Women & Aging Letter Long-Term Care Insurance Revisited
It Won't Happen to Me
Most people are convinced that they will not need long-term care. Yet many people will need some form of long-term care sometime during their lifetime.
The help that is needed typically includes assistance with managing medications, getting in and out of bed, bathing, eating, dressing, or reminders as to how and when to eat or care for oneself. Long-term care is provided in a variety of settings -- including one's home, an adult day care center, an assisted living facility, and a nursing facility. Most long-term care is needed for a number of months up to many years. The average stay in a nursing facility is 2.5 years, but that is often preceded by a lengthy period of care at home.
A recent article in the New England Journal of Medicine estimates that once we reach our 65th birthday we have over a 40 percent chance of entering a nursing facility sometime during the rest of our lifetime. This risk is even greater for women. Over half the women in this country who live beyond age 65 are expected to spend some time in a nursing facility.
It is important to note that the New England Journal of Medicine study did not examine care at home. But that is where most people receive long-term care! So it is very likely that as we pass our 65th birthday we will have at least a 50/50 chance of needing long-term care either at home or in a facility.
Now, you may be thinking that you will be in the lucky 50 percent category that will not need long-term care. However, as you will see below, rolling the dice on long-term care can be costly if you lose. In addition, if you are fortunate enough never to need long-term care yourself, you likely won't escape having to take care of a loved one in need of long-term care. In fact, for many women, long-term care hits twice. First, in providing care for their loved ones, and later in life when they may need long-term care themselves.
Don't Rely on Medicare
Many people believe that their long-term care costs will be covered by Medicare. Unfortunately, this is not the case. For the typical person in a nursing facility, Medicare pays nothing. That's because Medicare was designed to pay only for skilled care (along with other requirements), while most people who need long-term care need personal care or custodial care. Custodial care is not covered by Medicare. The only government program that pays for long-term care is Medicaid. But Medicaid is means tested, and one must deplete most financial assets before being eligible to receive assistance.
Cost of Care
The average cost of care in nursing facilities across the United States for 2008 ranged from $90 to $400 per day. The national average was $140 per day or $51,100 per year. Many people assume that care at home will be less expensive than in a nursing facility. Unfortunately, care provided by licensed agencies at home can easily cost as much in a nursing facility. When care at home is provided in part by family members or friends (free of charge), then it is possible for home care to cost less than in a facility. However, the true "costs" are understated in these situations because many times informal caregivers have to give up full-time employment or time they would have spent with their immediate family in order to provide this "lower cost" care.
Giving and Getting Care
Long-term care has been around for thousands of years in the form of caring for our older family members. Many times this responsibility falls to women. For example, in modern society men typically live shorter lives and are likely to need care first. Their wives and/or daughters more often than not are the ones providing care. After the men in their lives die, women end up with fewer family caregivers to care for them.
Long-term care policies are complex -- most individuals need professional assistance in determining what coverage, if any, they would need from a long-term care insurance policy.
There are special issues women should consider in choosing long-term care insurance:
· Married women should not automatically buy the same amount of coverage as their spouses. Differences in health and age should be considered when determining what amounts each spouse should buy.
· Since many women may be called upon to care for family members at home, it is a good idea to make sure those family members have coverage that will complement your availability and life style. For example, your parents may need help getting in and out of bed, bathing, and preparing meals. Decide which of these tasks you could best handle given your own commitments and responsibilities. Then select a caregiver, paid by your parent's long-term care insurance, to provide the rest of their care.
· Finally, you may need long-term care yourself and should consider a comprehensive long-term care policy that will cover most, if not all, of your care at home, in the community, or in a facility, especially since family members may no longer be available to care for you.
