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Paying for Long-Term Care | What Options Do You Have?

Updated: Dec 15, 2021

The world’s population is aging at a faster rate than ever before and people are living longer. Every day until 2030, 10,000 Baby Boomers will turn 65, and 7 out of 10 people will require long-term care in their lifetime. Here are some statistics (all are "on average") you should consider:

  • Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining year

  • Women need care longer (3.7 years) than men (2.2 years)

  • One-third of today's 65 year-olds may never need long-term care support, but 20 percent will need it for longer than 5 years

According to the Genworth Financial Cost of Care 2020 Survey, the average monthly cost of a one-bedroom unit in a Pennsylvania personal care residence or assisted living residence is $4,550. For a private room in a skilled nursing facility, the median monthly cost is $11,268. If you are looking for care for yourself or a loved one, you must understand how you are going to pay for it.

Many people believe – wrongly – that Medicare, Social Security, or Medicaid will pay for their long-term care needs. Medicare will pay for long-term care only if you require “skilled” services, meaning a short stay in a skilled nursing facility, hospice care, or the costs associated with home health care. Even then, they’ll only cover these costs for a maximum of 100 days. Since the majority of long-term care is non-skilled assistance (helping with eating, moving around, bathing, etc.), it may be safe to assume that Medicare will not cover your long-term care needs. And if you do meet their requirements, once that 100-day window closes, you’re on your own for 100% of the costs incurred.

Medicaid does cover skilled nursing facility care (not assisted living or personal care) for the impoverished. Medicaid is a benefit that is dependent on the value of your assets, which means your assets have to be depleted to a very low level before the government will step in and help you pay for your long-term care bills. This level varies on a state-by-state basis. You must apply through your State Medical Assistance office to see whether you qualify for assistance.

Pennsylvania Long-Term Care Medicaid Eligibility 2021

The preceding sections are designed to help you understand how you can pay for care – privately or through government programs. But if you or a loved one are considering long-term care, we recommend that you also talk with someone who can help you to understand your own financial situation, such as a hospital discharge planner, your local Area Agency on Aging office, or county’s Medical Assistance office. It is also recommended that you talk with an elder law attorney at Fiffik Law Group, who can help you understand how to best manage your assets.

costofcare 2020
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