Just another example of the haves and have nots. Assisted living is out-of-pocket unless you can get some VA benefits. Like almost everything in the great United States - show us the money and we will take care of you otherwise you are on your own.
Yes, show us the money and we'll take care of you. That's capitalism. Fortunately though, we also have Medicaid. If you've no money, we'll take care of you too. Maybe just not as well as if you had money. That's life.
All states have different laws when it comes to what Medicare will will pay. And, every facility is different in terms of what they will accept for payment. In our state, there is no assisted living facility that will accept Medicare or Medicaid for payment, while nursing homes do. Assisted living here is all private pay. My Dad is in a nursing home (long term care facility), and Medicare and Medicaid pays for everything. We only pay for his haircuts. My suggestion to you is to ask the facilities you are considering what they will accept. Good luck!
MediCARE pays for hospitalization, MD fees, other health care providers, short -term rehabilitation, medications. Medicare does not pay for the room & board for long term care whether in a AL or a NH.
This site has good articles on the difference between MediCARE & MedicAID. Please read them so that you understand what they can & can't pay for,.
MedicAID is an "at-need" program for those that qualify medically & financially for needing skilled nursing care. Most states have it such that MedicAID is designed for NH facility care. Some states have a Medicaid waiver program in which they will pay for AL rather than a NH. You need to find out what path MedicAID does in your state first & then which facilities even participate in a Medicaid waiver program and how they select residents to get the waiver. What I have found is that even though a facility accepts Medicaid for AL, that the current private paying residents are first & foremost on the waiting list for the Medicaid paid for bed. Often they have to be a private pay resident for a period of time even before they are on the waiting list too. Totally a self-selection process and totally legit to do.
As unicorn said, AL is out of pocket & private pay.
you may find that the only way Medicaid will pay is to get them into a NH than AL. You have to do whatever to have them qualify medically for needing skilled nursing care that a NH provides. If they are just old, forgetful, mild dementia, but can do their ADL's, they won't qualify for medical necessity. What is your situation?
N1 - my personal outlook on this is not positive for the future. Health care costs in the US are staggering and only getting more so. Obamacare, imho, is a step in the right direction but really until there is a central universal health pricing & provider system with the political will to place individual's needs above corporate interests, the current system will collapse. There is no cost containment. A county that considers itself to be 1st world, cannot have families declaring bankruptcy from adad having knee surgery or for the costs of a preemie. Ridiculous.
The NH lobby would love for Medicare to pay for NH as Medicare reinbursement rates are HUGE as compared with what Medicaid pays for. The states would love for Medicare to pay for NH as then all falls on the federal system. But what would happen is that your individual Medicare monthly payment whether you are still working and it's going into FICA or your retired and it's coming out of your monthly SS check would need to increase 100 - 200% to pay for the cost of Medicare. For those that depend on SS alone to make ends meet, it will be devastating. For the providers, many will quit taking Medicare as their payment will be fixed.
Also personally, I think the smart money will look to retire outside of the US and keeping something small in the US either close to family left in the US or close to good health care. My mom is in TX and I travel in TX for work, and you already see this happening in Houston & San Antonio where there is excellent all encompassing health science centers and with the bonus of being a short flight from Mexico and Latin America to airport that do international all the time. Although this is all anecdotal, in my mom's zip code, 78209, I'd say maybe 15% of all housing buys are for the "in the US" address and the 2 parcel&post stores in the zipcode has a waiting list for postal rent boxes...again to establish and maintain an "in the US address". This is for the retirees who live in Mexico, Costa Rica and Panama (they just stared a new 1K a month pension citizenship program, too and it looks really good). Also Belize looks good since you get the Eurpoean access since it still has UK ties. Retirement living aboard might be a good option for your kids.
