For Immediate Release:
Seniors Helping Seniors of North and East Raleigh, NC sponsored one of the latest episodes of Approved Senior Network TV’s new Facebook Live Video program: “How Do Families PAY for Senior Care Services?” with Valerie VanBooven RN BSN as the Host.
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Full Transcript: (Some typos are attributed to transcribing)
This live broadcast originally appeared here: https://facebook.com/approvedseniornetwork.
Our sponsor is Seniors Helping Seniors® North and East Raleigh, NC.
Hey everybody. It's Valerie VanBooven, RN BSN with Approved Senior Network.
And today we are going to talk about how to pay for senior care services.
I know that can be really confusing.
There are lots of terminologies, there are lots of different ways people pay for care, but we are going to talk about the differences in care and how people pay for it.
What I want you to know is as you're watching this, if you're watching the replay, I want you to type in underneath the video in the comments, type in the pound sign or #replay. So when you type that in, that lets me know what you're watching this as a replay. When you watch it live, then you don't need to type that in. If you're watching this as a replay, give me a sign by showing me #replay. And the reason we do that is that it's very interesting to us to know just how many people this video reaches.
So #replay if you're watching the replay. The other thing I want you to know, and I'll put this on the screen as I talk, is that if you want a pricing sheet or a pricing explanation or a guide, then all you have to do is type in #guide, uh, in the comments and I will make sure that you get access to our senior care guide that talks about how people pay for senior care and what types of senior care they're paying for and how that all work. So what I'm talking about in this video will be available in that guide as well. Let's first start with home care. How do people pay for in-home care services? There are two types of home care services. One is private duty home care, and it's usually nonmedical. That means someone comes out to your home. They are a companion.
They help with light housekeeping, light laundry. They might go down and get the mail for you at the mailbox. Maybe they take you to run errands or you're seeing your loved one. Uh, they, uh, might take you to the doctor's office. If driving's an issue, they can drive you to appointments. They might take you to social events, maybe they take you to church on Sunday. So this is someone who's more of a companion and that is non-medical home care. When you enter into a contract with non-medical Home Care Insurance and Medicare, and most of the time Medicaid do not pay for those services. Now, sometimes Medicaid will pay for some services like that, but that's a whole different story. So private pay, meaning your savings, your retirement, your investments. I'm a credit card, a cash family coming together to help pay for these things. That is who pays for private duty?
Non-medical In-Home Care
Non-medical home care can be a real lifesaver. First of all, it helps with socialization for those seniors who are kind of homebound because they aren't able to drive anymore. Maybe they're not able to get to the grocery. Um, you know, meals on wheels is a great thing to implement. But having somebody come to the house two or three days a week to do laundry and light housekeeping and prepare some light meals that they can just pull out of the refrigerator and eat is amazing. Having someone to take them to the doctor, having someone to take them to any appointment for that matter or to get their hair done or to visit with friends. Those kinds of things are so important. So, to maintain safety and independence non-medical home care is a great thing to implement. A lot of times families will come together to help pay for it.
So everybody chips in a little bit to help mom get those services. The other thing is some people will do reverse mortgages. So if you're a senior over age 65 and you own your own home and you don't have a mortgage anymore, you can use the equity in your home, turn that into cash and you can use that to pay for home care and other things that you might need. The other option that you have is, um, life settlements. Life settlements are when you take an insurance policy and it has to be sort of like a term life or some policy with a value of $250,000 or more. And you take that a term policy and you do what's called a life settlement. You can look that up online and that life settlement will buy out your policy and give you cash that you can use for senior care services.
And finally, um, and there's probably some other creative ways, but uh, the last one I want to mention here is VA Aid and Attendance Pension Benefit. Now, uh, this, the veterans administration has a pension for uh, folks who have served at least one day during a period of war. Uh, you can look all that up. If you Google VA Aid and Attendance Pension Benefit, you can find out everything you want to know about that. You don't have to be a veteran or the surviving spouse of a veteran. It doesn't matter if you were injured in inactive or not. This is to help veterans stay at home longer. It is not only dependent on your service but also dependent on your income level. So much like Medicaid, the VA Aid and Attendance Pension Benefit isn't going to pay big, big dollars, but it certainly can supplement what you do have the spend on home care and it can help pay those home care expenses.
So those are the things that you have to work with for non-medical home care. Um, Medicare and insurance do not pay still to this day for non-medical home care. There is an exception to that. Some, uh, insurance agencies and some Medicare Advantage programs have implemented some non-medical home care in certain circumstances and for a short period of time, chances are they're never going to pay for long-term care. But if you were to come home after having surgery or you have a new diagnosis and, and a little bit of non-medical home care, like those errands and companionship, can help you the first couple of weeks, two to three weeks after your surgery, then then some of our Medicare Advantage plans and some insurances will, will cover the cost of that non-medical home care. It has to be ordered by a physician. Um, there are all kinds of criteria it has to meet, but it is possible for some of those plans to start paying for that.
