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Understanding Long Term Care There is concern and confusion among seniors today about long term care and what it involves. No one likes to think about the chance of needing nursing home care. For those who think through the issue, questions arise about the cost, how will it be paid, and what are the alternatives? Then, there are countless letters from insurance companies and agencies that can further complicate the issue. How do you decide whether this information is important and what company or policy is the right one for you? The concern is obvious to anyone who has had family or friends who required long term care. Emotions may create stress for families who can no longer care for their loved ones at home. The average stay in a nursing facility currently costs about $50,000 per year.
Children often reply: "Don't worry, Mom or Dad, we'll take care of you", or "I would never let you go to a nursing home." Although well intended, these attitudes can reinforce the belief that they will never need long term care. Confusion over long term care can result in a lack of understanding about Medicare coverage and Medicaid. Medicare was not designed to pay for long term care. Medicare may partially pay up to 100 days of nursing home care, but only after meeting specific guidelines. Medicare supplement and employer group health policies provide only co-payment coverage if Medicare approves the stay. Neither Medicare, Medicare supplement nor employer group health plans will cover prolonged nursing home care. Medicaid is not the answer either. Medicaid was established as a financial assistance program administered by the Federal government and the states. Generally, individuals are eligible for Medicaid benefits once their assets are at or below the state's poverty level. Medicaid restricts the availability of long term care coverage in that it covers only Medicaid-approved facilities, and little or no coverage at home. Thus, the consumer is offered few choices. Long Term Care insurance offers a solution. Early policies were restrictive in their coverage and some provided minimum benefits. In recent years, standards have been established by each state to protect consumers. There are more policies available and rates show greater stability than earlier policies. Some of the better long term care policies are flexible and offer coverage based on individual needs. These plans have broader appeal and are affordable to many who could not have considered purchasing long term care coverage before. Home health care is often a part of long term care policies or can be added as a rider to the policy. This has interest for those who want to receive care at home. Let's face it, no one wants to go into a nursing home. However, studies show that 43% of Americans will enter a nursing home at least once in their lifetime.1 The facts are we are living longer because of advancing medical technology. When you combine these facts, care becomes a requirement in later years. The odds increase as we get older. Two questions then arise: 1. Who will provide this care: family members, friends, home health care
agencies or nursing homes?
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A lack of awareness or
concern often exists among those with no personal experience in nursing care.
Results often are indifference in planning for care. A common hope is, "It
will never happen to me." For these people, it is difficult to perceive the
emotional and financial effects of a nursing home stay for a family member.
Planning for long term care is an
important part of retirement planning. You owe it to yourself, your family, and
loved ones to examine all areas of long term care. It means preparing for an
event that will touch many of us. Whatever choices you make about long term
care, you should examine the facts and alternatives before making a choice.
Then, as an informed consumer, you can determine the best type of care available
to meet your individual needs.