Also there is the real prospect of future retiree's not ever qualifying for MedicAID. Right now if your "income" is over basically $ 2K, then you are disqualified because you have too much income. Well for those of us who worked good jobs and made our SS income base in the 1990's and early 2000's, we are likely going to draw over 3K+ a month in SS alone. We won't qualify for Medicaid without some serious divesting of income and assets early. Right now, for my mom's era (she's in her mid 90's) most of those elderly has SS payout under 1K. My late MIL was like only 500 a month and that is all she had. My mom is literally rolling in $ as she has SS and federal retirement with an income of almost $1,900 a month. If they live long enough unless they are generationally wealthy, they will run of out $.
I read a book by an economist in the mid 1970s which said that if insurance companies did what our governmental representatives do in terms of managing Social Security "insurance" funds, the insurance executives would be in prison. The author was not an alarmist doomsayer but he did predict the future bankruptcy of SS if things continue going the same way as they have been.
Folks, the REAL name of SS is FICA, the "I" standing for INSURANCE! Insurance companies are required to fund their policies. There have to be the monetary assets to backup their underwriting. Not so, and never has been, with the SS system. Government deductions withheld from workers earnings or deposited from the self-employed. No. Instead I'm going into a dedicated SS account that would be invested and earn interest or dividends and could have, over time, accumulated enough money to pay for itself, all the monies were, at the outset, AND STILL ARE, plunked into the general fund and spent on whatever immediate budget items are in front of the Treasury at the time. The amounts each person has paid in, each individual's balance sheet so to speak, is just a paper accounting, not actual money in the bank.
What has been true from the beginning of the system, what the economist wrote about in the 70s, and what is still true today is that money gained from workers today is what pays retirees today. I'm sorry I can't quote the exact statistics, but I'll give an example that in the beginning of SS, there may have been 25 people working and paying into the system for every one person collecting retirement. Tiday, still just an example mind you, there may be 3 people working for every 1 collecting. In the future, with the amount of retirees growing due to the baby boom of the 50's as well as people living longer than they used to, the portend of the future is that there will be one person working for every 10 collecting, maybe an exaggeration (but it could end up even worse) if you listen to the experts.
Does anyone remember that there was a huge budget surplus when Clinton left office? I believe the figure was somewhere around $450 BILLION !! One of the uses considered was "funding Social Security". THAT should have happened but initially nothing did and the money ended up being spent on the war. *sigh*
And another hot button topic is the need for a single pair medical system here in this country, duh! Bless you igloo, isn't it sad that folks in the future may have to, as some do already, maintain a fictitious US address and actually retire out of the country. It's nice for those who had the ability to preplan to do that or maybe others (unlike myself and many on this site who spent their savings caretaking) who have a retirement savings enough to afford to do it, but what of the people who don't prefer to leave their country because of mismanagement legally allowed by the government. Really, it's a travesty.
I work for an ALF in south Fl and here if you can get approved for a Medicaid Waiver which is used to help with covering part of the rent also they will give you 125.00 for supplies
Good luck!
-SS
This site has good articles on the difference between MediCARE & MedicAID. Please read them so that you understand what they can & can't pay for,.
MedicAID is an "at-need" program for those that qualify medically & financially for needing skilled nursing care. Most states have it such that MedicAID is designed for NH facility care. Some states have a Medicaid waiver program in which they will pay for AL rather than a NH. You need to find out what path MedicAID does in your state first & then which facilities even participate in a Medicaid waiver program and how they select residents to get the waiver. What I have found is that even though a facility accepts Medicaid for AL, that the current private paying residents are first & foremost on the waiting list for the Medicaid paid for bed. Often they have to be a private pay resident for a period of time even before they are on the waiting list too. Totally a self-selection process and totally legit to do.
As unicorn said, AL is out of pocket & private pay.
you may find that the only way Medicaid will pay is to get them into a NH than AL.
You have to do whatever to have them qualify medically for needing skilled nursing care that a NH provides. If they are just old, forgetful, mild dementia, but can do their ADL's, they won't qualify for medical necessity. What is your situation?
