INSURANCE

Laura Mutsko Agent, CSA and Certified Healthcare Reform Specialist

Q: Does Medicare cover the cost of residential care in a Skilled Nursing Home? If not, are there other ways to pay for nursing home care? A: Original Medicare will not cover the cost of a nursing home, if custodial care (assistance with feeding, bathing, and dressing) is the only care needed, Medicare will, however, provide coverage for up to 100 days in a skilled nursing facility after certain conditions have been met.

To qualify for Medicare coverage, you must (1) have been an in-patient in the hospital for three or more days prior to moving to a skilled nursing facility; (2) your doctor must confirm that you need daily skilled care given by, or under the direct supervision of, skilled nursing or therapy staff; and (3) you must have Medicare Part A benefits remaining in your benefit period.

Your share of the costs with Original Medicare:

• Days 1–20: You pay $0 for each benefit period.

• Days 21–100: You pay $164.50 coinsurance per day of each benefit period. • Days 101 and beyond: You pay 100% of all costs

If you need other resources to cover the cost of care beyond day 100, here are a few options: Out of Pocket

Many people pay for care out of their lifetime savings. In Ohio, plan on spending an average of $6996 a month for a semi-private room, according to a Genworth 2016 Cost of Care Survey. Veterans Benefits

The Department of Veterans Affairs (VA) provides long-term care services to some eligible veterans through three national programs: VA nursing homes; state veterans’ homes; and community nursing homes that work with the VA. Each program has its own eligibility requirements. For help determining whether you qualify for one of their programs, contact the VA social worker at your local VA facility. Medicaid

If you have limited income and assets and meet other eligibility requirements, the State of Ohio’s Medicaid program may help pay for nursing home and other long-term care services. The rules for Medicaid are complex. Visit http://www.medicaid.ohio.gov/ to find out more about this program. Insurance

Private insurance companies provide longterm care insurance to help you preserve your assets. If you have been a prudent planner and have long-term care insurance now is your time to take advantage of it. If you would like to learn more about long-term care insurance, I can show you a variety of plans to help you prepare for the future.

Home care often costs much less than residential care. Since people often wish to continue living in their own homes, you may want to research the cost of home and community-based services in your area.

For questions concerning long term care insurance, life, health, Medicare Advantage Plans or other insurance, please call me at 440-255-5700 or email me at Lmutsko@ mutskoinsurance.com.

Laura Mutsko Mutsko Insurance Services, LLC

6966 Spinach Drive, Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com