The Big Mistake People Make About Medicare and Assisted Living

10.16.17A large percentage of Americans require assisted living care at some point during their senior years. Their understanding of how that gets paid for is way off base. It’s a hard lesson to learn.

 Approximately one-third of Americans (34%) thought that Medicare would cover their nursing home costs, as reported in a survey from the Associated Press-NORC Center for Public Affairs Research. Another third, 27%, may have been a little smarter to say that they weren’t sure.

That’s not true, says WRAL’s recent post, “Expect Medicare to cover assisted living? Think again.” These results may correlate with the fact that only 37% of Americans think they’ll need any care in their later years, but in reality, about 70% will require this care.

Another survey by the AARP Policy Institute and the National Conference of State Legislatures found that 90% of people over 65 want to stay at home as long as possible—80% say they’ll live at home until they die.

Consider the cost: informal, independent caregivers can be $12-$18/hour. Trained and vetted Certified Nursing Assistants are at least $20-24+/hour, depending on the level of support needed. Round-the-clock agency care—even conservatively figuring a $20/hour rate—would cost approximately $14,400/month or $172,800/year.

Let’s now look at assisted living. Depending on geography, the cost for private-pay, month-to-month assisted living ranges from $2,500/month in a shared room to $7,500+/month in a private room. That’s about $30,000-$90,000/year. The average length of stay in assisted living is 28 months. Therefore, the total cost would be somewhere between $70,000 and $210,000.

The Centers for Disease Control and Prevention reports that 59% of all assisted living residents will eventually move to a skilled nursing facility. The average stay is 835 days. With four to five years of care, a family can spend $250,000 to $450,000 or more.

How much of this is covered by Medicare? About 12%, because Medicare covers only medical care costs.

Unfortunately, many families don’t plan ahead and only seek the help of an elder law attorney when the situation has already reached the level of a family crisis. A parent is suddenly unable to live independently, because of an injury or the sudden onset of an illness. They don’t know what resources might be available to help pay for care, or they are relying on proceeds from the sale of their parent’s home—but that can take months, and Mom or Dad need care right now.

By meeting with an elder law attorney long before these events occur and planning in advance for both good health and bad health, the parents and family will be prepared with resources in place, a plan for the short and long term and ensure that the parent or family member is able to receive the care they need, whether for a brief or extended period of time, while the spouse is able to maintain their lifestyle.

Reference: WRAL (September 16, 2017) “Expect Medicare to cover assisted living? Think again”

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