Understanding the cost of care
The average cost of a one-bedroom unit in personal care homes in the state exceeds $2,700 a month. For nursing home care, costs can exceed $5,000 a month.
If you are looking for care for yourself or a loved one, you must understand how you are going to pay for it, according to the Pennsylvania Health Care Association.
Many people believe wrongly that Medicare, Social Security or Medicaid will pay for their long-term care needs.
Medicaid does cover nursing home care for the impoverished, and Medicare may cover some of the cost of nursing home care for those who require short-term rehabilitation, but both require individuals to meet certain physical and medical standards. Generally speaking, neither covers the cost of personal care or assisted living.
Here is information to help you understand how you can pay for care privately or through government programs.
Personal resources
Most personal care home residents, and roughly 20 percent of nursing home residents, pay for costs out of their own savings and assets.
Frequently, when people enter a nursing home for extended long-term care, they first pay for their care out of their own assets and then expend their resources and apply for Medicaid.
Private Insurance
For the most part, private medical insurance does not cover the cost of personal care or nursing home care except in specific circumstances.
Long-term care insurance can be bought to provide some payment for nursing home care and personal care home/assisted living care.
Some Medicare supplementary insurance policies, often referred to as Medigap insurance, also may provide some limited payment. Many health maintenance organizations (HMOs) and other coordinated care plans participate in the Medicare and Medicaid programs.
These health-care plans often cover certain benefits in addition to those required by Medicare and Medicaid and are experienced in “coordinating” a member’s health care.
Some HMOs may also offer more medical or supportive services; others may not require a hospital stay before approving a nursing facility admission.
