Santa Clarita Elder Law Attorney

LONG TERM CARE: WHO PAYS THE COST?

By Jane M. McNamara, Elder Law Attorney

Older adults are living longer today than in the past. Today, a 60-year-old man has a remaining life expectancy of 20 or more years. A woman of the same age has a remaining life expectancy of 24 or more years. Given the potential to live a long time, many older adults and their families are concerned that the older adult will need to receive long-term care.

Many older adults and their families are especially concerned about long-term care in a Nursing Home. In particular, they are concerned about the quality of living arrangements and treatment, and about the cost. According to the California Department of Health Services, the average monthly private pay cost of Nursing Home care in California is now $4,477.00. This amount well exceeds $50,000 per year. Most families are shocked to learn that Medi-care does not pay for long term nursing home costs. Medi-care pays up to 100 days (days 21-100 are with a co-pay) of skilled care. Once Medi-care is no longer available, Nursing Home care costs are paid by either Long Term Care Insurance (which most elderly people do not have), personal assets, or Medi-Cal.

Medi-Cal is California's version of the Federal Medicaid program. Medi-Cal is designed to pay a very significant portion of the cost of Nursing Home care for an eligible person. To be eligible, a person needing nursing home care must have limited available resources. The rules in the area of Medi-Cal eligibility are currently under review, and are expected to change substantially within the next year, or sooner. These new rules will undoubtedly affect countless families whose loved ones require long term care, and are in need of Medi-Cal assistance, or wish to preserve assets while obtaining long term care through Medi-Cal. If faced with long term care needs, it is critical that accurate eligibility information is obtained before applying for Medi-Cal.

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