The Key to Accessing High-Cost Care

Stays in nursing homes and assisted living facilities are increasing as the baby boomer generation reaches its golden years. Unfortunately, most senior living facilities are expensive and those costs continue to rise.

Since qualifying for facility benefits can be difficult under Medicare, without assistance, there’s no soft landing when those bills arrive.

So what can you do for your clients? You offer a short-term care plan. Depending on the carrier, these plans offer benefits for up to a year in nursing homes, assisted living facilities, home health care, adult daycare, or hospice care.

Here’s how you can help your clients secure the right plan when the cost for services are high and the insurance coverage is low.

Listen to this article:

Understanding Rising Costs

The median bill for a private room in a nursing home is now $92,376 a year. That means that one year in a nursing home can now cost nearly as much as three years of tuition at a private college. Yikes. That’s not chump change. Which begs the question: Are your clients prepared?

It’s important to help them, and, in some cases, their adult children, understand the reality of health facility costs — not to scare them, but to prepare them for what they’re undertaking. Showing them the importance of preparation can help you showcase the benefits of the short-term care plan.

Facing Scarcity of Coverage

It’s also important to help your clients understand the coverage they qualify for. To qualify for nursing home benefits with Medicare, the beneficiary:

  • Must have spent three days as an inpatient in the hospital prior to their nursing home stay.
  • Must be receiving skilled care on a daily basis. The majority of care received in nursing homes is custodial.
  • Will only receive benefits after spending 20 days in the nursing home and benefits end at a maximum of 100 days.

In contrast, short-term plans:

  • Don’t require a hospital stay.
  • Provide benefits for all levels of care.
  • Can provide benefits for up to a year.

The other option for seniors are long-term care plans, but they can be expensive with difficult underwriting. Short-term care plans are a great middle ground for seniors who don’t qualify or can’t afford their Medicare or long-term care options. When you consider the costs Medicare beneficiaries could be left with, short-term care plans bring tremendous value.

Keeping Your Clients Informed

The more your clients understand about their options for senior living, such as nursing homes, hospice care, and assisted living facilities, the easier it is to get them into a plan that meets their needs.

Set an appointment or send out a letter to present your clients these key factors in their care, costs, and benefits. Since even a short stay could deplete a senior’s life savings, it is paramount that they are given every opportunity to secure the protection and peace of mind they deserve when it comes to their health coverage.

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