What are some considerations for Senior Citizens who plan to move?

Two of the largest determinants of where a Senior may plan to move are their health status including whether they need assistance and what type of financial support they may need. If the Senior is married often times they may be able to live independently, however their spouse may need more support than they can provide. The cost of Independent Living Communities are on the average $2800.00 a month. The cost of Assisted Living can run over $4000.00 a month and at the highest spectrum are Nursing homes at well over $7000.00 a month. To fund Senior Living, Seniors use assets such as retirement funds, sale of property, savings accounts, investments, Social Security income and rental of property to name a few. Some Seniors may also have a part-time job to supplement their income. Both nursing homes and Assisted Living have requirements that Seniors must need assistance with activities for daily living (ADLs). Admissions are screened to determine eligibility based on need. In other words, just because you want to be there does not mean you can be there. Conversely, Independent Living facilities require the Senior to be able to live independently with little or no assistance.

One option many people do not know about is the Reverse Annuity Mortgage (RAM). These are offered through Montana Housing 800-761-6264 website: housing.mt.gov/Homeownership/Reverse-Annuity-Mortgages. To qualify household income must meet the guidelines and the property has to be located in Montana and have no other mortgages or liens attached. The income from a RAM can help the Senior remain in their home by providing extra income.

Lastly an important point for all Seniors to know is that Medicare is NOT an option to pay for Assisted Living or Nursing Homes, Medicare will pay a limited number of days in a SKILLED nursing facility. Criteria has to be met in order for Medicare to pay a portion of the first 100 days maximum. The first requirement is that the individual has to have been in a hospital in an acute care bed for 3 over nights (Observation and Assessment status does NOT qualify). Then your physician has to decide that you need addition care in a skilled nursing facility for the same condition for which you were hospitalized. Even if all conditions are met only days 1-20 are paid in full by Medicare, days 21-100 have a co-pay of $194.50 per day and after day 100 the individual pays 100%. For more information go to: medicare.gov/coverage/skilled-nursing-facility-snf-care.

In the case of nursing homes and assisted living there may be financial help in the form of Medicaid (Public Assistance) if the individual qualifies by meeting the income guidelines. In the case of couples, congress enacted Spousal Impoverishment provisions to help ensure the spouse still living at home is able to live out their lives with independence and dignity. This provision allows the spouse living at home about ½ of the income resources up to a specified about. This varies from state to state. In 2022 general guidelines allow the spouse still living in the community between $27,480.00 minimum and $137,400.00 maximum resources. The Department of Public Health and Human Services in Montana has published a guide called: “Can Medicaid help with my nursing home bills?” located: dphhs.mt.gov/sltc/aging/longtermcareombudsman/brochures. Medicaid may also in some situations help pay for Assisted Living facilities. This is dependent upon the person meeting the level of care need for Assisted Living and qualifying for Medicaid Home and Community based services otherwise known as a Medicaid Waiver. The State only allows so many waiver spots so often times there is an extensive waiting list. If one qualifies for a waiver they may be able to get services in their own homes as well: dphhs.mt.gov/sltc/csb.

Another option for people who can afford it is Long-term Care Insurance. One should consider purchasing LTC insurance by the time they are 65. If you are in poor health, you might not be accepted. LTC insurance is a good option if you have assets you want to protect such as a family farm or ranch. Not all LTC insurance policies offer both Assisted Living and Nursing home coverage so research carefully before purchasing.

Lastly, if you are a service-connected Veteran and signed up for VA health care you may qualify for some assistance in your home or with long-term care costs. Montana also has three VA nursing homes located in Glendive, Columbia Falls and Butte. For more information: va.gov/health-care/about-va-health-benefits/long-term-care/ or contact your service representative: Brenda Evans Veteran Service Officer Montana Veterans Affairs Division – Havre 406-265-4225Fax: (406) 204-3916 or (406) 265-2666 [email protected].