Medicare Q & A

Wednesday, March 20, 2019

Does Medicare Cover Alzheimer Facility Care?

Morning, Toni:

I read your Medicare column regularly and have never seen you address the issue of paying for an Alzheimer facility care. I am concerned that I may wipeout my 401K or savings if need arises due to a long-term care or Alzheimer’s need arises for me or my wife.

Currently, my 88-year-old mother has been living in an Alzheimer’s facility for three years, costing me and my siblings over $5,500 each month. Is there any help we can get for her financially?

Thanks, Russell from Sugar Land

Russell:

No, Medicare does not cover Alzheimer, Assisted Living or Nursing Home care. Medicare will only pay for days 1-20 with a $0 co-pay and days 21-100 at $167.50 co-pay per day. After that time, the retiree must absorb the remaining cost themselves, and Russell, you are feeling the money pinch with your mother’s Alzheimer home care of $5,500 per month for the last three years with no end in sight.

You are wise to have your mother in an Alzheimer/Assisted Living facility to keep her active as she ages. A recent study showed that one in seven Americans over the age of 70 have some form of dementia and that the number rises to one in three Americans over the age of 85.

The need for Memory Care type communities are rising with the aging population growing and the family members wanting their loved ones to stay active.

A long-term care or chronic illness conditions can be very costly as you are experiencing with the 2019 average annual cost ranging from $60,000 to $85,000 per year for semi-private nursing home stay and $80,000 to $93,000 per year for private nursing home stay.

Boomers need to be aware that the cost of long-term care is projected to rise in 10 years to over $131,000 per year and growing to over $176,000 in 20 years.

Senior living options can be difficult to navigate and for the Adult Child to help their parents. Options include independent living, assisted living and memory care communities providing care for our seniors. Each caters to a different type of individual. Knowing when a loved one needs memory care over assisted living and independent living over memory care can be confusing. As the individual’s needs change, so do their needs from their living environment.

Memory care communities are growing because dementia is growing due to various diseases such as Alzheimer’s, Parkinson’s, MS and cardiovascular issues. These Assisted Living communities help residents with issues such as dementia living in a safe, homelike environment that caters to their cognitive (a fancy word for mental) needs. Memory care communities help with a range of needs including bathing, hygiene, feeding, incontinence, laundry, cleaning, medication management, mental stimulation and more.

The only way to have a long-term care issue covered financially is with a long-term care policy or pay completely out of your pocket.

Below are a few options for additional ways to find affordable long-term care or email info@tonisays.com for more information:

Traditional Long-Term Care: The younger you are when you purchase a long-term care policy, the lower the premiums will be. Make sure that your policy covers care at home and facility care.

Hybrid Life and Annuity Policies: Many life/annuity insurance policies have a provision if you need long term care; you can receive a certain amount of long-term care.

If you are still confused and would like to discuss your specific Medicare circumstances either email info@tonisays.com or call 832/519-8664 and the Toni Says® team can help you.