Life Plan Community
In order to help you make informed decisions about your future, Heritage Community of Kalamazoo has developed the following list of Frequently Asked Questions. If you have specific questions about our locations, including Meilland Square, Ridge Creek, and The Artisan, we encourage you to reach out to us via our contact page.
What is a Life Plan community?
Life Plan Communities provide the answer for a growing number of older adults who are looking for the opportunity to enjoy a vibrant and enriching lifestyle with peace of mind for the future.
Heritage Community of Kalamazoo offers beautifully designed residences for Independent Living and an on-site continuum of care including Assisted Living, Memory Care, Skilled Nursing and Rehabilitation. Should the need for these services arise, care is provided at significantly discounted rates when compared to fees incurred by the general public for these services.
How does a Life Plan community differ from an ownership community?
The primary difference between ownership communities and a Life Plan Community is that ownership communities typically do not include coverage for Assisted Living, Skilled Nursing Care or other healthcare services. In addition, ownership communities may not have a continuum of care conveniently available on the same campus as does a Life Plan Community. Residents (owners) of those communities are also responsible for the resale of their home and for payment of a monthly fee until their home is resold (even after they have moved out).
How does a Life Plan community differ from a rental community?
Like ownership communities, rental communities typically do not include Assisted Living or Skilled Nursing care services or facilities. If a resident develops the need for these services, the cost and management of care is fully the resident’s responsibility. Also, since these additional services are not available on-site, residents requiring care may need to move away from the community at their greatest time of need.
What’s included in the monthly fee?
The monthly fee is generally equal to or less than the monthly cost of living residents formerly paid in their homes before moving to Heritage Community of Kalamazoo, especially when one considers the cost of all of the services, amenities and upkeep included. In addition to the comforts and convenience of living here, residence at Heritage Community means saying goodbye to the cost of homeowner’s insurance, utility bills, home maintenance, yardwork and all the headaches of home ownership.
Why is there an entrance fee?
In developing the exceptional style of living that Heritage Community of Kalamazoo offers, and to ensure the services that enable our residents to live comfortably, our goal is to create a financial arrangement that appeals to potential residents and provides the opportunity to meet the expenses of operating Heritage Community. The concept of our refundable entrance fee program allows us and our residents that opportunity.
Many residents apply the proceeds from the sale of their home toward the entrance fee. This entrance fee model makes it possible for residents to enjoy the wonderful benefits of Life Plan Community living (such as meals, housekeeping, upkeep, utilities, enrichment and entertainment programming) as well as the assurance of multiple levels of care in the future at predictable costs. Residents appreciate knowing that a portion of their entrance fee will be returned to them, their children or their estate in the future.
Why should I consider Heritage Community of Kalamazoo today versus years from now?
When faced with a major life decision, most of us can think of many reasons to delay that decision indefinitely. The trouble is that by forestalling a choice like this, many of us will wait until a time when our choices can become limited or we have no choice at all. Click here to learn more about Life Plan Communities.
What type of Medicare coverage do I have?
Most people have “original” Medicare, which is implemented by the Federal government, and is available to most people when they turn 65. More specific information detailing “original” Medicare is outlined in the questions following. Another type of Medicare coverage are “Medicare Advantage plans”. Advantage plans are implemented by a third-party insurance carrier or managed-care provider. These managed-care companies are paid a monthly premium by Medicare to provide health care. Please visit www.medicare.gov for more information.
What does Medicare cover in a skilled nursing facility?
Medicare Part A helps cover 100 days of care at The Upjohn (formerly Harold & Grace Upjohn Care & Rehabilitation Center). Anyone with “original” Medicare will receive coverage for all costs for the first 20 days. After the first 20 days, the next 80 days have a coinsurance amount of $133.50. The co-insurance amount may be covered by a private insurance policy known as a Medigap policy. Medicare Advantage plans offer different amounts of coverage; check with your plan for specific information on your coverage.
Am I guaranteed 100 days of coverage with Medicare?
With “original” Medicare, you have up to 100 days of coverage; in order to remain on Medicare coverage, you must be receiving a skilled service. Some examples of skilled services are Physical, Occupational and Speech therapy, Skilled Nursing Care for acute illnesses and treatments, such as tube feeding, IV, etc.
How do I qualify to use my Medicare benefits?
In order for Medicare to pay, you must have stayed in the hospital for 3 consecutive days, within the previous 30 days from admission to The Upjohn (formerly Harold & Grace Upjohn Care & Rehabilitation Center). You must remain in the Care Center to receive treatment, which means that you cannot be gone overnight.
What is Medicaid?
Medicaid is a health insurance program for those with very low income and/or assets. It is administered by the State of Michigan and requires that a person apply for benefits through their county Department of Human Services. The application is reviewed and a determination of coverage can take up to 45 days. If you need assistance in completing an application, The Upjohn (formerly Harold & Grace Upjohn Care & Rehabilitation Center) has resources available to assist you with this process, please contact the Upjohn Community Care Center.
What does Medicaid pay for in a nursing facility?
Medicaid pays for room and board, as well as nursing care. It also serves as a Medigap policy for those who qualify for coverage. Medicaid will pay for x-ray services, physician services, outpatient hospital services, etc. Unfortunately, the state has been forced to reduce coverage for many services that were formerly covered by Medicaid; a caseworker at the Department of Human Services can assist with providing information regarding coverage.
If I qualify for Medicaid, what will I have to pay?
For your stay at The Upjohn (formerly Harold & Grace Upjohn Care & Rehabilitation Center), you will be told by Medicaid how much you must pay each month towards your care. This is called a patient pay amount and is usually based on the person’s monthly income. You will not be expected to pay for any additional service provided by the Care Center.
How often will my physician visit while I’m at The Upjohn?
Your physician will visit within the first 3 days of your admission here and then at least every 60 days thereafter. A Nurse Practitioner is in our facility 4 days per week to deal with medical issues as they arise. The Nurse Practitioner is able to write orders for medication and tests for most medical concerns that residents have.
Are there tax advantages to moving to Heritage Community?
Tax laws are often subject to interpretation, but recent legal precedents have been favorable for Life Plan Community residents who have sought to deduct portions of their fees. Of course, you and your tax preparation professional should consult closely to determine the best strategy for your circumstances.
What if I have long-term care insurance?
In most cases your long-term care policy will work hand-in-hand with your care at Heritage Community and pay earned benefits directly to you as the policyholder. These payments can help cover some or all of your monthly service fee at Heritage Community and help further preserve your assets. As with all insurance matters, you should consult with your carrier or agent for specific answers regarding your individual policy.