Oregon Health Insurance for Long-Term Care
*Please note: This information is provided for educational purposes only. The availability of each program is determined by that government agency and the individual’s situation. Please consult directly with your insurance company or the government program.
Many seniors who need long-term care find it difficult to rise from bed, shower safely and groom themselves. They need personal assistance for these basic living activities and further activities throughout the day. Once these needs become a reality, then the question arises: how to pay for long-term care.
Below offers a description of the many resources that families utilize when confronted with this same question. Since each option carries different consequences, we suggest you consult a financial or insurance adviser and refer to the resources below.
Oregon Long-Term Care Insurance
Some seniors plan ahead and purchase long-term care coverage when it's affordable. The long-term care coverage policies are more complex than buying the more standard types of insurance you are accustomed to, such as life, auto, and homeowners. When researching this option, you'll want to understand what physical and medical condition your loved one must be in before insurance begins to pay for one's care.For more information go to the U.S. Department of Health and Human Services website.
Oregon Reverse Mortgage
An Oregon reverse mortgage is a relatively new strategy that some seniors who are over age 62 rely on. It enables homeowners to convert part of the equity in their homes into tax-free cash without having to sell, give up title, or take on a new monthly mortgage payment. In an Oregon reverse mortgage the payment stream is "reversed." Instead of making monthly payments to a lender, a lender makes payments to the senior allowing them to remain in the home as long as they live, or move into a long-term care facility.For more information go to www.ReverseMortgage.org.
Oregon Medicare Helps with Short-Term Care Costs
Medicare is a federal health-insurance program that covers most Americans over the age of 65. It helps pay for short-term medical expenses, such as hospitalization, doctor bills, x-rays, radiation, and a variety of other tests and therapies. A copayment for a part of the expenses may be required. However, Medicare does not pay for non-medical care, such as long-term care and assistance with daily living activities, except in a few situations as the following outlines:Hospitalization:
To qualify for Oregon Medicare, a senior must have spent three nights in the hospital and must enter the nursing home within thirty days for rehab for the same condition that was treated in the hospital.
If conditions are met, Medicare fully covers the first twenty days of long-term care and partially for up to the next 80 days.
|
Days |
What Medicare Pays |
What You Pay |
|
1-20 |
Full cost |
Nothing |
|
21-100 |
All but a daily copayment |
A daily copayment |
|
Beyond 100 |
Nothing |
Full cost |
Other Considerations:
Oregon Medicare payments will continue as long as a senior is in a skilled rehabilitation program that's producing results, such as improved healing, strength, coordination and flexibility.Once skilled rehabilitation is no longer effective in improving a senior's condition, Medicare will stop paying—even if it's still within 100 days.
Families need to be strong advocates at the hospital for getting a senior into a nursing home if the family can't care for them at home.
Oregon Medicaid Helps with Paying for Long-Term Care
If your loved one enters a nursing home or long-term care facility, they may qualify for Oregon Medicaid once their assets have been depleted.For those over the age of 65, Oregon Medicaid helps pay for nursing home costs once a senior has exhausted all—or almost all—of their own means. Oregon Medicaid generally pays for care in a certified-nursing home. Since regulations vary from state to state, check this government site then select "Medicaid/Medicare" for the rules in your state.
Once a senior qualifies, they will have to pay any remaining monthly income—such as social security or a pension check—to the nursing home. Oregon Medicaid only pays the difference between the senior's remaining income and the nursing home's monthly charge.
Learn more about paying for long-term care by contacting a financial or insurance consultant.
