Paying for Assisted Living and Memory Care Using Long-Term Care Insurance
Mike McClernonNov 26th, 2020
Financial & Legal Considerations
Assisted Living or Memory Care communities are great options for many seniors. And on Long Island and in Greater NYC, we are fortunate to have many exceedingly high-quality, nationally recognized communities from which to choose. Assisted Living supports seniors who need some help with the Activities of Daily Living (ADLs), like dressing and bathing.
Memory Care is an extension of Assisted Living, providing help with ADLs as well as providing specialized support for dementia. But like all health care, it is expensive. Private Pay Assisted Living on Long Island and in Greater NYC ranges from around $4,000 to over $10,000 per month, and Memory Care is typically $7,000-$12,000 per month. And although there are a few Assisted Living Communities on Long Island that accept Medicaid, most do not. And there is virtually no Medicaid funded Memory Care in New York State.
Long-Term Care Policies Can Help Pay for Assisted Living and Memory Care
That is where long-term care (LTC) insurance comes in. Most LTC insurance policies cover expenses at an accredited Assisted Living community. While every situation is different, most Assisted Living and Memory Care communities qualify for reimbursement by LTC policies. In fact, many LTC policies will pay for most or even all the cost of Assisted Living or Memory Care. Each policy has payout limits – daily, annual, and lifetime. The good news is that insurance could cover 100% of your assisted living expenses, based on limits set in the policy itself.
Generally, Assisted Living and Memory Care communities are ‘pay as you go’. They give the senior or family a bill each month, and it is up to the recipient to pay the bill. The senior or family pays the bill each month from income or assets. In the case of LTC insurance, the family sends the bill to the insurance company for reimbursement. One important note – LTC is generally not paid out for general living expenses, like residence in a 55+ apartment complex. Care within an accredited Assisted Living or Memory Care community is understood to provide care services and health supervision and are covered. Assisted Living Locators of Long Island works with Accredited communities, and we can give you help before placement in verifying that your LTC policy will reimburse in the Communities we present to you.
To confirm that an Assisted Living or Memory Care community you are considering is acceptable relative to your LTC policy provider, policyholders or their power of attorney can call their insurance company to request a provider inquiry. To ensure that payments will go through, many people work with a private LTC insurance representative beforehand. For policyholders looking at specific communities, it is important that they call their insurance carrier before deciding on a specific community. It is important to confirm that the Assisted Living or Memory Care community chosen meets the requirements of the policyholder’s policy. If there is any question about coverage, these need to be answered before a financial commitment has been made to a community.
Assisted Living Locators of Long Island is ready to help you evaluate the 100 + Assisted Living communities on Long Island and in Greater NYC and 60 or so options for Memory Communities in our area. We can help you determine which community is the best fit on a number of levels, including financial, how long assets will last at a particular community, and how to access assets like long-term care policies to pay for the best and most appropriate care on Long Island and in the Greater NYC area.