Paying for Long
Term Care
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Medicare Part D Prescription Drug Plan
(PDP): can be a stand-alone plan (not joined
with other insurance) or it may be combined
with a Medicare Advantage Plan, also called a
Medicare Advantage Prescription Drug (MAPD)
Plan. Part D plans:
• Help cover the cost of prescription drugs
• May help lower prescription drug costs and
protect against higher costs in the future
Medicaid
Medicaid is the medical assistance program
that provides access to health care for eligible
families and individuals. Medicaid assists the
elderly and people with disabilities with the
costs of nursing facility care and other medical
and long-term care expenses. In Florida, the
Agency for Health Care Administration is
responsible for Medicaid. Medicaid recipient
care is managed through the Statewide
Medicaid Managed Care (SMMC) program,
implemented in 2014. Under the SMMC
program, most Medicaid recipients are enrolled
in a health plan. Medicaid covers long term care
expenses at home, an assisted living facility or
a skilled nursing facility, as well as medical and
prescription expenses. Please consult an elder
law attorney to determine eligibility and to
protect assets.
Long Term Care Insurance
The sole purpose of buying a long-term
care (LTC) insurance policy is to ensure that
funds will be available to pay long-term care
bills for a set period. Depending on the type
of LTC policy you purchase, a long-term care
insurance policy does pay for assisted living,
nursing home and in-home care.
• Standard Provisions: LTC policies are not
standardized, resulting in many different
policy designs. It is important to know the
types of coverages available, then to compare
each policy before purchase to make sure the
policy quoted carries the desired benefits.
• Coverage: While LTC policies vary in coverage,
they will usually pay either a fixed dollar
amount (an indemnity) or the actual costs
of care (reimbursement policy). However,
policies that pay for actual costs typically have
a specified daily benefit that places a limit on