Getting quality, affordable treatment and care for an Alzheimer’s patient can be an uphill battle. The disease is so hard to treat, and patients often go into a long, slow decline, which can easily turn into a costly situation. It’s important to understand their insurance coverage — including Medicare options — and to identify alternative funding options, since your loved one may need care for many years to come.
Costs and Coverage
The cost of long-term care is prohibitively high. Depending on where you live, assisted or senior living can cost anywhere from $2,525 to $5,745 a month. (The national average rate for Alzheimer’s adult daycare is about $1,500 a month). Medicare coverage helps, but its coverage is conditional where Alzheimer’s care is concerned. It pays the full cost of nursing home care, if deemed medically necessary, for 20 days and 80 percent for a further 80 days. Patients can expect to pay a national daily average of $67 out of pocket during those 80 days, since Medicare covers less than the average cost of a nursing facility room.
Medicare, however, does not cover personal care at home or in an assisted living facility. Medicaid, on the other hand, which is a state-based program for elderly and low-income individuals, provides benefits for Alzheimer’s or dementia care, though this varies by state.
Medicare and Other Insurance
If Medicare coverage is inadequate for your loved one’s needs, a Medicare supplement or Medicare Advantage plan may be more beneficial. Advantage plans are offered by large insurers, like Humana, and provide coverage for needs that original Medicare doesn’t, including dental and vision care and prescription drugs. These extra services can prove beneficial financially considering the other expenses associated with Alzheimer’s care.
It’s always best to check the fine print of your loved one’s health and life insurance policies, which may prove useful if long-term care becomes necessary. Assess any current income and other financial assets, and make sure you have the power to assist in making financial decisions. Keep in mind, too, that care costs are likely to blossom over time, and your loved one may leave behind debt and even funeral costs that you may need to cover. To avoid this, consider talking to your loved one about a final expense policy, which can help pay for these items and allow them to establish an end-of-life plan that matches their finances.
Alternative Payment Options
If their insurance situation, financial assets, and employment benefits aren’t enough, you may need to get a little creative. For example, a life insurance policy may allow you to access accelerated death benefits. Or, you could add a rider to a current insurance policy that would allow benefits to be drawn early based on need.
Bridge Loan
Eldercare loans are designed to help families who need immediate help paying for care. It’s a bridge loan for a limited period (two years or less) for people who are able to repay the amount later on. Keep in mind, the application process can take as long as a year; however, the funds are paid retroactively to the application date.
Conclusion
It’s difficult coming to terms with the costs associated with Alzheimer’s. There’s so much to find out and so much financial planning that needs to be addressed. The more you can find out about your loved one’s coverage options and financial resources, the easier it will be to access the care they really need.