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Recent legislation in Congress may make
it even more difficult for seniors to qualify for government-paid
long-term care coverage. If you don’t take action now, you may be
setting you and your family up for a Long Term Nightmare!
This problem is so potentially damaging, yet so little understood,
I’ve decided to dedicate multiple articles to covering it. In this
article, I’ll expose the problem. Future articles will explain
possible solutions.
Seniors know the potential cost of long-term care could devastate
them financially. The thought of seeing the nest egg they’ve worked
years to build evaporate to pay for their care is hard to take. Some
seniors seek to find ways to manipulate the system so that they can
qualify for government assistance. Others mistakenly believe that
Medicare and
Medicaid will pay for their care.
The reason that many feel the government should cover this cost is
because Medicare and Medicaid are designed to provide health
insurance to those over 65 (MediCARE) or to those who are
impoverished (MedicAID). Since the need for care is usually the
result of failing health, why shouldn’t it, they reason.
The terms ‘long-term care’ and ‘skilled-nursing care’ refer to
different needs. Understanding the difference is critical to
understanding the problems you and your family may face. Knowing the
difference will prevent a false sense of security.
‘Long-term care’ is a generalized term that refers to the assisted
care individuals may require in their homes, an assisted-living
facility or a nursing home. ‘Skilled-nursing care’ is a specific
term used when that assistance must be provided by a licensed or
registered nurse.
‘Long-term care’ includes the need for both custodial care and
skilled-nursing care. ‘Skilled-nursing care’ does NOT include the
need for custodial care. That’s the issue that creates the Long Term
Nightmare.
For instance, if someone needs assistance because they can’t bathe,
cook or dress themselves, they need custodial care. If someone has
dementia and needs to be supervised, that is referred to as
custodial care. If someone needs intravenous fluids (IV), they need
skilled-nursing care because it cannot be administered by anyone
else. Custodial care can be done by a family member. Skilled-nursing
care is provided by licensed nurses.
The assistance provided by Medicare to those over 65 is only for
skilled-nursing care. Typically this care occurs in a nursing home
while the patient recovers from a surgery or illness that required
at least a 3-day hospital stay. If the hospital stay didn’t occur,
Medicare won’t pay for it. Even then, Medicare will only cover
roughly 100 days.
Medicare does NOT provide any coverage when the assistance needed is
custodial. Those costs must be paid entirely by the individual
and/or their family. Medicare will not pay for stays in an
assisted-living facility.
For the impoverished who qualify, Medicaid will cover nursing home
costs. But the number of Medicaid beds is limited and recipients may
face long waiting periods to get into such a facility.
Sometimes Medicaid will cover assisted living facilities and home
health care, which includes custodial care. But these benefits are
harder to receive reimbursement for. Rules and benefits vary from
state to state. The bottom line for those depending on Medicaid is
that you will be left with few options and limited care.
The greatest need for long-term care as we age is often custodial in
nature. At some point, we are all likely to need help with our
medications, cooking and cleaning. Worse, we may be suffering from
the chronic effects of a long term illness. Even though we may not
be able to care for ourselves as a result, Medicare will not pay for
any help unless it requires a skilled nurse. They will, however,
cover hospice care for terminally ill patients.
Many families find themselves caught in the nightmare of having to
provide the care that isn’t covered by insurance or the government.
This problem will not go away—the government is likely to cover even
less care in the future. Take action now.
In a future article, I will talk about the long-term care coverage
provided by Medicaid and what is required to qualify for it. Then I
will outline steps you can take to avoid a Long-Term Nightmare.
Have a financial question? Send me an email and I’ll personally
respond, free of charge. Go to http://www.guardingyourwealth.com and
click on ‘Ask Jeff’.
In addition to being a nationally syndicated columnist and Certified
Financial Planning Practitioner, Mr. Voudrie provides personal,
private money management services to clients nationwide. |
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