Downsizing or Retirement - Life on your Terms

RISMEDIA, January 20, 2010

Recent headlines pointing to the detriments of reverse mortgages aren’t getting the story straight. One of the nation’s leading reverse mortgage lenders, Generation Mortgage Company, wants to separate fact from fiction.

The top 9 most common reverse mortgage myths include:

Medicare  and  Medicaid  Information

Confused about the relationship between Medicare, Medicaid and long term housing solutions? Read below for some clarification.
(provided by the Better Business Bureau)

Medicare

Many people mistakenly believe that Medicare, which is administered by the Health Care Financing Administration, covers the costs of most long-term care services. In reality, Medicare only covers short- term, acute care during a hospital stay.

Medicare is a federal insurance program that provides insurance to millions of Americans who meet the following criteria:
1. People who are 65 years of age
2. People who are disabled; and
3. People with permanent kidney failure.

Medicare ( Part A ) may help to pay for nursing care only if a person meets all of the following conditions:
1. A person requires daily skilled nursing or skilled rehabilitation services that can only be received in a Skilled Nursing Facility (SNF). This need must be certified by a doctor.
2. A person has been hospitalized for at least three days in a row (not including the day of discharge) prior to entering a SNF.
3. A person enters the SNF within a short time (usually 30 days) after leaving the hospital.
4. A person's care is for an illness that was treated in the hospital or arose when he or she was in a SNF for an illness treated in a hospital.

Medicare (Part A) can help pay up to 100 days of skilled care in a SNF during a benefit period. It pays for all covered services for the first 20 days. For days 21-100, a daily co-insurance amount can be charged to a Medicare recipient. If a person requires more than a 100 days in a benefit period, he or she is responsible for all charges beginning with the 101st day of continued residence at a SNF .

Medicaid

Medicaid is an assistance program jointly financed by federal and state governments for needy and low-income people of all ages. Using broad federal guidelines, states design their own programs. Therefore, exact details of eligibility will vary from state to state.

Under certain qualifying conditions, Medicaid will pay for care in Skilled Nursing Facilities (SNFs) and also Intermediate Care Facilities (ICFs). Depending on the situation, if a person is eligible for both Medicare and Medicaid, Medicare will pay for its allowable benefits period if all requirements are met, after which, Medicaid will take over the financial assistance .

Private Insurance Policies

Some insurance companies offer private insurance policies specifically for long-term nursing home care. These policies vary widely in coverage and cost, and it is important to understand precisely what kind of policy you are purchasing.

Make sure the policy being considered does not duplicate skilled nursing facility coverage provided by any coordinated care plan such as Medicare or Medicaid or other coverage already received. Check for any prerequisites required before the company will pay benefits. For example, ask if the company requires that a patient have prior hospitalization before any benefits are paid out. Some diseases such as arthritis-related problems and Alzheimer's do not require hospitalization before the need for nursing care arises.

If possible, seek an insurance policy that pays benefits immediately upon entry into a nursing care facility. Many insurance policies, which are purchased prior to the need for nursing care, require a waiting period after entry into a nursing care facility before payments are made. It is highly unlikely that nursing care insurance can be purchased after a person has entered a nursing care facility.

Another private insurance policy, Medigap supplemental insurance , is designed to close the gap between medical costs and amounts paid by Medicare. However, both Medicare and Medigap are primarily designed for short term, acute care and, consequently, are unlikely to meet the long-term needs of nursing care residents.

As in all insurance policies, it is vital that you understand exactly what your policy covers. Specific questions about policies should be directed to your state's insurance commissioner.

Types  of  Senior  Housing  Facilities  &  Services

Senior housing is found in the following categories: 

ADULT DAY CARE :    A wonderful and cost effective alternative to live-in care. Adult daycare offers

a safe environment for adults during daytime hours to participate in a variety of planned programs 

including social activities, nutritional, nursing and rehabilitation services. 

