Q: I have been talking with friends about the cost of nursing home care, and we differ on how these costs can be covered. Can you shed some light?
A: About half of all nursing home residents start out by paying costs out of their personal resources. As these resources decrease, those who have long stays eventually become eligible for Medi-Cal assistance. Medi-Cal, a state and federal program, will pay most nursing home costs for patients with very limited income and assets. Medi-Cal will, however, only cover the costs of nursing home care in a Medi-Cal-certified facility.
Many incorrectly believe Medicare and supplemental insurance will cover the costs of nursing home care. Under certain conditions, Medicare will pay for some costs for beneficiaries who need skilled care or physical or speech therapy. To be covered, they must meet strict qualifications, and even then, coverage is for a limited time. Medicare never covers custodial care.
Long-term-care insurance is a private insurance that can be bought to cover the cost of care. Generally only relatively healthy people qualify. Usually premiums are based on age, Therefore, the younger you are when you buy coverage, the lower the premiums will be.
Some people may have these costs covered or partially covered by managed-care plans or employer benefit packages.
Q: My neighbor receives an SSI check from the federal government each month. Is this the same as Social Security?
A: No. Although SSI, or Supplemental Security Income, is overseen by the Social Security Administration, the money comes from the general fund of the Treasury.
SSI is for people with financial need. Checks are paid to those who are 65 and older, as well as to blind or disabled people of any age if they meet eligibility requirements. Applicants must have very little or no income and very few assets. They must be U.S. citizens or in the country legally and live in the U.S. or Northern Mariana Islands.
Part of the funds in the SSI check may come from the state. For convenience of the recipients, the state and federal governments have agreed to combine their payments into one check that is rendered by the federal government.
Applicants must apply for other benefits, such as Social Security, before eligibility for SSI can be determined. For more detailed information about eligibility and benefits, contact the Social Security Administration.
Applicants found eligible for SSI are usually also eligible for Medi-Cal, and a separate Medi-Cal application is unnecessary. SSI recipients are ineligible for food stamps, as the state provides funds through SSI.
Not all SSI recipients get the same amount of benefits.
Today: “Let’s Look At Our Driving Skills” seminar from 1:30 to 3 p.m. at Westlake Village Civic Center, 31200 E. Oak Crest Drive in Westlake Village. No reservations required.
Tuesday: “The Loneliness of a Caregiver” seminar from 4 to 5:30 p.m. at Senior Concerns Day Care Center, 401 Hodencamp Road, Thousand Oaks. Call 497-0189 for information and reservations.
Feb. 22: Advocate one-on-one counseling services from 9 a.m. to 1 p.m. at Moorpark Active Adult Center, 799 Moorpark Ave., Moorpark. Call 517-6261 for information or an appointment.
Betty Berry is a senior advocate for Senior Concerns. The advocates are located at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362. Call 495-6250 or email email@example.com. (Please include your telephone number.) You are invited to submit questions on senior issues.