We frequently get asked about costs and payments for Assisted living and how it is different from Nursing Homes. Here is a brief summary.
Question: Both Assisted Living Facilities (ALFs) and Skilled Nursing Facilities (SNFs) are considered “Long Term Care” facilities. So what’s the difference?
Answer: Nursing Homes are reserved for those who NEED skilled nursing staff 24 hrs a day and cannot be cared for at home or in an ALF. ALFs are for those people who might have some needs for assistance with bathing, dressing, incontinence, or taking their medications correctly, but are also for those who are independent, or simply want to be in a place where there are nursing staff available 24 hrs a day in case they have a fall, a heart problem, or other issue. The ALF can serve as a safety net for those living alone or whose spouse can no longer safely help.
Question: Does Medicare pay for these?
Answer: Generally, not. If you are at a Nursing Home for Rehabilitation only, most of the cost is paid for by Medicare or your Medicare replacement plan, and you (or your insurance) pay a portion for up to about 100 days. If you need to stay long term (months or years) Medicare does not pay. Medicaid (the insurance for those with no assets and less than about $2,000 a month income) will pay for your care, provided you are sick enough to qualify.
For Assisted Living, Medicare does not pay for your stay and Medicaid is not accepted by most facilities. You are responsible for the costs unless you have a special insurance called “Long Term Care Insurance”. Long Term Care Insurance will pay for most of the cost of Assisted Living as long as you can prove that you need assistance with at least 2 Activities of Daily Living (ADL’s) which are bathing, dressing, eating, transferring, and toileting. People with Alzheimer’s disease or other types of dementia typically automatically meet this requirement.
Another coverage for Assisted Living is available for Veterans who were in the service during a time of war, such as WWII, Korea or Vietnam. Even the widow of a veteran can get some assistance. There are some income requirements, and you must need some ADL assistance (similar to Long Term Care Insurance), but it can provide monthly assistance of about $1,000 to $1,900 a month.
Assisted Living ranges greatly in terms of services and the quality of meals, staff, and accommodations. Some provide for basic needs of having unlicensed help available 24 hrs a day if help is needed. Others, like Canterfield, have licensed nurses on staff 24 hrs, have beautiful accommodations, and a wide variety of chef prepared meals with plenty of choices. All are monitored by the department of Health and are regularly inspected.
When it comes to living in our later years, we realize there is no need to stay in your home and worry about missing medications, cooking meals, shopping, cleaning, getting repairs and yardwork done if assisted living can do it for you. Why worry when an award winning assisted living community like Canterfield can fix gourmet meals, do your laundry, cleaning, and maintenance, and even drive you to doctors appointments. Stop worrying about your health, and start focusing on the best things in life, like making new friends and enjoying great activities. Check out assisted living today and see how really affordable it can be.
For additional information
Canterfield of Ocala WEBSITE