INDEPENDENT LIVING:    Ideal for individuals who do not require personal or medical care, but 
choose not to live alone or at home. Most facilities are equipped with standard safety features to make 
it easier for residents to get around. It is a wonderful place for seniors to be with others that share 
similar interests. Many recreational activities are planned by the community, including day field trips, 
shopping excursions and on-premise projects. Most facilities offer optional meal plans for residents 
and the majority of apartments are equipped with a kitchen so the resident can prepare their own meals. 
While there may be wellness programs, there are NO care options available at these communities. 

Also known as: Senior Apartments, Retirement Communities, Congregate Living
 
ASSISTED LIVING:     An excellent choice for people who choose not to live on their own and do not 
necessarily require 24-hour care. Assisted living facilities offer a homelike atmosphere with trained 
professionals who are available to help residents with their daily routines. An activity coordinator 
arranges both on and off premise activities for residents.


Also known as: Residential Care, Personal Care, and Adult Congregate. 

NURSING HOMES:    Offer 24-hour a day care for those who can no longer live independently. 
Nursing homes are equipped with medical professionals and supplies to offer specialized care for 
those with severe illnesses or injuries. Trained staff members assist residents with personal and 
daily activities such as getting out of bed, bathing, eating, using the bathroom and regulating 
medications. Nursing home facilities offer daily meal plans, laundry, housekeeping, medical services 
and a wide array of planned recreational activities.


Available services offered through Nursing home care (obtained from BBB)
 
Medical:     Many nursing facilities require residents to be treated by their own private physicians. 
However, every community should have a doctor available on a 24-hour emergency basis. If a 
community does have a staff doctor, ask how often he or she visits and/or monitors residents. Verify 
this information with other residents. With access to a resident's medical records, a community doctor 
may devise a treatment plan for the resident. The community should uphold a legally competent 
resident's right to have the final say in any matter affecting his or her health.
 
Hospitalization:    Every community must have an arrangement and procedure with a nearby hospital 
to handle patients who become seriously ill. Find out how the community handles such emergencies, 
including transportation, paramedic first aid, etc.
 
Nursing Services: There should be a registered nurse (RN) directing nursing services. RNs are 
assisted by licensed practical or vocational nurses (LP/VN) who have at least one year of specialized 
training. Nurse aids and assistants, who work most closely with residents' bathing, eating, dressing, etc., are supervised by licensed nurses.
 
Physical Therapy: If a resident needs assistance in regaining lost abilities such as walking, talking, or 
dressing, make certain that the community is adequately staffed with qualified physical therapists.
 
Grooming: Ask how often residents have access to barbers, beauticians, and other grooming services, 
including hair washing, manicures, etc.
 
Activities: Discover what types of activities are available for residents, including games, movies, crafts, 
classes, field trips, etc.
 
Social Services: A social worker on community staff or as a consultant can help with the adjustment 
process and provide community and financial resource information.
 
Religious Services: Residents should have the opportunity to attend religious services and visit with 
clergy of their respective faiths.  

CONTINUING CARE RETIREMENT COMMUNITIES:    Retirement communities comprise an 
entire campus of living choices from private homes and independent living to assisted living 
and even skilled nursing facilities. The residents can age in a place without having to relocate. 
They provide a type of housing no matter what your medical needs.

Financial Commitment:    To live at a CCRC, you may or may not have to pay an entrance fee 
or "buy in". Be sure to ask whether the fee is refundable or if it can be put in escrow for future 
health care. Additionally, there will be monthly payments that cover rent, meals, services, 
amenities and/or medical care.


Requirements:    Many times the community will have requirements to live there. They may be 
based on age, income, health status and/or financial assets. 


The types of residences that you may find at a CCRC are: 

Patio Homes 
Apartments 
Studios
Suites 
Nursing Facility
   

ALZEIMER’S CARE:    Facilities offering specialized care to residents who suffer from memory 
impairing diseases such as Alzheimer's and Dementia. Most nursing homes and assisted living 
facilities offer these designated programs.  

ACTIVE ADULT COMMUNITIES:    The terms "Active Adult" or "Senior" refer to rental communities 
where you must be 55 years or older and sometimes 62 years or older to live. These options are 
designed specifically for "age qualified" adults who desire the maintenance-free lifestyle. They 
offer an independent lifestyle in addition to social and recreational activities with older adults.