There are too many misperceptions to count when it comes to senior living in Somerset County, but some of the most prevalent has to do with cost. Specifically, what you’ll pay for care, how the cost of senior living compares to home, and the funding sources available to help your budget. Learn the facts here.
Misperception: Medicare will pay for all of your senior living costs.
Fact: Actually, Medicare only pays towards the cost of senior living in Somerset County if you require skilled services or rehabilitative care:
Following an inpatient hospital stay of at least 3 days
- In a Medicare-certified skilled care facility for a maximum of 100 days to receive nursing services, physical therapy, or other types of therapy. However, Medicare only pays 100% for the first 20 days.
Prescribed by a doctor as medically necessary to treat an illness or injury
- With part-time or intermittent skilled nursing care
To prevent further decline in medical conditions
- With ongoing long-term care services in senior living for people who have medical conditions that may not improve such as stroke, Parkinson’s disease, ALS, multiple sclerosis, or Alzheimer’s disease.
However, Medicare does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term senior care services.
Misperception: Medicaid will pay for the senior living costs that Medicare doesn’t.
Fact: Medicaid does pay for skilled nursing services in senior living. But to qualify, your income must be below the level set by your state and you must meet state eligibility requirements based on the amount of assistance you need with ADL. Also, covered services may vary from state to state.
Misperception: Health insurance will pay more towards senior living in Somerset County than Medicare.
Fact: Unfortunately, that’s not really the case. Health Insurance through your employer or even through a private health insurance plan typically covers the same kinds of senior living costs as Medicare.
For more information download our Family Guide to Funding Senior Care & Housing
Misperception: Senior living in Somerset County always costs more than staying at home.
Fact: Senior living in Somerset County is more affordable than you may think. Many families incorrectly compare the monthly cost of senior living to their monthly rent or mortgage alone. This is not a true comparison! The comparison should be between your monthly senior living costs and the total cost of living at home — mortgage or rent as well as the cost of food, utilities, home maintenance, property taxes, insurance, and entertainment. Why? These things are all typically included in the monthly cost of a senior living community. Also, don’t forget the costs of home health care and/or any home modifications you may need. After adding it all up; you may find senior living to be less expensive than home!
Misperception: If the cost of senior living is still too much, there aren’t any funding sources to help you stretch your budget.
Fact: Even without the benefit of Medicare, Medicaid, and/or health insurance, there are still funding sources to help you offset the cost of senior care including the VA benefit for senior living, long-term care insurance, life insurance conversion, and a reverse mortgage. Specifically, a wartime veteran or their surviving spouse may be eligible to receive the VA benefit for senior living. This non-service-connected benefit starts with the basic pension and, depending on medical need, gives you a rating that could add more money to your monthly pension. But to qualify for the VA benefit for senior living, you must meet the military service criteria as well as the medical requirement AND the financial requirement. To learn more about the VA benefit for senior living, including how to apply, visit VA Aid And Attendance Benefits And Housebound Allowance | Veterans Affairs.
Source: Administration for Community Living; https://acl.gov/ltc/medicare-medicaid-and-more