Monday, March 14, 2016

Comparative Assisted Living (AL) Costs (Private Pay and Insurance)

                                                                  -12-
On average, assisted living costs are about double independent living costs ($80,000/yr instead of $40,000/yr) for a couple in 2015 (Charts 8 and 10).
Tiger Place had a high entry level independent living cost but has the lowest assisted living cost as the same price covers both levels of care (blue MIN). This advantage is lost if you become in need of all of the services provided (red MAX).
Provision Living at Columbia (MO) also had a high entry level independent living cost but has an assisted living cost comparable to Mill Creek and Lenoir Woods. In other words bundled pricing and level of care pricing can yield different and the same total costs depending upon which level of care is needed. It takes a spreadsheet to sort this out.
When day care is added to Mill Creek assisted living, the cost equals that at Provision Living with a full service plan. This requires a judgment call as to which set of services fit the resident the best. The same judgment is required to consider in-home care at 6 hr/day.
The nursing home (NH) Medicaid Missouri state reimbursement (capitation) rate of $6,000/mo ($72,000/yr) is shown at two levels in Chart 10 to show the effect of one person having long term care (LTC) insurance (blue MIN). Some insurance pays for AL. Medicare does not (in 2015) pay for AL for long term care.

A residential care administrator must review every long-term care (LTC) policy. Both the benefits and the site license must be considered. The insurance will only pay if they match; also check the care plan for by item or all-inclusive billing.

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