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Making Smart Housing Decisions: Considering the Costs

Cost factors to consider in senior housing decisions
When it comes to senior housing there are four main options to consider: in-home care, home share, assisted living and nursing homes. Too often though, cost is the key factor in the decision-making process.  Furthermore, many people believe that Medicare and Medicaid will cover them for particular senior services. They are disheartened to discover both programs only cover certain requirements and only for a particular length of time. This article examines each of these main options and the costs associated with them.

In-home care
In-home care is often the most economical, especially if family members can act as caregivers, which costs nothing monetarily. For those seniors requiring extra attention, costs vary greatly – from as little as $10 an hour for errand type services to hundreds of dollars per day for advanced medical aid. Full-service in-home care agencies normally charge anywhere from $15 an hour all the way up to $40 an hour, depending on location, certification and level of care.

In-home care isn’t covered under Medicare, while Medicaid coverage and private insurance options are extremely limited. However, wartime veterans, even those not injured during wartime, could qualify for a disability pension for themselves and/or their spouses of approximately $900 to $1,900 per month by filling out VA Form 21-526 at the Veteran’s Administration, which helps off-set some in-home care costs.

Home share
Along the lines of assisted living, home share is a similar concept of aging in place. Seniors can rent out extra space in their homes in exchange for money or in-home care. Places like the National Shared Housing Resource Center provide state-by-state information for match-up programs and shared living residences.

Assisted living
Assisted living is another option for those who have the funds and possess the key abilities of basic activities of daily living (known as ADLs). According to the AARP, “Estimates of the average monthly rate in assisted living range from approximately $2,100 to $2,900,” which many residents pay out of pocket since few people have private long-term care insurance coverage and public subsidies are limited. However, two federal places that people can turn to are the Department of Housing and Urban Development and Department of Health and Human Services. H.U.D. offers solutions like assisted living conversion programs, while the H.H.S provides help in finding resources on assisted living options in local communities.

Nursing homes
Now here is something that Medicare and Medicaid do cover. However, it’s only for a limited time – a fact many people don’t realize. Medicare coverage is limited, but it will pay for a fixed period of care in a Medicare-certified nursing home. They use a period of time called a "benefit period" to keep track of how many days of Skilled Nursing Facility (SNF) benefits the senior has received, and how many are still available. A benefit period begins on the day a senior starts using hospital or SNF benefits and they can get up to 100 days of SNF coverage in a benefit period. Once those 100 days are gone though, the current benefit period must end before the senior can renew the SNF benefits.

"Estimates of the average monthly rate in assisted living range from approximately $2,100 to $2,900." – AARP

Medicaid will also pay for nursing home care, but once more, it must be a Medicaid-certified facility. Furthermore, it only pays when countable property and assets are depleted (such as cash over $2,000, stocks, bonds, IRA’s, etc.). It’s important to note that individuals can continue to possess exempt items (a home, a car, household goods, etc.) and still receive Medicaid benefits. Medicaid is a partnership of the federal and state governments, so benefits provided vary by state.

As for the cost of nursing homes, MetLife says it varies by region, but the average national cost for care is more than $77,745 a year for a private room, and more than $68,985 for a semiprivate room. One option to offset this cost is long-term care insurance that offers two basic policies: nursing home care or only home care – but seniors need to be sure which one they are buying. Polices should be bought prior to the age of 65 to receive the best rates.  



     
  • Despite what many people believe, in-home care isn’t covered under Medicare, and Medicaid coverage and private insurance options are extremely limited.
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  • According to MetLife, the national cost for nursing care is more than $77,745 a year for a private room, and more than $68,985 for a semiprivate room.
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  • In a home share situation seniors can rent out extra space in their homes in exchange for money or in-home care.