And that is brand new in 2019 in 2020 so check with your Medicare Advantage plan and it is very specific so it can't be just for any old thing. Um, there has to be a diagnosis or a surgery or there's, you know, some qualifiers for that service. All right, let's move on to home health care. So some of you have probably had surgery, maybe a knee replacement, a hip replacement or maybe you've had heart surgery or whatever. Those kinds of services. When you get home, oftentimes you have home health care coming out to the house. But this is a little bit different from private duty non-medical home care, home health care comes out to the house. They may check some, uh, do some wound care. They may be doing a blood pressure check, they may be doing a blood sugar check, they may be drawing some blood, they do something medical every time they come out.
It is ordered by a physician. It's part of your discharge plan from the hospital. It is um, a very short period of time that it's ordered. And those visits are short. So we're talking about maybe a 45-minute visit. You might have physical therapy, occupational therapy or registered nurse speech therapy. There are all kinds of people that can come out under Medicare as home health care services and that is paid for by Medicare. There's probably a deductible or something like that. But those services are short and they are not designed to help you long-term. They are designed to help you in the very short term. So non-medical home care is paid for privately and there are lots of ways to find those funds. A home health care, Medicare-certified or post-surgery kind of care where there is a medical need and a doctor's order for wound care or something like that.
Those kinds of visits are paid for by insurance. So it's important that you know the difference between nonmedical, which is more long-term and home health care, which is medical care at home. So those are the two different kinds of home care and that's how we pay for them. Now how much does non-medical home care cost in your local area? That depends on, definitely depends on where you, where you live and the cost of living. And you know, pricing is different everywhere. So in the Midwest, I'm going to say home care costs anywhere from 20 to $23 an hour. If you live in New Jersey, if you live in New York, if you live in a really expensive state, you're looking at anywhere from 22 to $25 an hour and maybe even up from their 25 to $27 an hour. It really depends on where you live, the cost of living and all kinds of other things.
So, um, east coast and west coast are going to be higher. Usually, the Midwest is usually a lower cost of living, so it's a lower cost per hour for non-medical home care. You can call your local home care agency and find out uh, what the cost of care is and ask them what their hourly rate is. Oftentimes what will happen is they'll need to know a little bit more information about you. So if they're caring for you and a spouse or if their person has certain types of certain diagnosis that makes them a little more challenging, um, then the price may be a little higher. And if it's something that's really easy, just some companionship and some errands running and the price might be a little lower. So your needs are your aging loved ones and needs sometimes can adjust that price a little bit.
And how many people are they going to be caring for inside the home? That can affect the price as well. Okay, so we've talked about home care.
Now let's move on to Assisted Living
So if you have a senior loved one who moves into an assisted living facility, and if you've never investigated this before, the prices can range anywhere from 3000 to $7,000 a month. Again, that really does depend on where you live and the pricing around you. And you can call any assisted living facility. You can take a tour, you can ask them what their monthly fees are. But remember that usually a monthly fee for assisted living includes not only your rent but all of your utilities. Um, cable meals two to three times a day. Most assisted living apartments have, uh, you know, like a little kitchenette, not a full kitchen, but you know, you can heat up food in the microwave.
You have a little refrigerator in the sink, um, one bedroom or two depending on how much room you need. So those can be very in price as well. But usually 3000 to 7,000 a month, there are some that are going to be, um, higher than that. If they're super classy or super upscale, they're going to be even higher. So that is a what assisted living costs. Now in order to pay for assisted living, Medicare and insurance do not pay for assisted living facilities. You can pay for an assisted living doing some of the same things that you can do when you pay for non-medical home care. One example is VA Aid and Attendance Pension Benefit will help pay for assisted living. Um, you can use retirement funds, you can use savings, you can use, uh, you know, whatever monetary means you can come up with. It can be adult children pitching in.
Um, but those are the things that will pay for assisted living in some states, not all. So Missouri would be a state that would be not be included in what I'm about to say. Some states like Illinois have what they call a Medicaid waiver program. So if you spend down all your money while you live there, you pay privately for a little while until your funds are gone basically down to like $2,000. Then they will work with your current income and your state and Medicaid to cover the rest of the cost of your assisted living. So you can still live there. If you've exhausted all of your funds and you're just living on social security and you need some help and assistance to stay there. It's called a Medicaid waiver program. Some home care agencies in some states can also work under the Medicaid waiver program.
