By Steven Buttice, Living By Your Design, Inc.
It will never happen to me. Well, it could be an accident like a fall, an illness, or issues of aging. It happens to more people than you would think. About 70 percent of people 65 and older will need long-term care assistance. If this would happen to you or a loved one, how would you pay for these expenses? The intent of this article is to consider your options if you or a loved on would have a LTC need. Your options may include the following
- Private pay — be prepared for the sticker shock
Nursing homes in our area vary in cost from about $200 to $270 or more a day. At $6,000 to near $9,000 a month, it would not take too long for one to exhaust their savings. - Medicare — a limited benefit
Medicare is most generally for people over age 65 or after two years on Social Security Disability. While Medicare is not intended for custodial care, it does provide limited care at skilled nursing facilities (SNF). This care must be for skilled care, such as rehab with the goal to return home. Medicare supplements have different benefits than Medicare Advantage Plans (MA). A supplement requires skilled care treatment, a three-day hospital stay, and then pays 100 percent of 20 days and then all but a $170.50 copay (in 2019) days 21 to 100. MA plans may not require a three-day hospital stay and benefits vary plan to plan. The best case would be that Medicare would pay, with copays, up to 100 days. So, what happens after Medicare‘s benefit ends? - Long-term care (LTC) insurance
For people that have LTC insurance, this plan may help or cover the cost of care. There are some requirements, such as an elimination period (number of days before benefits begin), and usually two of six activities of daily living (ADLs), also called “triggers,” must be met. These ADLs are usually bathing, eating, dressing, continence, toileting, transferring, or a degree of cognitive impairment. One must health qualify to buy these policies and benefits vary. LTC also may cover home care and assisted living. The maximum payment may be for a time period or a payment of dollar limit. This is a very simplified explanation of a very complicated subject. - Veteran’s benefits
There are basically two types of benefits possibly available through the VA. The first is the Aid & Attendance Pension (A&A). Veterans who served during war time and were not dishonorably discharged may qualify for $1,830 a month. Widowed spouses may also qualify for a lesser pension; more for a vet and dependent. Again, this pension is more complex, and this column will address it in more detail in the next few months (or call our office). The other possible benefit is to be admitted into one of the four VA homes in Illinois. While a little more restrictive, this can provide a valuable benefit for those who served.
- Medicaid
This is the last resort “catch all” for people. Note, there are requirements to spend assets and a portion of your income on care. Your selection of homes may be decreased. Medicaid may also affect a spouse’s assets and income. This subject is too long to add into this article; however, Medicaid planning is a very good idea.
No one wants to go to a nursing home, but it happens more often than we think, and often before we know it. If you desire more information or materials on these subjects, feel free to contact our office. Also there are resources available: www.Medicare.gov has “star ratings” for many types of senior communities, www.MRMS-INC.com, and www.LivingByYourDesignInc.com. Gather information before a crisis so that you can be better prepared if you need to make a sudden decision.
For more information, contact Living By Your Design, Inc., focusing on the issues of older Americans: legal, financial, and free guidance for residential referral health-care issues. Call: 309-285-8088. Web: www.LivingByYourDesignInc.com. Location: 809 W. Detweiller Dr., Peoria.