You may never need long-term care. However, in 2009 about nine million Americans over the age of 65 needed long-term care. By 2020, that number will climb to 12 million. A study by the U.S. Department of Health and Human Services reports that a person who reaches age 65 is likely have a 40-percent chance of entering a nursing home at some point. About 10 percent of those who do enter a nursing home will stay there five years or more.
What Is Long-Term Care?
Long-term care (LTC) encompasses a variety of medical and non-medical care services for people who have a chronic illness or disability. Many long-term care needs are non-medical, assisting people in the activities of daily living, such as bathing, getting dressed, and using the bathroom. LTC may be provided at home, in assisted-living facilities, in an adult family home, or in a skilled nursing facility.
When You Need Assistance
However the LTC need presents itself, you must confront big questions: What level of care is needed? What are my options, and how expensive are they? Who will pay, and what help is available? Will all of our assets be used up in caring for a loved one? The primary elements are touched on briefly below.
Whichever option is right for your particular situation, long-term care is likely to be expensive: costs can reach as high as $10,000 per month. Furthermore, state and federal laws governing all options are complex, and change often. The timing of any action can have a major impact on the overall situation.
Whether you are planning ahead or facing immediate care issues, each situation is unique. Figuring out the best course of action can be especially challenging when you are simultaneously coping with the LTC needs of a loved one. Mary can help you find the right path for your situation.
How Long-Term Care Works
Medicare
Medicare is a federal health insurance program for most people age 65 or older and those with disabilities. It offers insurance for short-term hospitalization, hospice care, outpatient medical care, prescription drugs, and other care (within specific parameters).
Many people wonder: Does Medicare cover LTC? Medicare typically covers immediate medical needs such as hospitalization for a heart attack, broken bone, or stroke, and a limited amount of rehabilitation afterwards. It does not cover the typical non-medical long term care costs created by a chronic condition.
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Medicaid
Medicaid is a social service program run by the State of Washington, and funded both federally and by the state. Medicaid makes it possible for certain low-income individuals and families to get both immediate and long-term medical care paid for. Recipients cannot have more than a specified amount in savings and other non-exempt assets, and they usually contribute most of their income toward their cost of care.
Medicaid in Washington State includes funding for programs that allow disabled individuals to remain at home or in a community setting rather than in a nursing home; this type of funding is known as COPES. Eligibility requirements for COPES differ somewhat from eligibility for Medicaid in a nursing home.
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LTC insurance
How does LTC insurance fit in to your support scenario? It may be a valuable element. You must choose wisely among the various options, considering factors such as various deductibles, types of benefits covered, whether benefits are covered in various settings (in-home care, in an assisted living or nursing facility), and any excluded periods. However, LTC insurance is often too expensive for middle-income elders, and may not even be available due to advanced age or pre-existing medical conditions.
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