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The Crisis In Long-Term Care - Seniors Long Term Care & Nursing Home Issues - SeniorSite.com
The Crisis In Long-Term Care - Seniors Long Term Care & Nursing Home Issues - SeniorSite.com

The Crisis In Long-Term Care

Do you know someone who has experienced a stroke, suffers from cancer or has experienced complications due to diabetes?

Is a family member or friend suffering from Alzheimer’s disease or Parkinson’s disease? Welcome to the world of long-term care. Government statistics say that nearly 70 percent of individuals over 65 will need long-term care at some time in their life. By 2030, thanks to the aging of the baby boomers, 19 percent of the U.S. population will be seniors---up from 12 percent in 2000. Most of them will ultimately need long-term care for their chronic medical conditions.

When you can no longer live independently as a result of a physical illness, chronic medical condition, or severe cognitive impairment (such as Alzheimer’s disease), then long term care is the type of care you may need. Personal assistance with activities of daily living (ADLs), such as bathing, dressing, and eating, is often required as well as supervision if cognitive impairment is diagnosed. The majority of long-term care users need this form of long-term care, referred to as custodial care. Long-term care could be intermediate or skilled care, which is most often paid by insurance or Medicare.

Long-term care is expensive. Nursing home costs can average about $230 a day or $80,000 a year. Even long-term care at home can wreak havoc on the finances of the elderly and their families, ruining the financial security of even the most comfortable families. For a married Alzheimer’s victim who stays at home and receives care from family members, the cost of home health care is so great (at $19/hour) that most families would be bankrupt in two years. Medicare provides only limited nursing home and home health coverage and Medicaid requires an individual to spend almost all of his or her savings, retirement monies and other assets before becoming eligible for nursing home coverage.

So who pays for long-term care? Today, Medicaid, the need-based government benefit for the poor, pays the majority of long-term care expenses, 49 percent. In 2013, Medicaid in the State of Ohio represents about 45 percent of the total General Revenue Fund. Of this sum, seniors on Medicaid make up 61 percent of the health care spending while representing only 19 percent of Medicaid enrollment. Less than 20 percent of long-term care is funded from personal assets, including reverse mortgages, annuities, and only seven percent is from private long-term care insurance.

Many seniors mistakenly believe that Medicare, the health insurance plan for individuals 65 and over, will pay for long-term care. Medicare only pays for medically necessary care in a skilled nursing facility with maximum coverage of 100 days. In rare cases when home health care is approved, it's provided under very limited circumstances and for brief stretches of time. In summary, long-term care is expensive; long-term care is very likely to happen; and long-term care is not covered by the government unless we are poor---Medicaid.

Nothing is more disturbing than having spent your entire life accumulating assets for retirement and legacy planning and then to find yourself impoverished. With long term care insurance, not only do you have options as to the type and level of care that you wish but also the ability to protect your assets from state estate recovery procedures. Depending upon the type of policy you choose, this insurance can pay for a wide variety of home, community-based and facility care services, and can offer you care options that may not be covered through government programs.

The State of Ohio participates in the Long Term Care Insurance Partnership Program (“Partnership Program”). The Partnership Program is designed to encourage individuals to plan for their long term care needs by allowing them to retain more assets than would otherwise be allowed under state Medicaid eligibility requirements. As a result, policyholders are able to retain assets they would otherwise have to spend down prior to qualifying for Medicaid benefits. Generally, individuals can participate in their state’s Partnership Program by owning a long term care insurance policy that meets the requirements for the Partnership Program. Policies qualifying under the Partnership Program generally do not cost more than non-qualified policies with similar benefits. For example, if you have a partnership policy which has paid $100,000 for your long-term care needs, you could potentially qualify for Medicaid coverage and still keep up to $101,500 of your assets. Without the partnership policy, you would not be eligible for Medicaid benefits until your assets were reduced to $1,500 (individual) or $2,250 (couple). Imagine being able to pass assets to your grandchildren without the fear of estate recovery. Married couples with one spouse living in their home may have additional asset protection of up to $115,920. Imagine being able to pass assets to your heirs without the fear of estate recovery.

We worry about heath care and spiraling costs today. We worry about the solvency of Social Security and Medicare. The real crisis we are facing as America ages is not health care costs but long-term care expenses and our dependency upon the Federal and state government to fund this form of care. It is bankrupting our system. Trust me, this can’t and will not continue. Long-term care can be managed with proper guidance from a licensed long-term care insurance specialist who can counsel you on all of your options and alternatives, including the often overlooked Ohio Partnership Plan.

Michelle Y. Graves is a Certified Senior Advisor and has been in the fields of aging and senior retirement planning for over three decades. A member of the Ohio Women’s Hall of Fame, she can be reached at mygraves@msn.com or toll-free at 866-411-7432.



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