Some programs require people to `spend down’

By Jim DeBrosse Dayton Daily News 

Dayton Daily News (OH) – Wednesday, December 8, 1999

Most of the cost of long-term care is typically paid by consumers and their families, although Medicaid will help the poor and those who have depleted most of their financial resources. 

The average yearly cost for nursing home care is about $46,000. 

Home care averages between $55 to $200 per visit. Adult day care runs $30 to $130 per day. 

Assisted living facilities, which are strictly private pay, can charge anywhere from $2,000 to $4,000 per month, depending on their services and level of care. 

Medicare covers only short-term acute health care services – up to 100 days in a nursing home or any medically necessary home health visits. 

Medicare will not pay for personal or custodial care such as help with bathing, dressing or eating, or for community support services such as Meals on Wheels, either at home or in anursing facility. 

Medicaid is the joint federal-state program of medical assistance to low-income people of all ages. 

Nursing home care and, in limited cases, in-home services can be paid under Medicaid, but financial eligibility requirements are strict and may require you to `spend down’ your income and assets until you reach the eligibility level. 

Long-term care insurance may pay for nursing home, community support and home care services that Medicare and Medigap policies do not cover. 

However, policies vary in terms of coverage, and premiums may be expensive – a good policy can cost $2,500 a year for a 65-year-old, and more than $8,000 per year for a 75-year-old. You may be denied coverage based on your health status or age. 

Private pay means drawing on your own resources instead of the government. 

Those resources include savings, investments, a home and insurance policies, mainly life or long-term care insurance. 

The Taxpayer Relief Act of 1997 changed the rules on the sale of a home so that, after May 6, 1997, profits on home sales are tax-free up to $250,000 and up to $500,000 for a couple. 

A reverse mortgage allows you to tap the value in the home if you are not in a position to sell because there is still a spouse at home or you want to pass it along to your children. 

Unlike a home equity line of credit, a reverse mortgage provides payments to you each month, assessed against the future sale of the house. 

Financial institutions in your area can provide information on how much your house is worth and how much they will pay you each month. 
WHERE TO GET HELP 

* For information about Medicaid or Medicare, contact the Area Agency on Aging at 341-3000 or (800) 258-7277, or visit their Web site at http://www.info4seniors.org 

* For information on private insurance matters, contact the Ohio Senior Health Insurance Information Program, a service of the Ohio Department of Insurance. 

Counselors are available to help answer many of your questions by phone. Call (800) 686-1578. Or contact the Health Insurance Association of America in Washington, D.C. at (202) 824-1600. 

* For brochures and information on reverse mortgages, long-term care insurance and other financial matters, contact the American Association of Retired Persons at (202) 434-2277.