So it really depends on who you're talking to and what kind of programs are available in your area. But the only way that you're going to know who accepts Medicaid waiver and who doesn't is to actually call a home care agency and find out, talk to them and say, you know, here's the situation. You know, here's what we can afford and or not afford. And we're wondering if you can help us find out more. And usually a home care agency, we'll be happy to help you figure out how to pay for home care. Assisted living facilities are exactly the same way. Go take a tour, sit down and talk to somebody and they'll help you understand. So we all probably know that nursing home care can be paid for two ways. Privately, you would like a private room and a private facility and you want to pay big dollars.
We're looking at maybe 70 - $100,000 a year and up for nursing home care paid for privately.
You can do that. Medicare will not pay for long-term care in a facility. Medicare will pay for skilled care in a facility, so for example, you have a hip replacement or a knee replacement and you need a couple of weeks of therapy to get back on your feet. The object of the game is that you're going to go home. You just need some therapy to get, you know, rolling. Again, Medicare will pay for up to a certain amount of days under Medicare for, for your rehab. As long as you're making improvements. Once you stop improving or you're good enough to go home, that's it. You need to go on home and then you can have a little bit of therapy at home. Then you can do outpatient therapy. Then you should be on your own, so they try to progress you through the system.
Back to independence. Medicare will pay for some rehabilitative therapy in a nursing home or a skilled nursing facility. If you need to live or your aging loved one needs to live in a nursing home or care center and that's, they're not going to get any better. Maybe have dementia, Alzheimer's disease, Parkinson's disease. It can be a whole host of things and mess their post-stroke, um, whatever the case. If they need to live there as their home, then there are only two options. That is, one is to pay for it privately, which is really expensive. But some people do that. And the other option is a Medicaid bed. So you need to find a facility that has Medicaid bed availability. Nine Times out of 10, you're going to be sharing a room with someone. Um, and they try to, I'm sure each facility tries to fit, you know, do the best they can to fit two clients together that are compatible.
They're both, either they're both confused or they're both not confused. And you know, men share a room with a man usually, unless you're a couple going into a nursing home together. Um, but Medicaid will pay for a semi-private room and you have to have exhausted all of your funds. It's a little bit of a process, but most nursing homes will help you walk right on through that. They're accustomed to it. They have a social worker who knows the system and knows how to help. So those are the different types of care that we talked about today. Nursing, home care, assisted living and home care. Those three types of long-term care services have different ways to pay for them. Um, but typically when we're talking about just starting out in just a little bit of help, typically that's going to be non-medical home care and that is going to be a private pay situation.
Lots of ways and avenues to pay for care. But it's going to be something that has to come from you and your family to pay for that care.
All right. The last thing I want to talk about and mention is adult daycare.
So adult day centers are very prevalent across the country and they are amazing. You can have your senior loved one go there for the day while everybody's at work or just to have more socialization and activity. Um, you know, people of all different needs. Um, go to adult day centers. Medicaid does pay for some adult day centers. You have to check with your adult day center and some are private, but the private ones are probably more like $75 a day, up to a hundred dollars a day and maybe even higher depending on where you live. Uh, and some adult day centers are um, Ha have Medicaid availability.
So Medicaid will help kick in some money to pay for that adult day center. So you do have a lot of options. There are some creative ways to pay for long-term care. It's just a matter of sitting down and actually talking to someone and w something that you think might not be affordable, you actually may be able to do it. So it's really important that you take that step to pick up the phone and call somebody and say, you know what, I'm not sure that I can afford this or our family can afford this. But we really want to check it out. Can you sit down with us and have a conversation and talk to me about the ways to pay for non-medical home care or assisted living or nursing home care and whoever it is on the other end of that phone will be happy and do this all the time.
They'll be happy to help you. So that is our live broadcast for today. If you would like our pricing sheet and it just shows you not exactly every price, but we're going to shut, show you what pays for care and what doesn't and what types of care are paid for. If you'd like a copy of that, all you have to do is put in there #guide I'm in the comment section and I will happily get that over to you or send you the link where you can download it. And if you're watching the replay today if you could put in #replay in the comments that way we know who's watching our replay. Thank you so much. And I hope if you look up here, you'll visit our sponsor.
If you live in the North or East part of Raleigh, North Carolina, please visit our sponsor, give them a call, ask them any questions that you want about senior care issues, they will be happy to help.
So, thanks everybody and we hope to talk to you soon. That is our, our episode for today. We are going to be on next week where we're going to do this twice a month, but because we have so many folks wanting to sponsor and watch and participate, we're going to do this four times a month or we're going to try anyway. Okay. Thanks, everybody. We'll talk to you soon. Have a great rest of your week. Bye Bye.