Long Term Care: Health Care and Medical Costs

Long term care of a family member carries with it unavoidable medical costs. Unless you are prepared to budget for such costs, caregiving can wreak havoc on your finances. Fortunately, there are a number of ways to control health care spending.

 

The following programs are important to know about while preparing to meet the needs of an elderly person. Knowledge of the basics related to payments can save unnecessary delays and overpayments.

Medicare: Medicare is a federally controlled health plan for persons aged 65 and older. A person is eligible for benefits if he or she has paid into social security throughout his or her years of work. Hospitalization is covered by Medicare part A; doctor's visits and lab fees are covered by Medicare part B or a monthly fee that is deducted from the social security check.

 

Hospitalization only covers the first sixty days in the hospital. A deductible is required and after sixty days, significant charges related to co-payments can result. Long term care or home care is not covered. Medicare covers hospice costs for patients with a terminal illness. Medicare does not cover costs for medical devices, such as hearing aids, and medication is only reimbursed if the patient is hospitalized. Skilled nursing and post-hospitalization health care are covered.

 

Medicaid: Medicaid is a health insurance program for disabled or low-income individuals. Most doctors' offices are reluctant to deal with this type of insurance. Medicaid pays for the nursing home if the elderly person qualifies financially, meaning that life savings have been depleted for health care costs. Medicaid also covers basic medical costs.

 

Medigap Insurance: Medigap is a plan that supplements Medicare in exchange for a premium, usually $70 to $150 per month. Medigap covers some deductibles and prescription medications not covered by Medicare. It fills the "gaps" in Medicare.

The HMO is a type of health insurance that provides an alternative to Medigap for supplementation to the Medicare plan. If the HMO has a Medicare contract, Medicare will pay for it. Only those doctors on the HMO list can be used, and emergency services will only be paid inside a designated geographical region.

Social security pays a monthly amount to workers who have been employed and paid taxes for at least forty quarters (ten years). Widows can collect at age 60, if the spouse fulfilled the work requirement. A reduced amount can be collected at age 62, and full payment at age 65.

Long term care is a type of private insurance. People who have assets that are not depleted can opt for this insurance to cover health care costs not covered by Medicaid.

 

Making medical costs a part of your monthly budget is essential if you are providing long term care for a dependant. Once you factor health care costs into your budget, you can determine how much, if any, extra funds you will need to cover expenses. From there, you can determine whether a home loan, line of credit, or simply a change in spending habits is required.

Government sponsored medical assistance is an option if you're having a difficult time with caregiving-related finances. Medical assistance is designed to help those who cannot cover their health care costs. Anyone who meets income, age or disability criteria may be eligible for this form of assistance.

 

Depending on the nature of the medical condition, you may be able to access additional financial help (as well as counseling, respite care for caregivers, and other assistance) through local organizations and charities. Many charities are set up to assist people suffering from specific illnesses.

 

Finally, if your parent or other dependant is willing, medical clinical trials may provide some relief. Many clinical trials provide free health care for the duration of the trial. In addition, clinical trial volunteers and their caregivers can access medical specialists they may otherwise be unable to consult.