Medicare, the health insurance benefit for all Americans once we turn age 65, offers an annual “open enrollment” period, the same as employer-based health insurance plans. The open enrollment for Medicare just opened in October and will stay open through December 7, 2012.
Medicare does not pay for all the care needs a senior may require. For instance, Medicare does not pay for ongoing care in a nursing home for seniors. However, if a senior on Medicare has experienced a major medical event such as a stroke, hip replacement or heart attack and has been hospitalized, they will most likely receive approval from a medical doctor for rehabilitation in a nursing home.
As nursing homes have become an extension of a hospital stay, Medicare will pay for up to 100 days in a nursing home but the benefit may not cover all the daily costs. Caregiverlist provides the only resource with the daily costs of nursing homes nationwide, to assist seniors and their families to determine the best nursing home for their rehabilitation needs.
Long-term care insurance is an additional option seniors may want to consider, to have a way to pay for the additional nursing home care, should the need arise. Medicaid, which very low-income seniors will switch to, from Medicare, does pay for ongoing care in a nursing home. As nursing homes may costs as much as $300 to $400 per day, sometimes seniors will exhaust their personal finances and will “spend down” to qualify for Medicaid. This is never something we want to think about but Americans can know that they will always be cared for in a nursing home, even if they do not have their own personal funds. Review the Medicaid financial qualifications in your state to understand the income limit for qualifications. There is the anti-spousal poverty law which allows one spouse to maintain certain assets while the other spouse spends-down to qualify for Medicaid. This can unfortunately be a need if one spouse has memory loss which requires around-the-clock care.
Caregivers should remind seniors to check their Medicare options during the Open Enrollment period. Seniors with the Medicare Advantage plans which provide the private H.M.O.’s or P.P.O.’s, should just check in to make sure their plan is still the best option. Remember, just as with health insurance plans provided for those who are not yet seniors, benefits may change from year to year.
Visit the Medicare.gov website to access a tool that will help in comparing options for Part D drug coverage plans and Medicare Advantage plans, based on where the senior resides. Seniors may also call, toll-free: 800-MEDICARE or 1-800-633-4227. You may also want to access Consumer Reports’ review of Medicare plans. Seniors may also request senior care services in their area to understand the costs of care and plan ahead.
