re insurance
policies can
insure your
golden years and
your financial
c„
assets. But there
ci) are pitfalls.
NORINE ZIMMER
Lu SPECIAL TO THE JEWISH NEWS
„
person doesn't have to be 80 or
90 to understand that there
comes a time when the proud de-
sire for independence turns into
frank acknowledgment of de-
pendence.
Nor is it surprising that no
other part of the healthcare
system generates as much
passionate concern and de-
bate as long-term care, given
the growth of the vulnera-
ble aging population.
We face a complicated and in-
timidating maze of types of care,
suppliers of care and ways of pay-
ing for it both as an aging nation
and as consumers.
Nationally, more than half of
all nursing home expenses are
paid out-of-pocket by individuals
and their families, and less than
half are paid by state Medicaid
programs. Neither Medicare,
Medicare supplemental insur-
ance nor employer-provided
health insurance will pay for
most long-term care (LTC) ex-
penses.
Medicare will cover the cost of
some skilled nursing care in ap-
proved nursing homes or in your
home, but only in certain situa-
tions. Medicare does not cover
nursing home care except for 20
days in skilled nursing care and
only immediately after discharge
from hospital.
Yes, it pays a little on the next
80 days in a nursing home, but
not enough to make a dent in cov-
ering the expenses. Medicare
does not cover custodial or inter-
mediate care. Medicare and Med-
icaid have their own definitions
of skilled nursing care which
don't necessarily match those de-
Norine Green Boner is a
practicing gerontologist and
resident of Huntington Woods.
finitions found in long-term care cause of prolonged illness or dis- ily members. It's complicated and
policies.
ability. It's also a phrase used to confusing determining which ser-
Medicaid, the healthcare pro- describe healthcare and other vices and living arrangements
gram for the impoverished, picks services.
will best meet your needs.
up the tab for 69 percent of the
LTC is provided by home care
current 1.5 million nursing home agencies, senior centers, adult TYPES OF CARE
residents. But, these nursing day care centers, traditional
Skilled nursing care is ordered
homes may not be the one you'd nursing homes, continuing care by a physician, involves a treat-
choose for yourself or a parent. retirement communities or fam- ment plan, care is administered
Medicaid eligibility requires
means-testing and meeting
federal poverty guidelines.
Your spouse at home will be
allowed to keep some of your
income and assets.
Based on studies done at
the Brookings Institution,
Employee Benefit Research
Institute and Brandeis Uni-
versity, a substantial portion
of Medicaid nursing home res-
idents weren't poor before they
entered the nursing home and
might have been able to afford
insurance. Most studies sug-
gest that between a quarter
and a third of Medicaid nurs-
ing home beneficiaries were
admitted as paying residents.
What made them poor was
the $46,000-a-year average
cost of nursing home care.
This is where private LTC in-
surance comes in to fill what
could be a huge gap between
what government covers and
what people have to pay out-
of-pocket.
Medicaid planning for
many families was to transfer
assets from seniors so that af-
ter three years they could be
poor enough to qualify for
Medicaid to cover their nurs-
ing home expenses. But, as of
Jan. 1, 1997, a new law makes
this a felony.
So let's get going. What is
long-term care (LTC)? It's the
kind of help you need ifyou're
not able to care for yourself be- Paul Kadish explains a policy to Ben and Sue Morris.