What is Long-Term Care?
Long-term care is a variety of services
that includes medical and non-medical care to
people who have a chronic illness or disability. Long-term care helps meet
health or personal needs. Most long-term care is to assist people with support
services such as activities of daily living like dressing, bathing, and using
the bathroom. Long-term care can be provided at home, in the community, in
assisted living or in nursing homes. It is important to remember that you may
need long-term care at any age.
You may never need long-term care. This year, about nine million men and
women over the age of 65 will need long-term care. By 2020, 12 million older Americans will need
long-term care. Most will be cared for at home; family and friends are the
sole caregivers for 70 percent of the elderly. A study by the U.S. Department
of Health and Human Services says that people who reach age 65
will likely have a 40 percent chance of entering a nursing home. About 10
percent of the people who enter a nursing home will stay there five years or
more.
Medicare and Long-Term Care:
While there are a variety of ways to pay for long-term care,
it is important to think ahead about how you
will fund the care you get. Generally, Medicare doesn’t pay for long-term care.
Medicare pays only for medically necessary skilled nursing facility or home
health care. However, you must meet certain conditions for Medicare to pay for
these types of care. Most long-term care is to assist people with support
services such as activities of daily living like dressing, bathing, and using
the bathroom. Medicare
doesn’t pay for this type of care called "custodial care". Custodial care (non-skilled care) is care that
helps you with activities of daily living. It may also include care that most
people do for themselves, for example, diabetes monitoring. Some Medicare
Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing
facility and home care (skilled care) coverage if the care is medically
necessary. You may have to pay some of the costs.
Medicaid/MediCal and Long-Term Care:
Medicaid/MediCal is a State and Federal Government program that
pays for certain health services and nursing home care for older people with
low incomes and limited assets. In most states, Medicaid also pays for some
long-term care services at home and in the community. Who is eligible and what
services are covered vary from state to state. Most often, eligibility is based
on your income and personal resources.
Choosing Long-Term Care:
Choosing long-term care
is an important decision. Planning for
long-term care requires you to think about possible future health care needs.
It is important to look at all of your choices. You will have more control over
decisions and be able to stay independent. It is important to think about
long-term care before you may need care or before a crisis occurs. Even if you
plan ahead, making long-term care decisions can be hard.
Long Term Care Partnership:
One of the most interesting new developments in long-term care is the expansion of the state long-term care partnership programs. In states that have passed these laws, people who have an approved long-term care insurance policy can qualify for Medicaid/MediCal to help pay their long-term care bills after they’ve exhausted their coverage without having to spend almost all of their assets first.
If their long-term care policy provides $250,000 of benefits, for example, they’ll be able to protect $250,000 of their assets after using up their long-term care coverage and have Medicaid/Medical pay the bills.
The following states currently offer Partnership programs - Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Indiana, Kansas, Minnesota, Missouri, New York, Nebraska, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Texas, Virginia. If your state is not mentioned, please contact us and we will give you status as to if and when it will be offered.
