How Can Medicare Affect Senior Housing?


The Medicare program has been affected the past few years by the implementation of The Affordable Care Act of 2010 and the I.M.P.A.C.T. Act of 2014. These legislative changes were designed to move the risk of care costs from the Federal Government to healthcare providers. These adjustments mostly affect what is referred to as “straight” Medicare, not the Advantage Plans that insurance companies offer.  It does, however, affect the “gap” policies that insurance companies offer to pay the charges that Medicare does not cover.

Each year the rules that healthcare providers and insurance companies are required to follow change, so be sure to review your coverage every year. The commonality of the complicated changes each year is an idea called value purchasing. By focusing on each patient, a concept referred to as Patient- Centered care, the expense of healthcare can be reduced by shorter stays in hospitals and rehabs, fewer visit by home health professionals, and more responsibility for Primary Care Physicians, who should know the patient’s needs the best.

The entire system is based on family care, meaning the primary caregiver is a family member who provides unpaid custodial care at home for as long as each patient needs it. Custodial care is the assistance with activities of daily living, largely affected by the need to move about and accomplish personal care tasks. When a willing competent caregiver is available the system works well. Potential gaps include seniors living alone, spouses too frail to provide the family-care solution, or other family members unavailable due to careers.

Senior Housing, Independent, Assisted, and even Nursing Homes provide the meals and transportation required, as well as housecleaning.  Most provide or have available caregivers to replace the anticipated family member for care requirements.  When this is needed for short terms it is referred to as respite care.  Longer periods can be called long-term care, but a more common terminology for the assistance needed is Assisted Living. The industry has responded with a system that only requires a 30-day notice to leave.

With the peak of 10,000+ Baby Boomers joining Medicare daily still a few years away, it is highly probable that this effect will not change. The custodial care options are paid for privately, and not covered by Medicare. Therefore, caregiving by family or hired as homecare or Assisted Living care does not add cost to the Medicare system. Planning for the probable years that care will be needed is very important. CarePatrol is here to help even if there has not been a plan before. If Long Term Care Insurance has been purchased already, it eases the situation.

About the author
David Wilkins


CarePatrol of the Villages to the Gulf

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