Long term care (LTC) includes medical, nursing and personal care. It also can include long term care services and supports like adult day and homemaker services. It is not limited to care in nursing facilities but can be provided at home, in a residential care setting home or in assisted living. Most LTC provides help for people who have physical limitations that make it hard for them to do daily activities like getting in and out of bed, standing, walking, grooming, dressing, bathing, or eating.
Long term care (LTC) may be paid for by Medicaid, private long term care insurance or self-pay. Also, Medicare pays for short rehabilitation stays in a nursing facility.
The cost and ability to get LTC insurance is based on your current health. If you already need long term care, you will not be able to purchase LTC insurance. Most financial planners recommend that you purchase LTC insurance in your late 50s or early 60s. The premiums are based on your age, health, and the type of plan that you purchase.
Medicare and Long Term Care
Medicare only pays for 100 days of skilled care in a nursing facility after a 3-day hospital stay. Payment is limited to 100 days for each "spell of illness." Skilled care is care such as therapy or nursing services that you need each day. Medicare does not pay for assistance with daily activities.
Medicare pays 100% for days 1-20. For days 21-100, there is a daily co-payment of $141.50. Some private policies that supplement Medicare pay this daily co-payment. These are often called Medigap policies. However, once Medicare stops paying for care, most private supplemental policies also stop paying for care.
Medicaid and Long Term Care
Most long term care is covered by Medicaid. You must be financially eligible and have a medical need for LTC. The Vermont Medicaid LTC program is called Choices for Care (CFC). CFC pays for long term care in your home or a nursing facility. Sometimes it can also pay for long term care in a residential care home or in assisted living.