From auto to home, insurance is an integral part of life. One of the more important varieties is health insurance, but no two plans or people’s medical needs are exactly the same. Consider those with a disability or condition and how their coverage needs vary from someone who is considered generally healthy.
Each type of disability and condition requires certain types of insurance to ensure the individual’s needs are met, ranging from government programs to long-term and life options. This article covers the types of insurance available to aid those living with dementia. Here’s what you need to know.
There are various government programs an individual with dementia can rely on. Medicare is the first and most common, which is available for those over the age of 65 or those under 65 who receive Social Security disability benefits. This program covers a majority of medical needs as well as nursing care, rehabilitation therapy, and prescription costs.
There is also Medicare advantage, which is a more managed care version that includes an HMO, PPO, and POS option. For the in-between, Medigap Insurance covers items that are either uncovered or come with high out-of-pocket costs under Medicare.
For those that cannot pick up Medicare, there’s Medicaid. This federal and state funded program helps those with low incomes maintain long-term health coverage. Each state may vary slightly, but Medicaid covers most costs and leaves individuals with mere dollar out-of-pocket costs.
Social Security plans also fall under government programs, but they’re worth discussing separately. First, there’s Social Security Disability Insurance or SSDI. SSDI is for those under age 65 with a disability, which means those with dementia who are unable to work because of the condition.
Second, there’s Supplemental Security Income or SSI. SSI provides a minimum monthly income for those with a qualifying disability like dementia, those over 65, or individuals with extremely limited income. For Both SSDI and SSI, make sure the individual with dementia meets the administration’s definition of disability.
Life insurance is beneficial to everyone, but those with dementia can rely on the quick cash they often need when in-between coverage. They can also receive part of the policy’s value as a loan. Make sure to review the plan before finalizing it, going over critical aspects like life insurance living benefits and accelerated death benefits. In some cases, life insurance policies can also be sold for immediate cash relief to help people afford long-term care.
Long-Term Care Options
Outside of government programs, there are long-term care options. These plans can vary wildly but always include standard basics with health insurance. When it comes to dementia, it’s essential that you review the policy to make sure the disease is properly covered.
First, make sure dementia and Alzheimer’s are covered. Both usually are, but it’s worth double-checking. Look at when the individual can collect benefits, what the daily benefit is, and if those benefits adjust for inflation.
Look over the length of time the benefits are paid and if there is a maximum lifetime amount. It’s also worth finding out if licensed care homes or nursing homes are covered, like this assisted living Lakewood facility. Finally, check for any tax implications.
COBRA is an option for those under 65 and still working. In the event that the individual has to leave the employer, they can continue their group coverage for up to 36 months. The same can apply when work hours are reduced below the minimum needed for the company’s health plan.
An insured employee does have to pay the full cost for coverage as well as two present of administrative costs, but this type of insurance is an excellent way to help those with dementia transition to Medicare, Medicaid, and other forms of coverage.