Finding the Right Care: The Finances

Jackie Hollis, Accounts Receivable Manager | September 20, 2018

At Villa St. Francis, we know how overwhelming the process of finding the right community for your loved one can be. It’s a big decision, and it’s important to get the process done right the first time. Often the complications, stress, and emotions can cause family members to make a move they might later regret. It’s our mission to provide care with compassion, excellence, and dignity – not just to our residents, but to their family members and caretakers as well. If you find yourself in the midst of this situation, we’re here to help. We’ve put together a quick overview of the smart steps you can take to get started with the financial side of the process.

Step 1: Figure out what you need.

Before we even look at the financials, you need to know what level of care you’re looking for. From Independent Living to Skilled Memory Care and everything in between, there are so many factors that go into determining the care level your loved one needs. Step one in this process is to contact your Area Agency on Aging to schedule a CARE Assessment (Client Assessment, Referral and Evaluation). This free assessment is required prior to admission to any Kansas nursing home, and will provide you not only with a better idea of what level of care your loved one needs, but also with resources as you begin your search.

Once you’ve narrowed down your options to communities that meet your loved one’s needs, you’re ready to dig into the financials.

Step 2: Figure out how you’ll pay.

Private pay, Long Term Care Insurance, VA, Medicare, Medicaid… The list of ways to pay for senior care is a long and complicated one. Sitting down with a specialist at your perspective community to discuss your options will help empower you to make the best financial decision for your loved one. At Villa St. Francis, filling out our Financial Data Profile is a great way to start the conversation with your family and to ensure you have all your bases covered. We’ll help you predict ancillary costs that can be easy to overlook when planning – things like incontinence supplies, wheelchair rentals, medication costs, etc. We’ll also help you decide the most efficient way to cover the cost of care based on your loved one’s needs and means, and to determine what, if anything, might need to be handled out-of-pocket.

Below is a quick breakdown of the three main ways senior care can be paid for – private pay, long term care insurance, and Medicaid. 

• Private Pay. Maybe you or your loved one were able to plan ahead for senior care and have funds set aside, or maybe your loved one’s monthly income from pension, social security, and retirement funds will cover the cost of care. If you complete the Financial Data Profile and determine you’re able to privately pay for the cost of your loved one’s care without insurance or Medicaid assistance, you’re ready to move forward with admission paperwork.

• Long Term Care Insurance. From Genworth, to Allianz, to John Hancock, there are a variety of Long Term Care insurance providers that we work with at Villa St. Francis. If your Financial Data Profile determined that your loved one purchased insurance to help with the cost of care, you’ll want to check with the communities you’re considering to confirm they accept your provider’s plan. Once you’ve made a decision and confirmed your loved one’s coverage applies, it’s time to reach out to your insurance provider to submit a claim, and to begin the community admission paperwork. From there, the community will work with the provider to complete any necessary paperwork, and to determine what, if anything, will need to be paid out of pocket.

• Medicaid. If you’ve worked through the Financial Data Profile and determined that your loved one has less than $2,000 in assets, you’ll need to determine whether or not the communities you’re considering accept Medicaid, a joint federal and state program that provides health care coverage for low-income individuals. At Villa St. Francis, we’re here to help you determine if Medicaid is the right fit for your loved one, and to walk you through the application process. When applying for Medicaid, there are a few key things to consider:

  • Is your loved one married? If so, your loved on and their spouse will want to work with an Elder Law attorney who specializes in Medicaid laws to assist with the division of assets.

  • Has your loved one given any sizable financial gifts or sold any large assets in the last 5 years? Be sure to disclose this information to the specialist at your community, as these could lead to the assessment of penalties from Medicaid.

  • Does your loved one have any kind of income? Are they a vet, or the spouse or widow of a vet? Do they have a life insurance policy, or any additional assets (i.e. a boat, land, automobiles, etc.)? These will all be factored in when determining whether or not they’re qualified.

  • Has your loved one outlined funeral plans? While it can be a tough conversation to have, these will need to be prepared and irrevocable before applying for Medicaid.

A few additional tips to consider:

• We highly recommend designating a Financial Power of Attorney long before one becomes a necessity. The process is separate from your Healthcare Power of Attorney, and is quick, easy, and will give your family the peace of mind knowing if your loved one’s conditions changed tomorrow, you’d be able to make financial decisions on their behalf.
  If you find yourself in need of an Elder Law attorney and aren’t sure where to turn, check their websites. Many offer free E-courses to help you determine whether or not their services will match your family’s needs.
  Sometimes, even the best savings plans can only go so far. Make sure you talk to your community about what will happen if your loved one someday runs out of funds to cover the cost of care. Determining the likelihood of this happening and having a plan in place for when it does will save you months of unnecessary stress down the line.

We know there’s a lot that goes into this process, and it can be draining both emotionally and financially. That’s why the Villa St. Francis team is set up to provide you with compassionate, expert assistance and advocacy every step of the way. We know that at the end of the day, the most important part of this situation is your loved one, and we work hard to enable you to focus on them while we handle the rest. If you have any questions, or want to sit down with us to discuss how all of this information applies to your loved one, call us or email us today to schedule an appointment.