their own, take a bath without assistance or manage personal grooming on their own. They require assistance in order to perform these daily tasks and other tasks that will confront them throughout the day. Once these needs become a reality, they then face the question: what are our options for long-term care coverage?

Below, Avamere has offered a brief explanation of some of the resources that people use when they are faced with this question. Since each option is different and the requirements and consequences are often complicated, Avamere suggests that you see a financial consultant or insurance advisor and refer to the resources below.

Oregon Long-Term Care Insurance

Some seniors plan ahead and purchase Oregon health insurance before it becomes too expensive. The long-term care insurance policies are more complicated than the everyday types of insurance like home, life and car. When researching Oregon long-term care insurance, you'll want to make sure you know what physical and medical condition someone need to be in before insurance will cover you care.

For further information go to: www.longtermcare.gov

Oregon Reverse Mortgage

An Oregon reverse mortgage is a recent program that some senior citizens over the age of 62 participate in. The program allows homeowners to convert part of the equity in their homes into tax-free cash without having to give up the title, sell or take on a new monthly mortgage payment. In an Oregon reverse mortgage the payment stream is "reversed." Instead of making monthly payments to a lender, a lender makes payments to the senior allowing them to remain in the home whilst they are still alive, or move into a long-term care facility.

For further information go to: www.reversemortgage.org

Oregon Medicare Helps with Short-Term Care Costs

Oregon Medicare is a federal health-insurance program that covers most Americans over the age of 65. It helps pay for short-term medical expenses, such as hospitalization, doctor bills, x-rays, radiation, and a variety of other tests and therapies. A copayment for a part of the expenses may be required. However, Medicare does not pay for nonmedical care, such as long-term care and assistance with daily living activities, expect for a few instances as summarized below:

Hospitalization:

To qualify for Oregon Medicare, a person must have spent three nights in the hospital and must enter the nursing home within thirty days for rehab for the same condition for which they were hospitalized.

If conditions are met, Medicare fully covers the first twenty days of long-term care and partially for up to the next 80 days.

Days

What Medicare Pays

What You Pay

1-20

Full cost

Nothing

21-100

All but a daily copayment

A daily copayment

Beyond 100

Nothing

Full cost

Other Considerations:

Oregon Medicare payments will continue as long as a senior is in a skilled rehabilitation program that is producing results, such as improved healing, strength, coordination and flexibility. Once skilled rehabilitation is no longer effective in improving a senior's condition, Medicare will stop paying - even if it's still within 100 days.

Families need to be strong advocates at the hospital for getting a senior into a nursing home if the family is unable to care for them at home.

Oregon Medicaid Helps with Paying for Long-Term Care

If your loved one enters a nursing home or long-term care facility, they may qualify for Oregon Medicaid once their assets have been depleted.

For those over the age of 65, Oregon Medicaid helps pay for nursing home costs once a senior has exhausted all, or almost all, of their own means. Oregon Medicaid generally pays for care in a certified-nursing home. Since regulations vary from state to state, check this government site - then select "Medicaid/Medicare" for the rules in your state.

Once a senior qualifies for Medicaid benefits, they will have to pay any remaining monthly income, such as social security or pension checks, to the nursing home. Oregon Medicaid only pays the difference between the senior's remaining income and the nursing home's monthly charge.

Find out more about the cost of long-term health care by contacting an insurance or financial consultant.


   
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