Paying for Your Needs
Determining how to pay for long-term services and supports is a daunting task. There is no single answer, since everyone’s circumstances are different. For instance –
- Do you have long term care insurance coverage?
- Will you use personal income and assets to pay for all or part of your care?
- Are you relying on Medicare or other benefits to cover some of the costs?
- Do you qualify for one of the special programs funded by the state and/or federal government?
Individuals needing long-term services and supports must usually pay for these services with their own resources (income and assets), unless they have purchased private Long-Term Care Insurance, they qualify for the Connecticut Medicaid Program (Title 19), the state/federal health coverage program for certain individuals with low-incomes, or qualify for some State-funded programs.
Unlike long-term care insurance, traditional forms of health insurance, including Medicare and Medicare Supplemental Insurance, are not designed to pay for long-term services and supports. Although Medicare is the major health insurance program for the elderly and eligible persons with disabilities, it does not cover most long-term services and supports costs. Medicare covers nursing home stays for not more than 100 days following a hospital stay of at least three days and assisted living costs are not covered. With regard to home health care, coverage is limited by type and duration, focusing on rehabilitation rather than long-term care.
For those individuals with low-incomes and few assets, the Connecticut Medicaid Program covers long-term services and supports at home, in community residences, assisted living facilities and in nursing homes. It is not uncommon for individuals to begin to pay for their long-term services and supports out of their own pockets and, due to the high cost of care over time, exhaust or ‘spend down’ most of their resources. Once impoverished, they become eligible for Medicaid to pay for their long-term services and supports. In fact, about one in three people entering Connecticut nursing facilities as private pay will eventually spend down their assets and qualify for Medicaid.
Note – Do not confuse Medicare with Medicaid. Medicare is the national health insurance program for people age 65 and older and eligible people with disabilities under age 65. Medicaid is a federal/state medical assistance program for certain low-income individuals provided through the Connecticut Department of Social Services.
For more information:
CHOICES, Connecticut’s health insurance assistance program, provides free counseling about health insurance, Medicaid and Medicare. If you are an older adult, call the Area Agency on Aging to speak with a counselor. If you are a younger person with a disability, contact the Centers for Independent Living in your area. In addition, Benefits CheckUp, a website developed by the National Council on Aging, can help you find federal and state programs that provide assistance.
Costs of Long Term Services and Supports
For up-to-date information on the specific private pay costs of various long-term care supports and services, including home and community based services and nursing home care, please click here.
Options for Paying
To explore the options for paying for long-term care support services, click on the links below: