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Medicare is willing to pay long term nursing homes thousands of dollars a year. My disappointment is with Medicare's practice of standards with not assisting or even paying for the cost of Home Health Aides 8 to 24 hours a day to enable the families/caregivers to have their elderly people remain in their homes. The cost to house elderly people in Long Term Nursing Homes is thousands and thousands of dollars a year, versus the percentage of money to have the elderly live in the homes of family/caregivers.
When did our rights to choose on how and where we live at the end of life get taken away. Wake up people we will all be geriatric people one day!!! Shouldn't we get to tell Medicare what they're going to pay for instead of them telling up??? After all, most of us pay into this fund all of our working lives.

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It is not correct for one commenter to very precisely say that people pay roughly $150,000 into Medicare but get roughly $350,000 out of it. He or she is probably using flawed research from a far left wing group named The Urban Institute. The research did not count the couple's income tax payments and did not count the multiple pooling effects of all insurance. You paid your own way in Social Security and Medicare if born after 1940. If born before 1940, you were given a special deal by Congress on Medicare, particularly if born before 1930.
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Medicare coverage is based on 3 main factors

1. Federal and State laws.

2. National coverage decisions made by Medicare about whether something is covered.

3. Local coverage decisions made by companies in each State that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.
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Forgot to say.That $450 would pay for twice weekly homecare visits and four cab rides a month to the doctor (2 per parent)
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We had a case worker come in and she said my parents were eligible for $450 worth of services a month. They could use that towards homemaking services, medical cab transport ...that sort of thing. We live in Massachusetts and I am pretty sure she said it was paid for by Medicare.
Unfortunately my Mom is refusing these services :{
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There's a down side to reverse mortgages... the ads on TV make it sound like such a wonderful thing, but it fails to tell the viewer that this is a *loan* plus interest and fees need to be paid back within months of the elder owner passing.

Most of the time whomever inherits the house may not be able to qualify for a new standard loan to pay back the reverse mortgage, thus the house has to be sold quickly or it goes into foreclosure.

Thank goodness a new ruling took effect back in August that now allows the surviving spouse, who was not on the reverse mortgage loan, to continue to live in the house.... but this is only for new reverse mortgages taken out starting in August. When my boss' wife died, he had to scramble and sell the family home that he inherited because only her name was on the loan.
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A reverse mortgage might help pay for some costs of home care, but my relative, who had a nice place, could not sell it because her son would not let her. She ended up going into an assisted living place.
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Regarding getting one's money's worth....Most people think that they are losing money on what they pay into Medicare. I have worked in the field for almost 25 years and I hear it every day. The average male worker contributes $55,000 to Medicare and gets $161,000 in benefits. A high income couple might pay in $140,000 in taxes, but use $343,000 in Medicare services over their lifetimes. The difference for Social Security is not as dramatic, but the fact is the vast majority of people take out a lot more than they put in. (These are 2010 numbers figured by the Urban Institute and reported in US News and World Report January of 2011).
It doesn't make the situations less frustrating, but at least we can know we are not being taken advantage of (on Medicare and SSI, anyway).
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As JessieBelle pointed out, Medicare does not cover long term care.
Medicare does cover Skilled Nursing Facility (SNF) care up to 100 days per benefit period, and Home Health care for medically necessary services that you would ordinarily receive at a hospital or SNF. Examples include: Wound care for pressure sores, patient and caregiver education, nutrition therapy or iv therapy, monitoring for unstable status or serious illness, and injections.
It is a logical theory that if Medicare paid for custodial care (activities of daily living or ADLs, such as dressing, feeding, medication, toileting, bathing, walking and transferring) that there might be fewer medical expenses, but as freqflyer pointed out, even at just $10/hour for unskilled care, providing 24/7 care would be $87,000 a year. Someone could live on in such a situation for decades. Presently over 10,000 people a day are turning 65. From the US Census Bureau in 2012: Approximately 56.7 million people in the civilian non institutionalized population had a disability in 2010. About 38.3 million people had a severe disability. These are people who need help with ADLs. There just aren't enough resources.
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First I have to say that Medicare will not pay for nursing home or home care. You are probably talking about Medicaid. The answer is a very simple one. Medicaid is paid by taxpayers and end-of-life costs are huge. Home care for all the elders on Medicaid would cost more than the state could afford.

Medicaid really does a remarkable job, especially considering the need for Medicaid is going up significantly every year.
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Living south. Home care generally runs between 20 and 25 an hour. When someone gets to where they need 24/7, they will quickly go through their assets and that includes the house. Hard to do home care without a house. Even with long term care insurance which usually only reimburses about 120 a day. This is why my mom will have to go to a facility. She's just going through her money too fast.
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Don't forget to add in the cost to maintain the house that the elder still owns and resides.

If there is still a mortgage, that needs to be paid, along with property taxes, home insurance, and umbrella policy to cover if a caregiver gets hurt. The monthly water bill, electric, gas, cable, telephone, etc. Outside maintenance, like weekly lawn mowing and yard care. Repairs to the house, such as the furnace breaking down, needing a new roof, needing to replace an appliance, etc. All that can add up quickly.
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I've always heard that it is less expensive, in the long run, to let the senior stay at home with care than to go to a nursing home - so I think it's a good question.
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Yvonne, you are lucky to live in NJ, where Medicaid Waivers are available to help keep mom at home or even pay for Assisted Living. Call Community Choice program's toll-free number at 609-588-6675.
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It could be because it is less expensive for an elder to live in a nursing home, then to pay for 3 shifts of Caregivers 168 hours a week.

If Medicare paid for around the clock care 52 weeks out of the year, it would be bankrupted.
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