The NH lobby would love for Medicare to pay for NH as Medicare reinbursement rates are HUGE as compared with what Medicaid pays for. The states would love for Medicare to pay for NH as then all falls on the federal system. But what would happen is that your individual Medicare monthly payment whether you are still working and it's going into FICA or your retired and it's coming out of your monthly SS check would need to increase 100 - 200% to pay for the cost of Medicare. For those that depend on SS alone to make ends meet, it will be devastating. For the providers, many will quit taking Medicare as their payment will be fixed.
Also personally, I think the smart money will look to retire outside of the US and keeping something small in the US either close to family left in the US or close to good health care. My mom is in TX and I travel in TX for work, and you already see this happening in Houston & San Antonio where there is excellent all encompassing health science centers and with the bonus of being a short flight from Mexico and Latin America to airport that do international all the time. Although this is all anecdotal, in my mom's zip code, 78209, I'd say maybe 15% of all housing buys are for the "in the US" address and the 2 parcel&post stores in the zipcode has a waiting list for postal rent boxes...again to establish and maintain an "in the US address". This is for the retirees who live in Mexico, Costa Rica and Panama (they just stared a new 1K a month pension citizenship program, too and it looks really good). Also Belize looks good since you get the Eurpoean access since it still has UK ties. Retirement living aboard might be a good option for your kids.
Also there is the real prospect of future retiree's not ever qualifying for MedicAID. Right now if your "income" is over basically $ 2K, then you are disqualified because you have too much income. Well for those of us who worked good jobs and made our SS income base in the 1990's and early 2000's, we are likely going to draw over 3K+ a month in SS alone. We won't qualify for Medicaid without some serious divesting of income and assets early. Right now, for my mom's era (she's in her mid 90's) most of those elderly has SS payout under 1K. My late MIL was like only 500 a month and that is all she had. My mom is literally rolling in $ as she has SS and federal retirement with an income of almost $1,900 a month. If they live long enough unless they are generationally wealthy, they will run of out $.
Folks, the REAL name of SS is FICA, the "I" standing for INSURANCE! Insurance companies are required to fund their policies. There have to be the monetary assets to backup their underwriting. Not so, and never has been, with the SS system. Government deductions withheld from workers earnings or deposited from the self-employed. No. Instead I'm going into a dedicated SS account that would be invested and earn interest or dividends and could have, over time, accumulated enough money to pay for itself, all the monies were, at the outset, AND STILL ARE, plunked into the general fund and spent on whatever immediate budget items are in front of the Treasury at the time. The amounts each person has paid in, each individual's balance sheet so to speak, is just a paper accounting, not actual money in the bank.
What has been true from the beginning of the system, what the economist wrote about in the 70s, and what is still true today is that money gained from workers today is what pays retirees today. I'm sorry I can't quote the exact statistics, but I'll give an example that in the beginning of SS, there may have been 25 people working and paying into the system for every one person collecting retirement. Tiday, still just an example mind you, there may be 3 people working for every 1 collecting. In the future, with the amount of retirees growing due to the baby boom of the 50's as well as people living longer than they used to, the portend of the future is that there will be one person working for every 10 collecting, maybe an exaggeration (but it could end up even worse) if you listen to the experts.
Does anyone remember that there was a huge budget surplus when Clinton left office? I believe the figure was somewhere around $450 BILLION !! One of the uses considered was "funding Social Security". THAT should have happened but initially nothing did and the money ended up being spent on the war. *sigh*
And another hot button topic is the need for a single pair medical system here in this country, duh! Bless you igloo, isn't it sad that folks in the future may have to, as some do already, maintain a fictitious US address and actually retire out of the country. It's nice for those who had the ability to preplan to do that or maybe others (unlike myself and many on this site who spent their savings caretaking) who have a retirement savings enough to afford to do it, but what of the people who don't prefer to leave their country because of mismanagement legally allowed by the government. Really, it's a travesty.
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