Payor Sources

Medicare

Many people have the false impression that Medicare will pay for any Long Term Care needs that arise after the age of 65. Actually, Medicare only pays for acute episodes and the guidelines for Medicare eligibility are very limited (see Skilled Nursing Care). Medicare never pays for Assisted Living services.    

Managed Care Plans

A nursing home must have a contact with your managed care plan in order for the facility to receive payment. If the home is approved by your plan learn if the plan also monitors the home for quality of nursing care.

Medicaid

Medicaid is a State program that will pay most costs for people with limited income and assets. Eligibility varies by State. Check your State's requirements to learn if you are eligible. Medicaid will pay only for home care that is provided by a agency certified by the government to provide service to Medicaid recipients. For more information about Medicaid payments, call the SHIP for your State or call your State's Medicaid office. The telephone number is in the blue pages of the phone book.

Long-Term Care Insurance

This is a private policy. The benefits and costs of these plans vary widely. For more information on these plans, contact the National Association of Insurance Commissioners (NAIC). It represents state health insurance regulators and has a free publication called "A Shopper's Guide to Long-Term Care Insurance." You also can get a copy of the Guide to Health Insurance for People with Medicare by calling 1-800-MEDICARE.

Personal Resources

About half of all home care clients pay the costs out of their own savings. After these savings and other resources are spent, many people who utilize services for long periods eventually become eligible for Medicaid.