As Medicare Advantage providers begin to implement new benefits, it is important to evaluate your insurance options during each Medicare enrollment period. Additionally, even with expanded benefits, it is still crucial to plan for long-term care. Private long-term care insurance, private paying, and Medi-Cal will still be the primary sources for paying for long-term care, not Medicare.
It is important to understand the options available to help you help your parents from in-home care and adult day programs; assisted living and board and care; to skilled nursing care. Although many of these options have significant costs, Medi-Cal may offer some financial relief. In particular, Medi-Cal will cover the cost of skilled nursing home care. Although Medi-Cal is a resource-based program, there are many strategies available to Californian residents to qualify for benefits without having to spend down your assets.
There are generally three types of fee structures: Flat Rate, Fee-for Service (may be called “point” system), and/or a hybrid, sometimes referred to as Levels of Care. Some places are creative in how they assess care charges but these three buckets will give you a general idea of what you are most likely to encounter in an Assisted Living environment.