Long-Term Care Insurance:
Eldercare Solution
By Jacqueline Marcell
When I suddenly had to become a fulltime caregiver to my elderly parents, both
with health problems and starting to develop dementia (namely Alzheimer’s), I
had never even heard of Long-Term Care Insurance. After we burned through their
life savings, and then started chipping away at mine, I was advised to apply for
financial assistance for them through the government’s Medicaid system--a program
for those at the poverty level. It was quite a long process with mounds of paperwork
and numerous investigations, but finally my parents were approved.
I was so happy that monetary help would finally be on the way, until I discovered
that the financial assistance would only pay to put my parents in a nursing home,
not even in Assisted Living, and with very little help to keep them in their own
home.
Since their levels of care were so different (my mother needed most things done
for her), there weren’t any facilities that would allow them to be together. They’d
be across the street from each other in different wings of the home. After fifty-five
years of marriage, my parents were adamant about wanting to be together in their
own home, in their own bed, where they could continue to cuddle and kiss--as they
so frequently did. And, since my father was so “difficult” with a terrible temper
and quite a long record of manipulative disruptive behaviors, the homes didn’t
want to deal with him anyway.
It was challenging, but I committed to keeping my parents in their own home and
attending Adult Day Health Care five days a week. Then, with the help of two marvelous
caregivers, after four more years of loving each other--they passed, just a few
months apart. Even though caring for every aspect of my parents’ last years was
the hardest thing I have ever done--I am proud to say I gave them the best end-of-life
I possibly could.
Had I only known to insist that we buy Long-Term Care Insurance for them prior
to their illnesses--their years of in-home care could have been paid for, and
I could have saved myself so much heartache, not to mention a small fortune. I
encourage you to learn from my mistake and look into LTC insurance long before
you need it—for your loved ones as well as yourself. Like fire insurance, hopefully,
you’ll never have to use it.
Also, call your local Area Agency on Aging, or Department of Aging, and ask if
there are any financial programs, waivers or grants available in your area that
you can apply for.
STARTLING STATISTICS
· An estimated 4.5 to 5 million Americans have Alzheimer’s disease. In a Gallup
poll, 1 in 10 Americans said that they had a family member with Alzheimer’s, and
1 in 3 knew someone with the disease.
· Increasing age is the greatest risk factor for Alzheimer’s. One in 10 individuals
over 65 and nearly half over 85 are affected. Rare, inherited forms of Alzheimer’s
can even strike individuals in their 30’s and 40’s.
· A person with Alzheimer’s disease will live an average of eight years and as
many as 20 years or more from the first onset of symptoms.
· More than 7 out of 10 people with Alzheimer’s disease live at home, where family
and friends provide 80 percent of their care. The estimated value of this informal
care is $257 billion annually.
· One half of the U.S. population has a chronic condition. More than one quarter
(26.6%) of the adult population provide care for a chronically ill, disabled or
aged family member or friend, which translates to more than 50 million people.
· 37% of caregivers are living in the same household as the person they care
for. 54% are between 35 and 64 years of age. 59% of the adult population either
is or expects to be a family caregiver, and 2 million more caregivers will be
needed in the next twenty years.
· An estimated 43% of Americans age 65 or older will spend time in a nursing
home. By 2012, 75% of Americans over age 65 will require long-term care. Long-term
care costs are rising at 6% annually.
· The annual cost of Alzheimer’s care in the U.S. is at least $100 billion, and
will soar to at least $375 billion by mid-century, overwhelming our health care
system and bankrupting Medicare and Medicaid.
· Alzheimer’s disease costs American business $61 billion a year, which is equivalent
to the net profits of the top 10 Fortune 500 companies. $24.6 billion covers Alzheimer
health care, and $36.5 billion covers costs related to caregivers of individuals
with Alzheimer’s, including lost productivity, absenteeism and worker replacement.
THREE WAYS TO PAY FOR LONG-TERM CARE
1. Pay for in-home caregivers and assisted living/nursing homes out of pocket.
This is expensive and can often deplete a family’s life savings.
2. Meet a very specific poverty level and qualify for government assistance through
the Medicaid program. Unfortunately, options are limited, only paying for nursing
homes that accept Medicaid.
3. Buy a Comprehensive Long-Term Care Insurance policy. This protects your family’s
assets from the rising costs of caring for someone who needs full time care. An
employer might pay the tax-deductible premiums. Consider buying it at a younger
age, when more affordable and accessible. It must be bought before a major illness
strikes. Medicare and regular health insurance does not pay for long-term care.
The average cost for a person who needs long-term care is $40-$70,000 annually,
depending on where you live, plus the cost to the family caregiver who may have
to leave their job.
QUESTIONS TO ASK YOUR INSURANCE AGENT
--Is the coverage comprehensive, meaning it includes all levels of care: in the
home, assisted living, board & care, and nursing/dementia facilities?
--What is the daily benefit?
--Is there 5% annually compounded inflation protection?
--What is the elimination period?
--Is it a lifetime benefit period or a limited time benefit policy?
--Is there a spousal discount?
--Can you hire caregivers privately as well as from an agency?
--Is the home care benefit based on a daily, weekly or monthly maximum, and if
the benefit is not used, can it be used in the future?
--Does it cover home care coordination of services?
--How many ADL’s (Activities of Daily Living) does it take to trigger a claim?
--Is there a time limit for filing a claim?
--Does it cover the cost of Adult Day Care & Adult Day Health Care, hospice
and respite programs?
--Is it a tax-qualified plan?
--Is the company highly rated and have they ever raised premiums?
--Can you see the company’s published annual audit to check their track record
for paying claims?
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Jacqueline Marcell is a national speaker on eldercare and the author of, "Elder
Rage", a Book-of-the-Month Club selection being considered for a feature film.
Over fifty endorsements include: Hugh Downs, Regis Philbin and Dr. Dean Edell.
Jacqueline also hosts a radio program heard worldwide on: http://www.wsradio.com/copingwithcaregiving . For more information: http://www.ElderRage.com |