Missouri Long Term Care Insurance
Many people mistakenly think their health insurance or Medicare will pay
for any long-term care services they may need at some point. But health
insurance really only pays for doctor and hospital bills. If you develop
a chronic illness or become disabled and are unable to care for yourself
for an extended period of time, you’ll need long-term care services.
And these services aren’t cheap. Full-time nursing home care averages
more than $60,000 per year and even part-time, in-home care can cost
more than $20,000 annually.
Click here to get a customized long term care insurance quote.
Explore this section to learn more about who needs long-term care insurance,
what types of care are covered, policy options and features, and where to
buy it. There’s also information to help you get a sense of what
long-term care services cost in your area.
These are individual insurance policies that may help you when you are
unable to take care of yourself due to prolonged illness or disability.
However, policies may or may not cover home health care, adult care or
other alternative services.
Benefits paid by a qualified long-term care plan generally are not
taxable as income. Benefits from a non-qualified long-term care plan
may be taxable as income. Check with your tax advisor about the possibility
of deducting a portion of the premiums paid in addition to the individual
tax consequences involved.
You do. Medicare only pays for short-term stays. Medicaid may pay if you
are qualified for government assistance after spending down most of your assets.
An important part of planning for long-term care is deciding how to pay for services.
This is because long-term care is very expensive, and contrary to what many people believe,
their Medicare coverage will not pay for most of the long-term care services they need.
While some people may qualify for Medicaid – the major payer of long-term care services,
most people won't. There are other federal public programs, such as the Older American's Act,
or state funded programs, that pay some long-term care services, but like Medicaid they
target those people with the most functional and financial need. Consequently, if you are
one of the 60% of people over the age of 65 who will need long-term care services – there's
a very good chance you will have to pay for some or all of your long-term care services out
of your personal income and resources.
Paying for long-term care out of your personal income and resources can be challenging.
Even if you have a modest need for assistance at home with personal care, say a visit
from a home health aide 3 times a week, based on 2006 average costs, you would have to
pay about $16,000 a year for those services.
To make the best decisions about how to pay for long-term care you need to understand
what services cost, what public programs you are eligible for and what they cover, what
private financing options are available, and which ones work best for you.
LTC includes a broad range of health and support services that people need as they
age or if they are disabled. The majority of these services are personal care, or
assistance with activities of daily living that many families are able to provide
all, or some of, free. But, as care and support needs increase, paid care is usually
needed to supplement family provided services and supports, provide respite to family
caregivers, or to pay for more extensive services in a facility, such as a nursing
home or assisted living, when individuals can no longer be cared for in their homes.
There are variations in costs based on the type and amount of care you need,
the provider you use, and where you live. Home health and home care services,
provided in two-to-four-hour blocks of time referred to as “visits,” are generally
more expensive in the evening, or on weekends or holidays. The costs of services in
some community programs, such as adult day service programs, are often provided at a
per-day rate, but vary based on overhead and programming costs. Many care facilities
charge extra for services provided beyond the basic room-and-board charge, although
some may have “all inclusive” fees.
The average costs in the United States (in 2006) are:
- $171/day for a semi-private room in a nursing home
- $194/day for a private room in a nursing home
- $2,691/month for care in an Assisted Living Facility (for a one-bedroom unit)
- $25/hour for a Home Health Aide
- $17/hour for a Homemaker services
- $56/day for care in an Adult Day Health Care Center
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Avg. Daily Nursing Home Rate : Private
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Avg. Daily Nursing Home Rate : Semi-Private
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Avg. Monthly Cost in Assisted Living Facility
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Home Health Aide Average Hourly Rate
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Homemaker Services Average Hourly Rate
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Kansas City
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158.49
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138.14
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2,683.60
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22.48
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16.20
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Rest of State
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118.49
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107.65
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1,996.59
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17.65
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16.21
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St. Louis
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124.90
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110.70
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2,270.94
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27.74
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18.61
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State Average
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133.96
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118.83
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2,317.04
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22.62
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17.00
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Source: 2006 Cost of Care Survey, Genworth Financial, March 2006
If you have sufficient income and assets, you are likely to pay for your
long-term care needs on your own, out of those private resources. If you
meet functional eligibility criteria and have limited financial resources,
or deplete them paying for care, Medicaid may pay for your care. If you
require primarily skilled or recuperative care for a short time, Medicare
may pay. The Older Americans Act is another Federal program that helps
pay for long-term care services. Some people use a variety of payment
sources as their care needs and financial circumstances change.
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Long-Term Care Service
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Medicare
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Private
Medigap
Insurance
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Medicaid
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You Pay
on Your
Own*
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Nursing Home Care
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Pays in full for days 0-20 if you are in a Skilled Nursing Facility following a recent
hospital stay. If your need for skilled care continues, may pay for days 21 through 100
after you pay a $119/day co-payment
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May cover the $119/day copayment if your nursing home stay meets all other
Medicare requirements.
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May pay for care in a Medicaid-certified nursing home if you meet functional and
financial eligibility criteria.
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If you need only personal or supervisory care in a nursing home and/or have not
had a prior hospital stay, or if you choose a nursing home that does not participate
in Medicaid or is not Medicare-certified.
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Assisted Living Facility (and similar facility options)
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Does not pay
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Does not pay
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In some states, may pay care-related costs, but not room and board
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You pay on your own except as noted under Medicaid if eligible.
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Continuing Care Retirement Community
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Does not pay
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Does not pay
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Does not pay
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You pay on your own
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Adult Day Services
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Not covered
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Not covered
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Varies by state, financial and functional eligibility required
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You pay on your own [except as noted under Medicaid if eligible.]
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Home Health Care
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Limited to reasonable, necessary part-time or intermittent skilled nursing care and
home health aide services, and some therapies that are ordered by your doctor and
provided by Medicare-certified home health agency. Does not pay for on-going personal
care or custodial care needs only (help with activities of daily living).
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Not covered
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Pay for, but states have option to limit some services, such as therapy
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You pay on your own for personal or custodial care, except as noted under Medicaid,
if you are eligible.
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*See private finance options to learn more about a variety of
private financing options to help you pay for your long-term care needs.
The total amount spent on long-term care services in the United States (in 2003) was $183 billion.
This does not include care provided by family or friends on an unpaid basis (often called
“informal care.”) It only includes the costs of care from a paid provider.
While most information on “who pays for long-term care” presents these national figures,
it is important to remember that each person's individual experience will differ. These figures
combine the experiences of everyone receiving paid care, but there are significant variations
from person to person.
On an aggregate basis, the biggest share, 48 percent, is paid for by Medicaid. On an
individual basis, however, “who pays for long-term care” can look very different. This is
because people with their own personal financial resources do not qualify for Medicaid unless
they use up their resources first paying for care, so-called “spending down”. If you have
reasonable income and assets, most likely you will be paying for care on your own.
Also, while Medicare overall pays for 18 percent of long-term care, it only pays under
specific circumstances. If the type of care you need does not meet Medicare's rules,
Medicare will not pay and you are likely to pay for your care on your own.
Learning more about the “rules” for when Medicare, Medicaid, other public programs or
private insurance might pay for long-term care is an important part of understanding
“who will pay” if and when you need care.
Click here to get a customized long term care insurance quote.
Copyright © 2008 by The Insurance Resource