Covering the Cost of Long-Term Health Care

*Please note: This information is provided for educational purposes only. The availability of each program is determined by that government agency and the individual’s situation. Please consult directly with your insurance company or the government program.

Aging adults will often require long-term care because they require assistance for basic living activities throughout the day. As it becomes clear that these needs have become a reality, they come to the question: how do you pay for long-term care?

We offer below a description of some of the resources that people use when confronted with this question. Since each option carries different consequences, Avamere suggests that you see a financial consultant or insurance advisor in supplement to the resources below.

Oregon Long-Term Care Insurance

People will often plan in advance and buy long-term care coverage when it's still affordable. The long-term care coverage policies are more complicated than the more common types of insurance, such as home, life and car. When looking into health insurance for senior citizens, you'll probably want to be familiar with what physical and medical condition your loved one will need to be in before insurance begins to pay for one's care.

For more information go to: www.longtermcare.gov

Oregon Reverse Mortgage

An Oregon reverse mortgage is a relatively recent strategy that some senior citizens over age 62 rely on. The plan allows seniors to convert part of the equity in their homes into tax-free cash without having to sell, give up the title, or take on a new monthly mortgage payment. In an Oregon reverse mortgage the payment stream is "reversed." Instead of making monthly payments to a lender, a lender makes payments to the senior allowing them to remain in the home whilst they are still alive, or move into a long-term care facility.

For more information go to: www.reversemortgage.org

Oregon Medicare Helps with Short-Term Care Costs

Oregon Medicare is a federal health-insurance program that covers most Americans over the age of 65. It helps pay for short-term medical expenses, such as hospitalization, doctor bills, x-rays, radiation, and a variety of other tests and therapies. A co-payment for a part of the expenses may be required. However, Medicare does not pay for nonmedical care, such as long-term care and assistance with daily living activities, with the exception of a few situations as outlined below:

Hospitalization:

To qualify for Oregon Medicare, a senior must have spent three nights in the hospital and must enter the nursing home within thirty days for rehab therapy for the same condition for which they were hospitalized. If conditions are met, Medicare fully covers the first 20 days of long-term care and partially covers up to the next 80 days.

Other Considerations:

Oregon Medicare payments will continue as long as a senior is in a skilled rehabilitation program that is producing results, such as improved healing, strength, coordination and flexibility. Once skilled rehabilitation is no longer effective in improving a senior's condition, Medicare will stop paying - even if it's still within 100 days.

Families need to be strong advocates for getting a senior into a nursing home if the family can't care for them themselves.

Oregon Medicaid Helps with Paying for Long-Term Care

If your loved one enters a nursing home or long-term care facility, they may qualify for Oregon Medicaid once their assets have been depleted.

For those over the age of 65, Oregon Medicaid helps pay for nursing home costs once the individual has exhausted all, or almost all, of their own means. Oregon Medicaid generally pays for care in a certified nursing home. Since regulations vary from state to state, check this government site - then select "Medicaid/Medicare" for the rules in your state.

Once a senior qualifies, they will have to pay any remaining monthly income, such as social security or pension checks, to the nursing home. Oregon Medicaid only pays the difference between the senior's remaining income and the nursing home's monthly charge.

Educate yourself further on the cost of long-term health care by contacting an insurance or financial consultant.