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Planning for long term care
By Patricia M. Dunn
Chronic conditions such as AIDS, disability and age-related problems
are changing the structure of the health care delivery systems in the United
States. Supervision or actual care is often needed when chronic illness
strikes. Family members are less able than in prior generations to provide
care needed. Thus, we turn to day care, home care, assisted living and
nursing homes to fill the gap.
Later in life, especially in the 80’s and 90’s people begin to need
help with shopping, cleaning, cooking, walking and/or bathing. If dementia
strikes, 24-hour care in a facility may become necessary. Costs may be
overwhelming.
Assisted living, in 1999 averaged about $35,000 per year. Home care
costs vary with need. Personal care averages about $8,000 per year while
skilled nursing care can be $25,000 or more. Nursing home care averages
about $200 per day or $70,000 per year.
The trend of costs is upward.
Medicare payments are limited and have specific criteria for eligibility.
Medicaid requires a spend-down to a minimal savings account. So, the possibility
of privately paying for care is real. Some life insurance policies allow
living benefits to pay for terminal care. Long-term care insurance can
cover much of our long-term care, but buying it is confusing and rates
vary. It’s an option for people who can afford it and for those who want
to protect their assets. The cost of long-term care insurance depends on
the age at the time of purchase, the state of health and the benefits you
choose. Consider buying it while you or your parents are in the 50’s or
by age 65, since premiums escalate greatly after that.
Examining long-term care policies can be mind boggling and confusing
as we look at deductibles, daily benefits, coverage, compounding and actual
qualifications for eligibility. Add to this the lack of objectivity when
a salesman knows much more about it than you do.
To assist our fellow nurses, patients and families to purchase wisely,
our newly formed group of semi or fully retired nurses decided to take
on a year-long project of making sense out of long-term care insurance.
Together, we examined reams of literature, articles, government publications
and listened to salesmen’s lectures. We will share our findings through
the next several monthly columns in Mass. Nurse. In the meantime, you may
wish to access information from the sites listed here. Look for additional
resources in future editions of Mass. Nurse.
Resources
Regulations in Mass. Covering Long Term Care Insurance may be obtained
from
Mass. Division of Insurance
211CMR 65.00
One South Station
Boston, MA.02110-2208
www.state.ma.us/doi
A Shoppers Guide to Long Term Care Insurance
National Association of Insurance Commissioners
120 W. 12th St.
Suite 1100
Kansas City, MO 64105-1925
816-842-3600
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