An overview of senior care agency costs
by Sue Lanza
Being a senior doesn't automatically equate to the need for health care but at some point in your aging journey, you or a family member may be faced with some quick decisions about health care. Why not prepare yourself by reviewing some basics about health care costs?
General Cost Considerations
- Information about health care costs is presented generally or by what pertains to the majority of the population. Each family member is an individual so you must remember to review how your specific situation applies to the cost factors.
- Health care costs are often quoted in either daily rates, monthly costs, annual spending, or for a one time visit. When comparing the costs of one facility or agency to another, be sure that you measuring the same thing. For example, if you are looking at a day rate from an Assisted Living facility, you would be wise to consider other facilities by their day rates to see if they are comparable.
- Insurance may cover some or none of your costs. Hard as it is to believe, the insurance you have been paying into for years may not reimburse you for expenses as you expected. Make it a point to understand the limitations of your Medicare coverage, Medicare gap insurance, and other managed care policies before you need to use them.
- Cost is normally based on the amount of care or services that you require with companion services costing the least all the way up to skilled nursing care or hospital care costing the most.
Levels of Care
The first step in determining your potential health care cost is to know what level of care you may need. Often this step is accomplished by meeting with a health care professional--either your doctor, an agency, or facility representative. Once you know the level of care desired, you can shop among similar facilities or agencies that provide that range of care. You may even be able to receive some services in your own home so ask. Here are some of the most common entry points for care:
- Companion or Simple Non-Medical Home-Care Services. Help with activities such as light housekeeping, reading/writing letters, food preparation or laundry would fall into this category. Often just a little help with these duties can help a person remain independent in their home environment.
Average costs: $15 - $25 per hour
- Home-Care, Medical Services. A trained staff member provides limited assistance with daily living skills such as bathing, feeding, medication management and nursing care such as injections, intravenous medications or wound dressing changes.
Average costs: $21 - $35 per hour
- Assisted Living. When home is no longer an option, a person may need assisted living with supervision 24 hours per day in a congregate living environment. Staff members are present but the residents of assisted living centers have their own living spaces, must have some level of independence and usually eat 2 or 3 meals daily with a group. The amount of supervision and added services regulate the costs in assisted living so be sure to look at the base price plus the amount of extra care to arrive at the final daily rate.
Average costs: $105.00 per day or $38,000 per year
- Long-term Care. Also referred to as "nursing homes" or "skilled care", these facilities are also 24 hour centers staffed by all types of personnel who can provide all the daily needs plus skilled nursing care and rehabilitation services. You may hear the term "sub-acute", which usually refers to a type of long-term care that immediately follows a hospital stay. The services in long-term care are extensive so the costs are the highest, other than hospital care
Average costs: $219.00 per day or $79,000 per year
Now that you have the rough information about costs, it is time for you to take a good hard look at what insurance coverage options you have. Will any of your plans pay for portions of your stay? How will you finance the care you need?
At this stage, you might look at speaking with your insurance agent, an elder care consultant, a financial official at your banking institution or even an elder care attorney. This basic information is meant to give you a starting point as you explore the right health options for you or your family member.