Having the financial resources to care for elderly parents is an escalating problem for many Americans. Baby boomers across the country are looking for solutions to the responsibilities they are facing. And they are also wondering what their own futures may hold.
As many are finding out, elderly care is expensive, whether delivered in-home, at a nursing facility or in a day-care setting. It’s hard to know where to turn for help. “The fact is, because Americans are living longer, elder care is quickly becoming as big an issue as child care,” says Lakewood resident Brian Hall. “Not everyone can afford to reach into their pockets to cover the cost of nursing home care, which is approaching $50,000 a year, or assisted living, which is averaging around $70 a day,” he says.
Hall is one of a handful of people in Texas, and the only one in Dallas, to be “Certified in Long-Term Care.” Certification is a joint undertaking by the Corporation for Long-Term Care Certification and the National Academy of Elder Law Attorneys, the country’s leading legal association dealing with issues facing the elderly and their families.
“People typically don’t realize the need for planning ahead unless they’ve been involved in their parents’ struggle with illness or disability, or they’ve seen friends drain their assets to care for elderly loved-ones,” Hall says. “People are finding out that Medicare and supplemental programs offer limited coverage; private health insurance typically applies only to acute medical care; and Medicaid, of course, is an option only for the indigent.”
“Basically, your alternatives are to be rich, be poor or be insured,” he says. “Aside from the benevolency of the Masons, being a war veteran or a handful of other small entities, personal assets or long-term elder care insurance are the only other options,” Hall says.
Hall and wife, Melissa, have a company called Portfolio Services, which represents 10 long-term care providers. “It’s a complex process and finding the right provider is key,” Hall says. There are many options involved in creating a long-term care plan, designed to meet the needs of individual lifestyles and budgets. Hall offers this guide when comparing long-term care insurance policies.
1. Review what levels of care are covered by the policy. Does the policy provide benefits for nursing care and personal care? Does it pay for any nursing home stay regardless of the level of care you receive?
2. Review where you can receive care covered under the policy. Does the policy pay for care in any licensed facility or are there restrictions? Does the policy provide home care benefits for skilled care, care given by home-health aides or homemaker services? And does the policy pay for care received in adult day care centers, community centers or other settings?
3. Know how long benefits are provided and what amounts are covered. What is the maximum daily benefit for nursing home care and home care? Are there limits on the number of days or visits per year?
4. Some policies have inflation protection. Are you allowed to buy additional increments of coverage?
5. Consider other provisions covered under the policy. Is there a waiver of premium provision and how long do you have to be in a nursing home before it begins? Is there a nonforfeiture benefit, a return of premium benefit or a death benefit?
6. Know when benefits begin. How long is the waiting period before benefits begin and how long will it be before you are covered for a pre-existing condition.
7. Ask how the policy determines whether you are eligible for benefits: doctor certification of medical necessity, failure to perform activities of daily living (ADLs), prior hospital confinement, or cognitive impairment.
8. Compare policy costs. Consider costs of the annual premium, the premium for home care, inflation rider, and the nonforfeiture benefit. Are there any discounts for buying more than one policy?
Long-term elder care insurance coverage may be purchased for people of almost any age, however premiums will vary, depending on the age of the insured when coverage is initially purchased.
