Long term care is a costly proposition for which few people are prepared. Yearly costs for a nursing home stay average $47,000 in Maricopa County at the present time. Many people mistakenly believe that Medicare will cover the cost of long term care, but Medicare only pays for approximately 9 percent of nursing home costs. Rather, Medicaid - the health insurance program for those financially and medically eligible - picks up almost 70 percent of the tab.

Medicare is a federal health insurance program for people over 65 and certain disabled people under 65. It is not a long term care program. Rather, Medicare covers only those nursing home facility services rendered to help a beneficiary recover from an acute illness or injury. Medicare is administered by the federal government’s Centers for Medicare and Medicaid Services (CMS) and is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Payments are made to providers through private insurance companies with which the government contracts or through HMOs who have risk contracts with Medicare.

Medicaid is a cooperative federal-state program designed to provide assistance to low-income people. It has become the major funding source for long term care. Medicaid is administered by the states under broad federal guidelines. Reimbursement rates per day of care also are set by the States. The Arizona Long Term Care System (ALTCS) is a Medicaid program administered by the Arizona Health Care Cost Containment System (AHCCCS). ALTCS provides long term care services to Arizona residents who meet financial and medical criteria.

Because many Americans fail to plan for their long term care needs, tens of thousands of Americans are impoverished each year by the cost of long term care. Recently enacted health insurance legislation has helped make private long term care insurance an important option to paying for long term care costs. Long term care insurance can protect personal assets and inheritance for the family, provide greater choice in the selection of long term care settings (nursing and assisted living facilities) and generally provide for financial security. Recently enacted federal health insurance legislation has helped make private long term care insurance a more viable option for paying for long term care costs while preserving personal savings, choice and dignity.

The Department of Veteran’s Affairs (VA) provides care in its own facilities to veterans in need of skilled and intermediate nursing care. In some communities, the VA contracts with local facilities to provide care for veterans. Beds are available to all veterans on a space-available basis. Contract your local VA for information.

LongTermCareLiving.com provides additional information on paying for long term care.