The right insurance can help with the staggering costs of Alzheimer’s disease
Crawford Frazer
Alzheimer’s disease can take an emotional toll on any family. Once the later stages set in, caretakers often struggle with the realization that their loved ones no longer recognize them. Even worse for the many who battle Alzheimer’s and those who face the battle alongside them is the cost of treatment.
Growing costs
Alzheimer’s gets progressively worse over time, which means the costs usually build. You can expect some or all of the following costs identified by the Alzheimer’s Association and The Fisher Center for Alzheimer’s Research Foundation:
- Medical treatment. This begins with diagnosis and includes potentially years of office visits.
- Prescription drugs.
- Personal care supplies.
- Adult day care.
- In-home care or care in an assisted living or nursing home.
- Hospice care.
The Archives of Internal Medicine found in a May 2011 study that most dementia-related Medicare expenses are for hospitalizations and hospice care. For the 5.5 percent of the patients in the study who saw the most expenses, costs exceeded $12,000 for 90 days. While these patients were identified as “highly skewed,” it’s certainly a scary proposition for anyone without adequate coverage.
How do I pay?
Once the symptoms of Alzheimer’s appear, you probably can’t buy individual health insurance on the private market, according to the Alzheimer’s Association, as it will be considered a pre-existing condition. If you already have coverage, either through a group health insurance plan or an individual plan, check your policy to see what it will cover.
Depending on your age and financial status, you may be able to cover some treatment costs with:
- Medicare. Many assume that Medicare will cover all costs associated with Alzheimer’s, according to the Alzheimer’s Association. Often, however, that’s not the case.
According to Medicare.gov, Medicare covers medically necessary care, whether at home or in a skilled nursing facility, for a certain amount of time. However, if that care isn’t medically necessary (in other words, you can technically live without it), Medicare will not cover the costs. So, if you need help with daily activities like bathing, dressing and eating (as many who suffer from Alzheimer’s do), that help will not be paid for by Medicare.
- Medicaid. Medicaid does cover long-term care. However, your assets often have to be severely depleted for you to qualify. The Alzheimer’s Association warns against giving assets away to family members so that you can qualify for Medicaid; doing so may be against state laws.
- Disability insurance. Disability insurance, if you have it, would cover a portion of your income if you can no longer work because of health issues. Employer-sponsored disability policies may cover 60 percent to 70 percent of your lost income, according to the Alzheimer’s Association.
- Life insurance. If you face dementia and have a whole life insurance policy (as opposed to a term life insurance policy), you may be able to take a loan based on its face value to pay for care. Keep in mind that if the loan isn’t repaid before your death, the death benefit to your beneficiaries will be decreased.
Long-term care insurance
The Fisher Center identifies long-term care insurance as possibly the best coverage option for someone with Alzheimer’s. Offered by many private insurers, long-term care insurance covers a certain dollar amount per day for nursing home care or at-home care. Unlike Medicare, it covers the cost of assistance with daily activities. And, because coverage is based on a daily allotment, you have more spending flexibility.
As with many insurance policies, the older you are, the higher your premiums will be — and you may be denied coverage. For this reason, The Fisher Center recommends buying a long-term care insurance policy well before you think you need it.
