How Medicare Can Cover Elder Services - Landmark Senior Living


Dec 17 2018

How Medicare Can Cover Elder Services

Post by: Jackson Bentley

Medicare is an excellent resource for covering a wide variety of healthcare needs. Unlike Medicaid, which is based on income, medicare provides coverage for health insurance for anyone 65 or older and anyone with a disability severe enough to qualify, regardless of income level. However, understanding and making use of health insurance through Medicare can be confusing for many. Choosing your Medicare plan can also be difficult if you do not understand the differences between each plan. Medicare is broken into four parts: Part A, Part B, Part C, Part D. Each plan comprises different benefits and there are some services that Medicare will not cover at all.


Original Medicare

OG Medicare is the most commonly used form of Medicare coverage, comprised of Part A and Part B. Each part covers different types of healthcare services. Part A is Hospital Insurance while Part B covers Medical Insurance.

Part A: Hospital Insurance

The first part of OG Medicare is used to cover residential (or inpatient) stays, residency ina skilled nursing home, hospice care, and several home health services. Similar to other insurances, there are limitations, deductibles, co-insurance, and other out-of-pocket costs. Part A can be used without a premium if your senior has worked and paid social security taxes for at least 10 years. If not, then a monthly premium will apply. If you are considering using your senior’s Medicare to cover assisted living or a nursing home, keep in mind that custodial services are not covered by Medicare.

Part B: Medical Insurance

Part B of Medicare covers most medically necessary equipment, doctors, mental healthcare needs, outpatient services, and preventative care, as well as some health and ambulance services. As with Part A, a monthly premium may be required in order to receive coverage from Part B.

Private Medicare

This is the part where medicare insurance can be confusing. Unlike original medicare, Part C and Part D Medicare plans are provided by third party private insurance companies that have contracts with the government. Once you are eligible for Medicare Part A and B you may choose to receive your Medicare benefits from a Medicare-approved private insurer by enrolling in a Medicare Advantage plan. To do so, you will need to enroll manually.

Part C: Medicare Advantage

Under Part C Medicare, individuals can receive similar coverage to that found under Part A and B. Known as Medicare Advantage, this plan also offers dental, vision, and hearing coverage’s that aren’t offered under Parts A and B. Medicare Advantage can actually be less costly than the out-of-pocket costs paid under original Medicare. Depending on your senior’s situation and medical needs there may be limitations and restrictions.

Part D: Outpatient Prescription Drug Insurance

Medicare Part D is primarily for covering prescription drug costs. If you choose to go with Medicare Part D, you’ll have to be covered by an existing Medicare plan. Many Medicare Advantage plans offer Part D coverage. If you have Original Medicare only, you can choose a stand-alone Part D plan.

As you attempt to transition your loved one into some form of daily care, it can be challenging to decide on which service is more cost-effective. Is In-Home care the way to go? Or does assisted living offer a broader spectrum of services for a flat rate? For many, these questions are essential in determining how their loved one will be cared for as they age. Below is information related to the expenses of daily senior care and which one might be more affordable for you and your loved one.

In-Home Care

In-Home care is most certainly the preferred care option for the elderly and their loved ones. Many seniors needing daily care want to achieve that in their own home, not in a facility or senior living community. The familiarity of one’s longtime home can bring a sense of peace, and in turn, that can help tremendously with the complications that follow In-Home care.

Correspondingly, you’ll need to make sure that you visit your loved one regularly, as the last thing you want is your loved one to form a co-dependent relationship with aides. Far too often family members hire home care for their elderly loved one and stop visiting them entirely.

Whether you and your family hire an aide or attempt to take care of your loved ones’ needs as a collective unit, there are lots of things to balance during the process.

Assisted Living Care

An elderly couple enjoying their apartment in their assisted living facility

Assisted living care comes with a plethora of pros and cons. For starters, there is only one monthly payment made to whatever company is hosting your loved ones, regardless of the amount of care he/she needs. Usual pricing at assisted living facilities is roughly $3500 a month. Amenities are provided and included in your monthly fee, there are no aides to pay hourly, and there are a multitude of inclusive activities for your loved one to participate in. Assisted living care is unique in the way that it offers all of the caring needs your loved one requires while simultaneously being an all-inclusive community for your loved one to enjoy.

Correspondingly, you can’t put a price on the comfort of your own home. At the end of the day you’d be asking your loved one to move out of their home; and regardless of how long they have been living at their home, it’s a transition that is difficult for almost everyone. The magnitude of transitioning into assisted living care can and does vary from person to person. This is an instance where proper communication between your loved one and your family must take place. No one knows how your loved one feels other than them. Make sure to ask a lot of questions regarding preferences of comfort if you have decided that an assisted living facility/community is the path to go on.

In Conclusion

Having an aging parent or relative living alone can be a dangerous, especially if there aren’t health professionals on call. With an assisted living facility, seniors can receive the care they need while socializing with other senior citizens and engaging in fun, new activities. There’s nothing more important than keeping your loved one safe and happy, you can do this by guiding them along as they choose how they want to live in the next chapter of their life. If you’re ready, have the conversation with your loved one about how senior housing can impact their life and discuss the options that they can choose from.

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