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 wipe out my 401K or savings if the arises due to 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 3 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’s, Assisted Living or Nursing Home care, r at home care. Medicare will only pay for a Skilled Nursing stay with days 1-20 having a $0 co-pay and days 21-100 at $176 copay 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’s home care of $5,500 per month for the last 3 years with no end in sight.

You are wise to have your mother in an Alzheimer’s/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 is rising with the aging population growing and the family members wanting their loved ones to stay active.

Long-term care or chronic illness conditions can be very costly as you are experiencing with the 2020 average annual cost ranging from $65,000 to $87,000 per year for semi-private nursing home stay and $80,000 to $93,000 per year for private nursing homestay.

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, nd 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 the sted 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 ways to find affordable long-term care or email info@tonisays.com for more information:

• Long-Term Care options for you and your spouse:

1. Traditional Long-Term Care: The younger you are when you and your spouse purchase a long-term care policy, the lower the premiums will be. My advice is to search for Term Care while younger and in relatively good health.  Make sure that the policy covers care at home and facility care.
2. 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 with your life/annuity policy’s face amount.

Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the Medicare Survival Guide® Advanced book. Email Medicare questions to info@tonisays.com or call 832/519-8664