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beckyl Asked December 2015

Why isn't AL covered by insurance?

Can someone with more experience in these things explain to me why AL isn't covered by insurance? It's not as if it's a luxury. It's a very real necessity for many. Insurance will cover my mother's medications, doctor visits, and any therapies she might need, but not the charge for the room. She definitely can't live by herself any longer, and no longer qualifies for skilled nursing. It's all so frustrating and overwhelming.

GardenArtist Dec 2015
Becky, I think this is going to be one of the difficult but influential broader issues for the next few decades, at least, as the Baby Boomers move into their senior years and hopefully lobby for better legislation to support caregivers as well as their elders.

I was thinking the other day that at one time people were looking for the Fountain of Youth (remember Ponce de Leon and his efforts to locate it in Florida?). Over the centuries various issues, such as child labor, changes wrought by industrialization, advent of motorized vehicles, women's right to vote, democratization of technological changes and extension to many levels of society....these were influencing factors in our lives, governments and societies.

I think the caregiving issues are on the cusp of being one of these major forces, and it can't come too soon for me, and I'm sure many others.

beckyl Dec 2015
Thank you for your helpful answers. I knew that there would be people here with much knowledge in this kind of thing. As many of you have said, there needs to be a better way to take care of our aging parents without a financial burden.

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pamstegma Dec 2015
If your mother purchased long term care insurance, many years ago, it should be covered. Most ALF's take private pay only (private insurance or injury settlements) and do not accept Medicaid patients at all. They also accept payments from the VA, if mom is the widow of a wartime Vet.

GardenArtist Dec 2015
Who would pay for the premiums? The cost would have to be individualized; it's not realistic to think about federal assistance with legislators channeling funds to their own states and pet projects (yes, that's meant to be a snide remark about the project prioritizations of elected reps).

Medicare is reasonably priced; if it included AL the premiums would be astronomical, and would have to be tailored to individual needs. Medicare premiums are fairly standard now.

People can purchase long term care insurance. I don't know if it would cover AL or some other type of facility though.

Personally I'm not sure insurance is the answer but I don't know what it. As a nation, we're going through changes perhaps equivalent to those wrought in scope by the Industrial Revolution, with large numbers of the population providing care for older loved ones in desperate need of assistance beyond that of the family.

I don't know what the solution is, but I'm guessing that some of the more socialized countries such as the Scandinavian ones have better options than we do. They also have much higher tax rates.

I think this is one of those questions that doesn't really have a good answer.

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