Long Term Care is not a subject that people spend much time thinking about– unless they need it.  Until most people focus on the subject, they have a vague sense for the various forms of care and don’t really know the differences between Homecare, Assisted Living, and Nursing Home care.  A nursing home– something you visited a long time ago when your grandparents were there?  Homecare– care at home?  Assisted Living– sort of like a really nice nursing home?  Here is a simple breakdown of the four primary forms of long term care to help you better understand what they are– and their differences.

1- Home Health Care: Living support and care at various levels provided at home by licensed or unlicensed workers as well as designated family members.  Home health is primarily private pay, but Medicare and Medicaid will reimburse some forms of “medically necessary” home health services provided by licensed practitioners for people meeting eligibility requirements.  Private pay is accepted and will cover a wider variety of medical and non-medical services.

2- Assisted Living: Housing for the elderly or persons unable to live independently that will provide mid-level custodial care, medication support, lifestyle activities, transportation, and meals.  Assisted Living is a “private pay” environment not covered by Medicare and Medicaid.

3- Nursing Home: Higher level “skilled or SNF care” provided in a licensed facility with transfer agreements in place with hospitals for people requiring long term medical or nursing care; or short term rehabilitation services for injured, disabled, or sick persons. Medicare will reimburse 100 days of “medically necessary” rehabilitation care, and Medicaid will reimburse long term care for those people meeting medical necessity and eligibility requirements.  Private pay is accepted and will allow for more choice such as private rooms, enhanced lifestyle options, and wider selection of locations.

4- Hospice: A specific form of care to manage pain, symptom relief, and emotional/spiritual support provided to people typically in the final 6 months of life as certified by a physician.  Hospice care can be provided at home, in an assisted living community, a nursing home, or a free standing care center.  Medicare and Medicaid will reimburse for certain levels of Hospice care.  Private pay is accepted and not subject to requirements to be medically re-certified every 60 days.