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Nursing Homes and Insurance Matters

Many elderly individuals who need medical care and nursing facilities cannot afford them because they do not have comprehensive healthcare. After all, the cost of nursing homes or assisted living is extremely expensive. In fact, a private room at a nursing facility can cost an average of $90,000 a year. That is not a cost that most people will be able to afford to pay out of pocket. Because of the expense, it is important that a patient and their loved ones fully understand the type of health insurance available as well as details on Medicare.

Health Insurance for Elderly Patients

Most elderly individuals, even those who do not have nursing home expenses, will deal with high medical bills due to doctor’s appointments, medications, and other potential costs. Senior citizens can begin receiving Medicare for financial assistance when they reach age 65, but many  will actually retire before they reach that age, meaning they will not have any assistance at all. This is why healthcare insurance is a must.

When a person is employed, the company will pay a large portion of the cost of a policy. However, when that person retires, they will become responsible for the whole policy, which can be double or more the cost beforehand. If the elderly individual determines that they cannot afford the cost of continuing their health insurance policy after they have retired, they have two options. These options are:

  • Purchase a supplemental health insurance plan that works in conjunction with Medicare.
  • Rely on a pension plans, if available, which allows individuals to continue receiving health insurance from their former employer at the lower cost they paid while they worked.

Since there are options available, elderly individuals should be able to obtain health insurance that will ensure they are able to afford a nursing home.

Paying for a Nursing Home

Since nursing home expenses are quite high, getting health insurance coverage can be somewhat difficult. If the patient will be using Medicare to cover the costs, then they will need to choose nursing facilities that are eligible for Medicare payments.

It is possible for the loved ones to purchase a long-term healthcare plan which is designed to cover some of the cost of nursing home care as well. These long-term plans are usually available through an employer and that is why the elderly person often depends on their son or daughter to purchase these plans.

Planning for the Expense

Once it has been determined that an elderly individual must enter a nursing home, a plan for payment must be prepared. To come up with this plan, there are a few things to do:

  • Begin by determining if Medicare will be used.
  • Next, look into pension plans and determine if the insurance will cover the cost.
  • Consider getting a long-term health insurance policy through an employed loved one.
  • Look into supplemental insurance including Medigap and AARP.

Once all of these options have been exhausted, then the remaining balance will need to be covered out of pocket. If that number is high, then it is a good idea for several family members to pool their resources so that the expenses do not fall on one person alone.

Keep in mind that insurance plans often have different levels that they use for nursing home expenses. Some things may be covered and some may not, so it will be vital to thoroughly research the insurance policy and determine what type of expenses will be covered. This way, the patient and their loved one will have less of a chance of high out of pocket expenses that could come along with long term stays in a nursing facility.

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